Physio for Achilles Tendonitis

My Achilles tendon is sore. How do I get it better?


Why is my Achilles tendon sore? Do I have Achilles Tendonitis?

Soreness or swelling of your Achilles tendon is caused by overuse or trauma. Constant stress placed on the Achilles tendon causes irritation, inflammation and pain.

There are several factors that can lead to inflammation of the Achilles tendon:

  • Overtraining
  • Tiredness or increased stress levels
  • Poor running technique (biomechanics)
  • Reduced lower limb and core muscle strength
  • Poor balance (proprioception)
  • Poor flexibility
  • Inadequate footwear
  • Running on hard surfaces


If you notice swelling in your Achilles tendon, the initial treatment is POLICE – Prevent further damage, Optimal Loading, Ice, Compression, Elevation.

Preventing Further Damage:

If your Achilles tendon is injured then the first thing to do is minimize any further damage. The easiest way to do this is to stop or minimize any activities that cause your Achilles to get sore. Your Chartered Physiotherapist is fully qualified to determine the extent of the damage in your Achilles tendon and advise you on the appropriate management strategy to adopt.

An Achilles tendon injury can vary from complete rupture to low grade inflammation. If you continue to run on an inflamed and injured Achilles tendon, you may put yourself at greater risk of an Achilles rupture. A complete rupture will require either surgery and a period of immobilization in a cast or a combination of both.

Optimal Loading:

Seek advice from your physiotherapist on what optimal loading for your Achilles is. This may vary from complete rest on crutches to continuing with modified training such as cycling, swimming, stretching and strength work.

Ice, Compression, Elevation:

Inflammation can be reduced by icing, compressing and elevating your injured Achilles. Apply ice for 20 minutes every 2-3 hours during the initial phase. Ensure you use a towel or a damp cloth placed in between the icepack and your skin to prevent ice-burns.

Your Chartered Physiotherapist can also use a combination of massage, taping, dry needling and exercise to decrease inflammation and improve recovery time from injury.

Rehabilitation Back to Full Training:

Achilles tendon injuries are notoriously slow to heal and have a very high recurrence rate. Once your inflammation has subsided and there is no pain on walking, your physiotherapist will commence you on a rehabilitation programme to get you back to full training and sport. Rehabilitation programmes consist of exercises to improve your leg and spinal muscle flexibility and strength. These exercises will also help improve your running technique (biomechanics) and balance (proprioception) and are essential in decreasing the chances of the injury recurring.

Your physiotherapist can assess your foot biomechanics and may also suggest changes in your footwear or temporary or permanent orthotics to decrease the work load on the Achilles tendon.

Somerton Physiotherapy Clinic has two clinic locations in Dublin 15:
Blanchardstown Village and Westmanstown Sports and Conference Centre.

To book an appointment call us on T: 0852455600, Contact us here or you can book online.

Osgood-Schlatter Disease, Patellar Tendon, Knee-Pain

My child has knee pain: Is Osgood-Schlatter Disease causing their pain?

What is Osgood-Schlatter Disease? 

Osgood-Schlatter disease is where there is an extra bone growth on the bone below the patella (knee cap). It is common in active adolescents especially those participating in sports that involve running, jumping and changing direction. The disease is associated with growth spurts and can occur in both knees in approximately 30% of cases.

What causes it? 

The exact reason for the onset of Osgood-Schlatter disease is unknown. Repeated stress of the quadriceps muscles on the tibial tuberosity and abnormal quadriceps tightness can lead to an enlargement of the tibial tubercle. Onset may be caused by the relative imbalance of strengthening quadriceps muscles compared with the growing bone. Other contributing factors include over training, poor or inadequate foot wear and poor lower limb biomechanics or running technique.

Signs and Symptoms of Osgood-Schlatter Disease:

Pain, tenderness, and swelling around the tibial tuberosity which is the bony prominence located just below the knee cap.


Conservative treatment consists of rest from painful activities, icing, and NSAIDs until pain levels have reduced. A strengthening and stretching program will be devised by your Chartered Physiotherapist that involves both increasing the strength and flexibility of all the muscles around the knee.  Your Chartered Physiotherapist will also guide you through a return to sport protocol eventually back to your pre-injury status.

