What is Achilles Tendinopathy?

Achilles tendinopathy is commonly known as Achilles tendonitis. It is a condition that causes pain, swelling, stiffness, and weakness of the Achilles tendon that joins your heel bone to your calf muscles. It is thought to be caused by repeated tiny injuries to the Achilles tendon. After each injury, the tendon does not heal completely, as should normally happen. The tendon tends to thicken and over time, damage to the Achilles tendon builds up and Achilles tendinopathy can develop. There is no true inflammation in Achilles tendinopathy, but the small areas of damage weaken the tendon, causing a decrease in strength.

What are the causes?

There are several reasons that may lead to these repeated tiny injuries to the Achilles tendon. For example:

• Overuse of the Achilles tendon. This can be a problem for people who run regularly. Achilles tendinopathy can also be a problem for dancers and for people who play a lot of tennis or other sports that involve jumping.
• Training or exercising wearing inappropriate footwear.
• Having poor training or exercising techniques – for example, a poor running technique.
• Making a change to your training program – for example, increasing the intensity and/or the frequency of your training.
• Training or exercising on hard or sloped surfaces.
• Having a low arch foot, flat feet.
• Having poor flexibility – for example, having tight or underdeveloped calf muscles.

What are the signs and symptoms?

• Pain and stiffness around the Achilles tendon region, especially first thing in the morning.
• Gradual onset of pain.
• Pain following increase inactivity.
• Tightness in the calf muscles.

How common is Achilles Tendinopathy?

It is rare for people under 35 to have Achilles tendinopathy. People such as athletes who are very active and over-stress the tendon are more likely to have problems.

What can I do to help?

Exercises (see the back page for more information). Always check with your Physio about exercising.

Footwear/Orthotics
Orthotics help support the sole of your foot and prevents you overstretching the foot while you are walking. Try to wear supportive shoes or trainers and avoid flip flops and excessive flat-soled shoes.

Pain Relief
Simple painkillers or anti-inflammatory medication can help reduce the pain in the early stages. Always check with your GP or pharmacist before taking any new medication. You may find it comfortable to use some ice following exercise to help with the pain.

Exercises to help your problem

Calf Stretch

• Point both feet forwards (affected leg at the back).
• Keep the back-foot heel in contact with the floor.
• Lunge forward onto the front leg until you feel a stretch in the lower part of your back leg.
• Hold the stretch for 20 seconds and repeat regularly

throughout the day.

Calf Raises

• Using a stable surface to push on, use your hands to lift your heels off the floor.
• Slowly lower your heels down to the ground taking 5 seconds to do so.
• Repeat 8 times and aim to do 4 sets of the exercise.

If it becomes too easy try the above exercise on one leg.

(Exercise may temporarily increase your pain)

The key thing to remember is to be patient. Keeping up gently/graded exercise will help you recover. Achilles tendinopathy can be hard to treat and won’t get better overnight. Some recovery can take up to 18 months. Self-management is the key to progress.

You should consult your doctor should you not see any improvements within 6 months of the perseverance of the tips given in this leaflet.