Achilles tendinopathy: Symptoms and causes and how to treat Achilles tendinopathy

Achilles tendinopathy is a condition that affects the band of tissue (tendon) that links your lower leg muscles to your heel bone. You may have discomfort, stiffness, and edema around your heel. It’s a frequent injury, particularly if you’re physically active or participate in a lot of sports.

About Achilles tendinopathy

Your Achilles tendon is your body’s thickest and strongest tendon. It links your calf muscle to your heel bone, allowing you to move your foot while you walk, run, climb, or leap.

When you have Achilles tendinopathy, your Achilles tendon gets injured and stops functioning properly. It is generally deteriorated over time as a result of repetitive usage and injury. The injury might make your typical activities unpleasant and difficult.

Achilles tendinopathy is also known as Achilles tendonitis. This indicates that your tendon is irritated. However, since inflammation does not always occur when a tendon is damaged, this phrase is not precisely correct.

Symptoms of Achilles tendinopathy

Achilles tendinopathy may result in a variety of symptoms, including:

• Pain in your heel – this might be an ache or a sharp pain that becomes worse when you move or put pressure on it.
• Tendon stiffness – this is frequently worse first thing in the morning or after a period of rest.
• your ankle is swollen at the back
• soreness when your tendon is touched
• When you move your ankle, you may hear a grating noise or experience a cracking sensation (crepitus).

If you experience abrupt discomfort in your heel or calf, you may have ripped your tendon. This is referred to as an Achilles tendon rupture. You could hear it shatter and have difficulty bearing weight on your leg. If this occurs, seek immediate medical attention.

Achilles tendinopathy causes

Achilles tendinopathy is often brought on by overuse, which is defined as prolonged, repetitive stress on your Achilles tendon. This may result in changes to the structure of your tendon, as well as small rips, making it weaker.

Achilles tendinopathy may be caused by any sport or activity that puts strain on your Achilles tendon. This includes running and any activity that requires leaping, such as dance, gymnastics, squash, and tennis. You may also be more prone to Achilles tendon injury if you:

• employ subpar equipment, such inappropriate footwear
• have inadequate technique or have not adequately trained for the activity
• Increase the amount of exercise you undertake or the intensity with which you exercise unexpectedly.
• practice on a firm or sloping surface

See our preventive section for tips on how to overcome these problems.

Other factors that might increase your chances of developing Achilles tendinopathy include:

• As you become older, your Achilles tendon gets less flexible and less capable of coping with stress.

• having a family history of the disorder
• if you’ve already hurt your tendon or the muscles around it
• having long-term health concerns such as rheumatoid arthritis, diabetes, high cholesterol, or thyroid issues
• experiencing issues with your feet or legs
• being very overweight or obese
• using certain drugs – for example, quinolone antibiotics, corticosteroids, or statins

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Achilles tendinopathy self-help

There are some things you may take to alleviate the symptoms of Achilles tendinopathy without seeing a doctor. These are some examples.

• Reduce (or halt) the activity that caused your symptoms to rest your tendon.
• To relieve discomfort and minimize swelling, wrap cold packs or ice in a towel. However, do not apply ice straight to your skin as this may cause injury.
• To relieve discomfort, use over-the-counter pain relievers such as paracetamol. Nonsteroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen may also help to relieve pain at initially, but NSAIDs should not be used for an extended period of time.

If possible, continue to bear weight on your leg. If you can, perform some easy calf stretches as well. Swimming is an example of a workout that won’t place too much strain on your Achilles tendon.

Once the discomfort subsides, you may gradually resume your daily activities. But, until the discomfort is fully gone, avoid uphill and downhill jogging and stick to gentler running surfaces. You should also warm up thoroughly and stretch your calves often.

Heel lifts may be useful for you. These are the insoles that you put into your shoes. They may alleviate your discomfort by reducing the strain on your Achilles tendon. It may also be beneficial to see a podiatrist, a foot expert. They can advise you on the best footwear to wear based on your feet, posture, and activities.

See our section on prevention for additional information on preventing future damage.

Seeking assistance with Achilles tendinopathy

If your symptoms do not improve after a week or two of self-help techniques, you may want to consult a physiotherapist or speak with your doctor. You may be able to self-refer to a physiotherapist on the NHS in certain regions. In certain cases, a recommendation from your primary care physician is required. You may also pay for private physiotherapy.

If you believe you have ruptured your Achilles tendon, see your doctor or go to a minor injuries clinic. If you burst it, you would most likely be in excruciating agony and may have heard a cracking or breaking sound.

Achilles tendinopathy diagnosis

Your doctor or physiotherapist will ask you questions about your symptoms and inspect your leg, heel, and ankle. They may ask you to do a series of motions or exercises to assess your ability to move your leg. To assess the mobility of your foot, they may pinch your calf muscle.

They may also inquire about your medical history in order to rule out other possible causes or illnesses. Your doctor can determine if any drugs you’re taking have elevated your risk of Achilles tendinopathy. They may also advise you on whether or not you should stop taking them. See our section on Achilles tendinopathy causes for further information.

Achilles tendinopathy is generally diagnosed based on your symptoms, and no additional tests are usually required.

