Hi, I'm Ali! I'm one of the physios from treatmyachilles.com. We are an online specialist
service for Achilles tendon problems, where we offer virtual physiotherapy appointments, which
means we can do an initial assessment followed by a rehabilitation program over a period of time to
get you back to the activities that you would like to do. Information on that service can be found
underneath the description of this video. What I wanted to talk to you today about is whether
you can walk when you have Achilles pain or an Achilles problem. This is quite a common thing
that people tend to google, and it's a question that we get quite commonly. What we're thinking
about when an Achilles is causing pains and problems, so, causing an Achilles tendinopathy is,
the tendon is starting to get a bit irritated and a bit angry. And normally this is a response to
loading. Now, loading in this context means the activity that you're asking this Achilles to do,
and then generally, if you look back over the last weeks to months, maybe a change in that activity.
It could be that you've had some time off and then gone back to normal, or you've increased
what you normally do, or you've changed footwear or changed terrain or changed the speed that you
do your activity at – and in this case, we're talking about walking – or you have changed the
elevation that you're walking at, because the more that you are going uphill, the more that
you are on your tiptoes, which makes your calf and Achilles complex work harder. So, if you have this
Achilles tendinopathy – and there is a link to a description about how to know whether you have one
of those Achilles tendinopathies, with the common symptoms in the description below as well – what
we are then looking for, is trying to help with that load management, that activity management,
and that will then answer the question about whether you can continue to walk.
So, a good rule is a niggle rule – a niggle rule of naught to three. And again, there is a
description of a video that we've done on how to know when to do your activity underneath, which
describes this further. But this naught to three, this niggle-only rule, is something that tells us
that your Achilles isn't getting more irritated with the activity that you're doing, and we can
maintain the activity that you can do within that niggle. So, if you were to go for a walk and your
pain stays at that naught to two out of ten during that walk and for the 24 hours after, because
it's really common to get a latent response, a pain later on or a reaction the next morning,
like stiffness when you're getting out of bed. So, if you have maintained that 24-hour pattern at a
niggle only, then you know that amount of walking is not irritating your Achilles tendon further.
So, we could go through the rest of our days just keeping at this niggle-only,
and that might mean that you can quite comfortably walk for a period of time. But if you were to try
and then increase that amount of walking or again change any of those parameters like elevation
that we spoke about earlier, you might find that Achilles tendon starts to flare back up again.
So, how do you go and treat that? Well that's when strengthening programmes come in. And those
strengthening programs need to be progressive and gradually getting more difficult over a period of
time to replicate the amount of demand that you need to do when you're doing your activity, so,
when you're walking. As you get stronger, that Achilles and calf complex gets more robust.
As it gets more robust, it can withstand more activity, so therefore you can walk further
within that niggle rule. You get stronger, you walk further again, until you're back at the top
with whatever activity and whatever amount of hiking and walking that you want to do.
If you would like to get more advice on a tailor-made program for you about how
to adapt your walking or how to do the strengthening exercises,
then that is something we can help with. All these programs need to be individualised and are
made just especially for you, because it takes into account all of the different factors that
could be causing your Achilles tendinopathy: how strong you are now, what activity you want to do,
and how we can progress that forward with what equipment you may have to do,
the exercises and so on and so on. I hope this makes sense! Thanks very much, take care! Bye!