Somerton Physiotherapy Clinic has two clinic locations in Dublin 15: Blanchardstown Village and Westmanstown Sports and Conference Centre.

To book an appointment call us on T: 0852455600 or Email us at [email protected] or Contact us here


Ankle Sprains in GAA players


I have sprained my ankle – what should I do next?

A sprained ankle is an injury that occurs when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue (ligaments) that help hold your ankle bones together. A large majority of these injuries are sustained during sporting activity; in fact ankle sprains have been shown to be the most common injury in a total of 24 different sports (Fong, 2007). They are particularly common in sports that involve change of direction or jumping, with high incidences reported in Gaelic football and hurling (Watson, 1999).

The ankle joint connects the bones of the lower leg to the foot. It is made up of three different points of contact between four bones – the Tibia, Fibula, Talus and Calcaneus (see Image 1). The arrangement of the bones allows the ankle joint to move in four directions, plantarflexion, dorsiflexion, inversion and eversion.



Image 1.

The ankle is supported by several strong ligaments (see Image 2). The Deltoid ligament lies on the medial (inside) aspect of the ankle with three ligaments supporting the lateral aspect

including the Anterior Talofibular ligament (ATFL) which is the most commonly injured ligament in a sprained ankle. The ankle ligaments act as support structures and serve to prevent excessive and damaging movement occurring at the ankle joint.

Image 2.

Ankle ligament sprains are among the most common injuries in GAA players. A 6-month prospective study of injuries in Gaelic footballers was conducted by Wilson et al. in 2006. There were nearly twice as many injuries during matches as during training. The ankle was found to be the most commonly injured site (13.3%) followed by the quadriceps and hamstring muscles (both 12.2%).

As previously mentioned the ATFL is the most commonly injured ligament in a sprained ankle. Up to 73% of ankle sprains involve isolated rupture of the ATFL (Fong et al 2009). Damage occurs to this ligament when the ankle is forcefully inverted (or turned inwards) which is what happens when you roll over onto the outside of your foot (see Image 3).

Image 3.

The deltoid ligament can sustain damage through excessive movement in the opposite direction (see Image 4). However due to the anatomy of the ankle, we generally have much less eversion range of movement. The position of the fibula relative to the ankle prevents excessive eversion and so the deltoid ligament is injured less frequently.

Image 4.

The activities involved in GAA games place significant amounts of pressure and strain on the ankle joint. A lot of research has been carried out in order to identify potential causes of ankle sprains in a range of sports. There are both external and internal factors involved in identifying the risk of an ankle injury.

Extrinsic factors for ankle injury can include poor quality training surfaces, ill fitting footwear or inappropriate training drills/intensity when the player is unprepared. A case could also be made to suggest that too much grip on the sole of football boots may increase the likelihood of rolling over on the ankle by allowing less leeway when trying to change direction at speed.

Willems et al (2005) found that lower overall cardiovascular fitness levels and slower running speed were recorded in men who sustained ankle sprains. Other factors identified included deficits in balance, decreased dorsiflexion range of movement and decreased strength and reaction time in the muscles around the foot and ankle. These factors are particularly important in GAA games given the pressure placed on the ankle joint.

If you suffer an injury to your ankle you should initially follow the RICE protocol. You will need to Rest from any activity which aggravates the pain in your ankle. Ice the affected area as soon as possible after the incident. Apply the ice wrapped in a damp towel and keep it in contact with the ankle for 15-20minutes. Placing a Compression bandage around the ankle may also help to support the joint in the acute stages. Elevating the foot as often as possible will serve to control some of the swelling that can occur after an ankle sprain. Following these steps will help reduce your pain and swelling and speeding up the recovery process.

This type of injury mechanism also has the potential to result in a fracture to one of the bones in the foot or ankle. If you are unable to walk for four steps and have significant swelling or severe pain on either side of the ankle joint you should seek treatment in an emergency department in order to have an X-Ray carried out.
You will need to be assessed by your chartered physiotherapist to determine which structure has been injured, the extent of the damage, the likely recovery time and the best course of management for your injury. At Somerton Physiotherapy Clinic we will perform several tests in order to identify if any of the ankle ligaments have been torn.

