Achilles Tendinopathy: Information, Answers and Self-Help

Achilles Tendinopathy This leaflet provides information, answers and self-help strategies regarding your Achilles tendinopathy.

INFORMATION What is Achilles tendinopathy?

Achilles tendinopathy is also known as ‘Achilles tendonitis.’ It is a condition that causes pain, swelling and thickening of the Achilles tendon which joins your calf muscles to your heel bone.

Achilles tendinopathy commonly occurs when we overload the tendon and continue to do this for a period of time. This results in changes in the tendon, causing pain and swelling making everyday tasks such as walking, wing stairs, or running painful.

What causes Achilles tendinopathy?

Common causes of Achilles tendinopathy are: Long-term overuse of the tendon.

Training or exercising when wearing inadequate footwear.

Inefficient running technique.

Making a change to your training program, such as increasing the duration and intensity of your training, ie doing too much too soon.

Training or exercising on hard or sloped surfaces.

Poor foot biomechanics, such as foot turning inwards (pronation) and/or high foot arches.

Having reduced flexibility in the muscle around your calves.

Signs and symptoms Pain and stiffness around the Achilles tendon location, especially first thing in the morning.

Gradual onset of pain.

Pain following increase in activity.

Tightness in the calf muscles.

Usually the tendon itself is painful to squeeze.

Thickening of the Achilles tendon.

FREQUENTLY ASKED QUESTIONS

How common is Achilles tendinopathy?

Achilles tendinopathy is commonly seen in very active individuals. It is normal for regular walkers and runners to also get Achilles tendinopathy.

It is usually seen in those between 30-50 years of age.

What can I do to help?

Exercises (see the back page for more information) Exercise has been shown to be very effective for Achilles tendinopathy.

Keeping up with a gentle and graded exercise programme will help build tendon tolerance to load. Some tendons can take up to 18 months to fully heal. It is important to be persistent with your rehab and make relative modification to your daily routine. Your physiotherapist or healthcare practitioner can provide you with further guidance.

Pain relief Simple painkillers or anti-inflammatory medication can help reduce pain in the early stages. (Always check with your GP or pharmacist before taking any new medication). You may find it useful to use some ice following exercise to help with the pain. Only apply for a maximum of 15 minutes if needed.

Footwear and orthotics Orthotics may help support the sole of your foot and prevents you overstretching the foot while you are walking or running. Try wearing supportive shoes or trainers and avoid flip flops and excessively flat-soled shoes.

Extracorporeal shockwave therapy (ESWT) Shockwave therapy can also be a very effective treatment for Achilles tendinopathy and can be offered as another treatment modality as an adjunct to treatment. This can be discussed further with your physiotherapist if deemed appropriate. You will have to ensure you meet the criteria for such treatment.

EXERCISES TO HELP YOUR PROBLEM Calf raises Initially you may want to start off by holding on for support.

Gently raise your heels from the floor by pushing up onto your tiptoes.

Slowly lower your heels down to the ground, taking five seconds to do so.

Repeat this between eight and 12 times and aim to do four sets.

Calf raises with knees bent As above, using a table or wall for support, aiming to push up onto your tiptoes on both feet, but this time with your knees slightly bent.

Slowly lower your heels down to the ground, taking five seconds to do so.

Repeat eight times and aim to do four sets.

You may experience some discomfort doing these exercises which is normal and does not mean you are doing any harm. Your pain should be no more than a four out of 10 when exercising, if zero is no pain. Ensure your pain is not worse the following day as there can sometimes be a delayed response. As a guide, start with two to three sets of 10 repetitions of each exercise and work through the stages as you progress.

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