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Achilles Tendonitis

Achilles Tendonitis - Why does this happen?
The Achilles Tendon is connective tissue which attaches the calf muscles to the bony area on the back of the heel. 

Achilles Tendonitis, or Achilles Tendinopathy, is a condition where the Achilles Tendon degenerates or becomes inflamed due to micro-tears in the tissue.  This is often due to overstretching, repeated stress or a change in stress on the tendon such as increase in running distance, a change of running surface or change in foot position with new trainers.  Muscle imbalance, a poor foot position, poor warm up and tight muscles may be contributing factors.

What are the symptoms?
  • Pain and tenderness on the back of the calf between the muscle and the heel.
  • Pain is worse on walking, weight bearing and calf stretches.
  • A thickening may be felt on the tendon.
  • Pain is relieved after a period of rest.    
  • After a period of rest there is stiffness and pain when starting to walk.
Diagnosing Achilles Tendonitis

Your GP or Physiotherapist can usually diagnose an Achilles Tendonitis by simply examining your leg and hearing where the pain is and how it started.


X-rays and other tests are not usually necessary.
What is the treatment?

Achilles Tendonitis will usually recover with some simple changes to daily activity and exercise.  By trying to avoid or reduce the activity which causes the pain, you will allow the damaged tendon time recover and heal. 


To help reduce the symptoms an 'ice pack' can be placed on the painful area for 15 - 20 minutes, twice a day.  Do not place the 'ice pack' directly on the skin.  Wrap the 'ice pack' in a damp towel before placing on the painful area to ensure you do not burn the skin.  


When possible elevate the leg during the first 48 hours.


During the initial painful stages it is important to manage the pain.  A shoe with a slight heel or a flat shoe with an inserted heel wedge can be worn to help reduce pressure on the tendon as it recovers.

Painkillers and anti-inflammatory medications  -  These may be prescribed by your GP if the pain is costant.  This is a temporary measure to break the pain cycle, but can continue as required.
Exercise  -  Exercise is important to help regain full ankle movement in the acute stage. Once the pain has settled it is important to strengthen the surrounding muscles and work on your balance to help prevent reoccurrence.  Click here for a list of exercises suitable for Achilles Tendonitis.
Biomechanical Analysis  -   If there are significant mechanical problems insoles or specific trainers may improve your leg position and help avoid further injuries.  A biomechanical assessment by a Podiatrist or Physiotherapist will determine whether insoles or specific trainers would be of benefit.
Physiotherapy  -  If exercise alone does not improve symptoms then physiotherapy treatment may be required.  A physiotherapist can use specific treatments including, ultrasound, deep friction, massage, interferential, acupuncture or taping to help relieve pain and aid recovery. Click here for more information about Physiotherapy.
Injections  -  In some cases your GP or Consultant may recommend an injection.  These can be used to reduce inflammation and pain when the symptoms are severe and constant.  This is not a 'cure' and it is important to follow the exercises and modify activities.  A 'Cortisone Injection' can help reduce inflammation in the tendon, whilst a 'PRP Injection' (Platelet Rich Plasma) can help to stimulate healing.
Surgery  -  This is not common for Achilles Tendinopathy.  In some cases when symptoms are persistent surgery may be considered.    
Remember an important part of treatment for Achilles Tendonitisis your home exercises and modifying activities.