Initial treatment is likely to involve very gentle range of movement exercises, soft tissue massage and light stretching in order to prevent excessive stiffening of the joint in the acute stage. As your pain levels and ability to move improve you will begin to work on the strength in the muscles around the ankle. When appropriate your physiotherapist will introduce higher level exercises designed to improve the balance and proprioception around your ankle. This can involve exercises on wobble disks or balance cushions in order to challenge your ankle appropriately before returning to football or hurling. Running, sprinting, agility and change of direction drills also need to be incorporated to prepare you to meet the demands of your sport.

Your Physiotherapist will advise you when it is safe to return to sport once you have cleared all of the return to play criteria. Returning to play without having sufficient levels of leg strength, control, balance and proprioception can put you at significantly higher risk of suffering a recurrence of your ankle injury.

Clanton et al (2012) reported that that up to 80% of people who sustain an ankle sprain will suffer from recurrences of the injury and up to 72% can develop chronic instability. These figures show just how important it is to properly rehabilitate your ankle injury prior to returning to football and hurling games.

Somerton Physiotherapy Clinic has two clinic locations in Dublin 15: Castleknock and Westmanstown Sports and Conference Centre.

Contact Us:
To book an appointment call us on T: 0852455600 or Email us at [email protected]



Overview of Lower Back Pain


Introduction to Lower Back Pain:

Approximately 80% of all adults experience back pain at some point in their lifetime. It is one of the most common causes of job-related disability and a leading contributor to work absenteeism in Ireland. A recent survey on back pain in Ireland, found that 68% of Irish people suffer from back pain at least once a week, and that a staggering 50% of adults in Ireland have suffered from back pain for more than five years. Back pain is so prevalent that financially it costs the country more than cancer and diabetes treatments combined.

Men and women are equally affected by lower back pain, which can range in intensity from a dull, constant ache to a sudden, sharp sensation that leaves the individual incapacitated. Pain can begin abruptly as a result of an accident or by lifting something heavy, or it can develop over time due to age-related or degenerative changes to the structures of the spine.

Anatomy of the spine and lower back:

The lower back, where most back pain occurs, consists of five vertebrae (referred to as L1-L5) which support much of the weight of the upper body. The spaces between the vertebrae are maintained by intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place. Nerves branch off from the spinal column at each level of the spine. Theses nerves pass through small holes then connect together to form the Sciatic nerve, which travels into the lower limbs. When an individual reports that they have “Sciatica” it is these nerves that are trapped.

Causes of lower back pain:

Lower back pain has many causes. Most episodes of lower back pain are musculoskeletal in origin and can be treated with a course of Physiotherapy. Examples of the main causes of lower back pain include:

Sprains and strains to muscles or ligaments account for most acute lower back pain episodes. Both can occur from twisting or lifting something incorrectly, lifting something too heavy or overstretching your lower back.

Intervertebral disc degeneration is one of the most common causes of lower back pain and occurs when the usually rubbery discs lose integrity as a normal process of ageing. In a healthy back, intervertebral discs provide height and allow bending and extending of the lower back. As the discs deteriorate, they lose their cushioning ability.

Herniated or ruptured discs can occur when the intervertebral discs become compressed and bulge outward (herniation) or rupture, causing low back pain.

Radiculopathy is a condition caused by compression and/or inflammation to a spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that radiates to other areas of the body. Radiculopathy may occur when a herniated or ruptured disc compresses a nerve.

Sciatica is a form of radiculopathy caused by compression of the Sciatic nerve. This compression often causes sharp low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot.

Spondylolisthesis is a condition in which a vertebra of the lower spine slips forward, pinching the nerves exiting the spinal column.

Spinal stenosis is a narrowing of the spinal column that puts pressure on the spinal cord and nerves that can cause pain or numbness with walking and over time may lead to leg weakness and sensory loss.

Scoliosis which is an abnormal curvature of the spine.

Osteoporosis leads to the bones of the spine becoming brittle and porous, making spinal compression fractures more likely.

Signs and symptoms of lower back pain:

There are several warning signs, known as ‘symptoms’, that may indicate that you are about to develop an acute episode of lower back pain. If you feel the onset of any of the below signs and symptoms it is important you consult your local GP or Chartered Physiotherapist.