Treatment for Achilles tendinopathy

If self-care approaches do not assist your Achilles tendinopathy, your doctor or physiotherapist may recommend various therapies. This will normally begin with a physiotherapy exercise regimen, followed by further therapies if this does not work. Most individuals see an improvement in their symptoms within 12 weeks.

Achilles tendinopathy physiotherapy exercises

Physiotherapy may help you strengthen and function your Achilles tendon. For roughly six weeks, you may need two to three physiotherapy sessions each week.

Your physiotherapist will recommend certain exercises to you. Achilles tendinopathy exercises often begin with moderate stretching before progressing to eccentric movements. These are workouts specifically intended to stretch and extend your Achilles tendon over time. They are very beneficial for Achilles tendinopathy. To get the most out of your Achilles tendinopathy exercises, you should practice them twice a day, every day for at least three months.

Other Achilles tendinopathy therapies

If self-help techniques or physiotherapy exercises do not improve your Achilles tendinopathy, there may be further therapies you may try. These are some examples.

• Shockwave treatment extracorporeal. A machine sends shockwaves through your skin to the injured section of your tendon. This may assist to alleviate your discomfort. You may need many sessions.
• Injections of blood or platelet-rich plasma (PRP). These employ a portion of your own blood that is high in growth factors and may aid in the healing of your Achilles tendon. Your doctor may inject plasma or blood into or around your injured tendon, often with the use of ultrasonography.
• Needling without water. This includes inserting a small needle into your tendon in order to stimulate the healing process and strengthen it.

Some of these treatments may be available through your physiotherapist. Others, on the other hand, may need a referral to a sports or musculoskeletal expert. Some of these therapies may be provided only via specialized clinics or as part of a research study.

Surgery for Achilles tendinopathy

The majority of individuals do not need surgery for Achilles tendinopathy. However, if you’ve tried alternative therapies and they haven’t worked for many months, surgery may be a choice. You will need to be sent to a foot and ankle surgeon who can determine if surgery is necessary for you. Your surgeon may request scans to assess the condition of your tendon.

During surgery, damaged sections of your tendon are removed and what remains is repaired. For these procedures, your surgeon may need to take tissue from further up your Achilles tendon or from a separate tendon. Achilles tendon surgery will take time to heal from, and it will leave scars. Surgery does not always cure Achilles tendinopathy.

Achilles tendinopathy prevention

• You may do a number of things to help avoid Achilles tendinopathy.
• Wear proper and well-fitting shoes whether jogging or participating in other activities. It may be beneficial if they are well-padded.
• Whether you’re active at work or in sports, be sure you’re using the proper equipment and skills.
• Reduce repeated actions that put strain on your tendon.
• Build up new activities gradually. You should gradually increase the intensity and length of your activities.
• Warm up thoroughly before beginning your workout, and then stretch your calf muscles.
• If you have underlying health issues that put you at danger, be sure they are adequately addressed.
• Maintaining a healthy weight is important since being overweight increases your risk of Achilles tendinopathy.

If you have a difficulty with the form of your foot or how you walk, using orthotics (special inserts) in each shoe may assist. Orthotics are available from pharmacies and other merchants, or they may be custom-made for you by a podiatrist. Consult your physiotherapist or podiatrist for assistance.

Achilles tendinopathy frequently asked questions

What is the duration of Achilles tendinopathy?

Achilles tendinopathy may take weeks or even months to heal. Most people’s discomfort and mobility improve after around 12 weeks of self-help and physiotherapy activities. However, certain patients may need more specialized care. See the sections on self-help and treatment above for further information.

How is Achilles tendinopathy treated?

Rest your foot and avoid any activities that may have contributed to your Achilles tendinopathy. Pain relievers and chilling the affected region might assist to alleviate discomfort while your tendon recovers. Some patients need further assistance, such as physiotherapy. See the sections on self-help and treatment above for further information.

What causes Achilles tendinopathy to worsen?

You may discover that some items aggravate your Achilles tendinopathy. Any action that puts strain on your Achilles tendon at the rear of your heel can aggravate the condition. Running and leaping activities, such as gymnastics, squash, and tennis, are examples. See our section on causes for additional details.

Are there any Achilles tendinopathy exercises?

Yes. A physiotherapist may provide exercises to aid treat Achilles tendinopathy. Achilles tendinopathy workouts may gradually extend your Achilles tendon. These are known as ‘eccentric exercises.’ These exercises should be done twice a day for at least three months. See our treatment section for additional details.

What is the difference between Achilles tendonitis and Achilles tendinopathy?

Achilles tendonitis is an inflammation of the Achilles tendon. However, your tendon might be injured and stop working correctly even if it is not inflamed. This is why the term Achilles tendinopathy is now often used. See the section above under “About Achilles Tendinopathy” for further details.

Which shoes will aid in the prevention of Achilles tendinopathy?

Wearing properly fitted shoes may assist to prevent and treat Achilles tendinopathy. The best shoes for you will be determined by when, where, and why you will be wearing them. Running shoes should be well-padded and provide enough support for your feet and ankles. You may get further information from a podiatrist.

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