Achilles Tendinopathy

Self Help Guides | Ankle and Foot Conditions | Achilles Tendinopathy

Pathophysiology

The achilles tendon attaches to the calcaneous bone at the heel and divides into the calf muscles, allowing us to point our toes and is particularly important in walking or climbing stairs. The achilles can become overloaded with a sudden change in activity causing a reactive tendinopathy or degenerative. The location of irritation can either be at the insertion of the tendon to bone or in the middle of the tendon, depending on this the treatment varies slightly.

Symptoms

Pain directly over the achilles tendon, tender to touch
May be swollen
Pain and stiffness for under 30 minutes on waking in the morning which improves with movement
Pain tends to be worse after activity and this may last 24 hours after a flare up
Pain on walking, running or stairs
Pain with footwear which compresses the tendon

Management

Activity modification
Ice or heat
Pain relief
Appropriate footwear which provides support and doesn’t rub on the tendon
Orthotics
Weight loss if overweight or obese (most people will notice an improvement in joint pain and function after losing 5% of their body weight)
Physiotherapy including range of movement exercises and a graded strengthening programme
Orthopaedic options- If pain and functional limitation is significant after 3-6 months of conservative measures may be considered

Investigations

Generally not indicated, ultrasound can assess level of tendon swelling and x-ray can assess for foot deformity

Downloads

Download “For pain in your Achilles”

Exercises to try

Single Leg Stand

Ankle Inversion and Eversion

Seated Calf Raises

Ankle Circles

Calf Raises