  • Muscle ache or stiffness in the region of the lower back
  • Pain that radiates down the lower limbs
  • A sensation of pins and needles or numbness radiating into the lower limbs
  • Limited flexibility or range of motion of the back – particularly in the morning time
  • Disrupted sleep due to pain in your lower back
  • Discomfort with sitting or driving
  • Discomfort on bending or lifting
  • Difficulty walking or exercising

Risk factors associated with developing lower back pain:

A risk factor is something that increases your chances of developing lower back pain. Having more risk factors means you have a higher chance of sustaining a back injury. I have highlighted the main risk factors below that your local GP or Chartered Physiotherapist will discuss in more detail with you.

Occupational – Prolonged standing or sitting, repetitive lifting or poor sitting posture and work ergonomics are all recognised as factors that contibute to the development of back pain.

Age – Studies have shown that the risk of lower back pain increases as an individual gets older. Back pain is the most frequent cause of the limitation of activity in people under 45 years old.

Family History – A family history of back pain has been shown to increase one’s risk.

Gender – The evidence here is confusing: Some studies have shown that males are at greater risk of developing lower back pain, while other studies suggest that females are more likely to develop this type of pain. Women who have had two or more pregnancies have a higher risk of developing lower back pain.

Level of Physical Activity – The strength and endurance of the back and abdominal muscles have been shown to be related to the development of back pain. Studies have shown that physical fitness and conditioning may help to prevent back injuries.

Obesity – While not conclusive, several studies have shown an increase in back pain in obese patients, especially in women.

Poor Posture and Alignment – Poor posture or improper alignment may predispose individuals to developing back pain over time as this can cause undue stress on spinal structures in the lower back.

Previous Back Injury – The single best predictor of back pain is a previous back injury. Evidence has shown that relapses are very common in individuals who do not treat their lower back pain in the correct manner.

Psychological / Social Factors – It is increasingly recognised that a wide variety of psychological and social factors can increase the risk of low back pain. Research has shown that anxiety, depression, stressful responsibility, job dissatisfaction, mental stress at work, and substance abuse can place people at increased risk for developing chronic low back pain.

Smoking – Studies have shown that smokers have a 1.5 to 2.5 times greater risk of developing lower back pain than nonsmokers. It is thought this may be due to reduced oxygen supply to discs and decreased blood oxygen from the effects of nicotine on constriction of the arteries.

Sports – Participating in sports such as skiing, snowboarding, gymnastics and contact sports such as GAA and rugby increase the participants risk for developing lower back pain.

Other factors – Other factors may play a part in the development of acute and chronic lower back pain. These include underlying spinal conditions such as osteoporosis, spondylolysis, discogenic disease, degenerative joint disease (osteoarthritis) of the spine and scoliosis.

Treatment of lower back pain:

Treatment choice for lower back pain generally depends on whether the pain is acute or chronic. Most episodes of lower back pain will respond favourably to a course of physiotherapy treatment. Early and accurate assessment and diagnosis is essential in order to prevent a worsening of symptoms. A Chartered Physiotherapist can provide a variety of treatments, help you understand your problem and help you get back to your normal activities of daily living pain free.

Manual therapy such as spinal manipulation or mobilisation and massage are often used to alleviate symptoms and manage lower back pain in the acute stage. A home exercise programme will be devised to help restore muscular strength and re-educate spinal movement patterns. Other modalities such as dry needling, acupuncture, electrotherapy or hot / cold packs may also be beneficial in relieving the symptoms of lower back pain. Preventative activities such as pilates or yoga are recommended to help keep your lower back in a healthy state and reduce the likelihood of a recurring episode in the future.

Summary of lower back pain:

  • Back Pain is a very common complaint in Ireland
  • Bed rest and inactivity are not helpful in the long-term management of lower back pain
  • Lifting and bending are safe when carried out correctly
  • Avoiding activities and moving carefully does not help your back in the long-term
  • Poor sleep, high stress levels, low mood and worry influences back pain
  • Supervised exercise (by a medical professional) is good and safe for you if you have back pain
  • If you feel the onset of lower back pain it is important you contact your local GP or Chartered Physiotherapist as early intervention leads to greater outcomes
  • A Chartered Physiotherapist is expertly placed to accurately diagnose and treat lower back pain.

Contact us today for a physio consultation in Blanchardstown or Westmanstown.