Achilles tendinopathy

Achilles tendinopathy is a common condition affecting the Achilles tendon and is usually caused by overuse – this means repeated stress on your tendon that over time can create structural changes to it and produce microtears that make the tendon weaker.

Tendonitis, which refers to an acute inflammation of the tendon, is very often associated with chronic tendinopathy – which simply means a recurrent state of underlying wear and tear of the tendon.

Symptoms of tendinopathy are:

– swelling that can be perceived either as a small bump on the tendon itself or spread to the space between the Achilles tendon and the back of your ankle bones.
– pain while standing, walking or running
– pain at touch
– calf tightness

Tendinopathy tends to establish itself over a prolonged period of time, particularly if you perform regular sports activities such as running, jumping or climbing.

The easiest way to diagnose Achilles tendinopathy is via an ultrasound scan which can identify areas of inflammation as well as structural changes to the tendon sheets.

What can be done?

RICE (rest, ice, compression and elevation) is very helpful during the acute stages of Achilles tendinopathy. Staying away from the activities that seem to be triggering the pain is the key to reduce the stress on the affected tendon.

Once the acute phase has passed it is crucial to start the appropriate rehabilitation program. A physiotherapist or an osteopath will be able to create a tailored exercise plan to help you return successfully to a normal day-to-day routine. This period of rehabilitation can last between 4 and 12 weeks depending on the severity of the tendinopathy.

A rehabilitation program might include:

– calf strengthening and stretching exercises
– balance exercises on an unstable surface
– elastic band loading of the Achilles tendon
– eccentric loading with plyometric exercises (involving jumps and progressive changes of direction)

Very often manual techniques are also successfully used for the treatment of Achilles tendinopathy, these might include:

– soft and deep tissue release of the calf muscles
– dry needling acupuncture
– trigger point stimulation
– manipulation of the ankle and foot joints
– Kinesio taping and strapping

Ultrasound therapy might also be suggested to reduce the local inflammation on the tendon.

In the vast majority of cases, physiotherapy and osteopathy are the gold-standard treatments for Achilles tendinopathy. Only in very rare cases, the treatment is surgical and this is mostly needed if the tendon goes through a full rupture due to direct trauma or an acute sports injury