Achilles Tendinopathy

What is Achilles Tendinopathy?

A condition affecting the Achilles tendon either at its insertion into the heel bone or in the mid-portion of the tendon (the bit you can grab onto around the back of your heel).

A tendon acts as a stretch and recoil mechanism to transmit force from muscle to bone. In simple terms it can be thought of as an elastic band. When the band has force applied to it then it will change shape and stretch but as the pressure releases it returns back to its original shape. We can think of a tendon like this and muscle exerts the stretching force onto the tendon. As it recoils back to its original shape it will release energy to move the associated joint. In this case the ankle as it propels us forward when walking, running or jumping. The Achilles tendon generates huge forces.

Tendinopathy will cause a change in the structure of the tendon, and thus its capacity to tolerate the loads applied to it as explained above can change. This change in structure also involves the release of chemicals that irritate nerve endings and cause pain and this then effects muscle activation patterns. This can occur due to a number of factors including peaks in training load, previous injury or weakness through certain muscles. Often there a combination of factors and spotting these is important for treatment so a detailed assessment by a physiotherapist is essential.

How Does It Present?

It commonly present as a minor niggle after exercise as well as becoming quite stiff as you take you take your first few steps in the morning. Eventually this condition can start to impede training and daily functional activities. You might notice that the tendon becomes slightly thickened compared to the other one and it will be tender to touch. The pain is often described as a dull tooth ache sensation with occasional sharp pain.

How Is It Treated?

The treatment gold standard is a progressive loading programme but this must be prescribed by a Physiotherapist or specialist healthcare professional according to the location and duration of symptoms as well as the individual’s functional goals.

What You Need To Know
  • Do not ignore it! The longer you ignore it the longer it will take to get better.
  • Do not try to stretch the calf/ tendon as this will aggravate the condition.
  • Wearing a shoe with a sight heel raise can ease the pain.
  • The gold standard treatment is a bespoke, progressive loading programme.