Hi, I'm Ali! I, I'm one of the physios at treatmyachilles.com. This video is talking
about whether you can still play football – or soccer – if you have an Achilles tendonitis or
tendinopathy. At treatmyachilles.com, we are a virtual, online physiotherapy service looking
at all things related to the Achilles tendon. This could be tears, could be ruptures, and the
rehabilitation after that, or it could be those with an Achilles tendonitis and tendinopathy,
and that's what this talk is relevant to. We're going to be looking at what the Achilles does when
you're playing football. So, what's its role when you're training and when you're playing matches?
We're going to have a look at what you can do to change your activity if you have an Achilles
tendonitis or a tendinopathy. And then, what you can do if you can't play football
at this present moment in time. So, if we think about our anatomy of the Achilles tendon,
we know that it is your calf muscles, your gastrocnemius and soleus, that come down and
make the Achilles tendon, that attaches into your heel bone. So, I think you can see on our picture.
When you are moving, which is the part where you are landing with your foot to the floor and then
raising up onto your tiptoe to push off to move, your Achilles works like a spring. With your
foot flat on the floor, it recoils and stores that energy. And as you push off onto your toe,
it releases that energy. And therefore, with football, doing movements where you are raising up
onto your toes – so, these are running, sprinting for the ball, and indeed jumping for things like
to head the ball – these are sorts of things that can cause aggravation to your Achilles.
If you have an Achilles tendinopathy, sometimes it may be that you can still continue to play
football and soccer and not have a problem. This all depends on the severity or irritability of
your tendon. So, what we mean by that is, how much symptoms you have, when those symptoms come on,
and how irritable they are; so, how quickly they come on or how long they last for. So, this comes
into how we can manage our Achilles tendon; how we can look at the pain symptoms to help.
So, if you're playing football and your Achilles pain is a lower end of the score out of 10, so,
a zero, one, or two – and quite typically with an Achilles tendonitis or tendinopathy, you may
feel it at the beginning of a training session or a match, then it sort of warms up into it;
sometimes it can come back at the end – then, if it is this low level: zero, one or two,
you may be able to still train or play. The important thing to consider is that
with Achilles tendonitis or tendinopathy you get a latent response. That means a later-on pain,
so, a pain that could happen any time after that training or match session
for the next sort of 24 hours, including that morning ... the morning after. And typically,
a type of symptom you would find with an Achilles tendinopathy first thing in the morning, is a
feeling of stiffness in that tendon, that when you put your foot to the floor and start to move,
it's quite stiff and it's quite uncomfortable. So again, it's important to monitor your symptoms
for that full 24-hour period or even longer than that. So, if you are somebody with an
irritable tendon, we'd be saying that would be irritated for quite a long period of time,
and therefore you would want to modify your training or your match play. If there was
quite severe pain that meant that you are unable to now walk properly, or you are unable to do the
things you wanted to do the following day or the day after, because your Achilles was sore,
then again, this would be something that we would … might say is too much. Whatever you're doing,
training or activity wise, is too much at this moment. So, we come onto Point 3:
How can we look after our Achilles? How can we still keep playing? Or can you modify your
activity so you are taking away some more of the running or the sprinting drills or jumping drills?
So, things like speed, agility, quickness, drills that you might be doing in your training sessions,
going over ladders, going side to side? Can these be changed, slowed down, or avoided at this time?
Could you be playing for a part of the game rather than all of the game? Could you change
your training drills so you're only working at set pieces, for example, for the moment, or you're
walking football, so you get more control of the ball? These are things that would need to be
discussed with a coach, or again, you could modify with your football colleagues. What we're then
thinking about is that these are definite signs of an Achilles tendinopathy. So, if you cannot play
or you've got those warning signs that we've been talking about – the pain that's located around
that Achilles tendon, the pain that's coming on like a warmup pain and then goes away, or the
pain that comes on afterwards or that latent response with the stiffness the next morning,
or just that response the next morning – these are all signs of something that you need to do about.
So, these things that you can do is to gain advice by a professional, and a physiotherapist
should be able to then guide you onto: Have we got the correct diagnosis? And then what can we
do to make your Achilles more robust? So, if we can keep your activity at that zero, one, two
out of 10 whilst you're making your Achilles more robust, normally with strengthening exercises,
you then can start to do a little bit more. Then, you change those exercises and get stronger again,
and you can then do more again until you're eventually back playing football properly.
Thank you very much for your time. Goodbye!