The Achilles tendon is the largest tendon in the body. It attaches the calf muscles to the heel bone and is very important because it lets you lift your heel when you start to walk. It also helps you to walk, run or stand on tiptoe.

Symptoms of Achilles tendinopathy include:

  • Pain in the back of the heel
  • Pain and stiffness when walking – especially first thing in the morning or after long periods of sitting.
  • Swelling and tenderness of the Achilles tendon.AdobeStock_65799806-WEB (1)

Achilles tendinopathy is more commonly referred to as Achilles tendonitis, however recent research suggests that “tendinopathy” is a more appropriate term rather than “tendonitis”. This is because the suffix “itis” means inflammation, and we now know that with most tendon injuries, it is damage and degeneration that causes the pain, not inflammation.

There are several factors that can contribute to Achilles Tendinopathy, the main issues being anything that causes extra work for the tendon. This extra work can be caused by an increase in sport or training, an increase in time on the feet (such as at work), a change in work activities (like using stairs or a ladder more often), increasing walking or running, or any activity that involves jumping. Other issues such as poor or unsuitable footwear, poor foot biomechanics, tight calf and hamstring muscles, and stiff joints can also contribute to the onset of Achilles tendinopathy.


How Is Achilles Tendinopathy Treated?

Achilles tendinopathy is a condition that responds well to conservative treatment if treated early. If disregarded, symptoms and treatment can last for several months. Conservative treatment may include:

  • ·        Exercise programs are the most effective treatment for Achilles tendinopathy. This may seem counterintuitive, but a well prescribed, specific exercise program to load the tendon the in the right way will actually allow the body to repair the damaged tendon.
  • ·        Training modification. Your training schedule should be reduced to enable healing of the damaged area. This helps to allow successful and effective treatment administration.
  • ·        Rest from certain activities that may be aggravating the condition
  • ·        Ice may be used in the early or acute stage of the injury  
  • ·        Heel Raises. These can be worn inside shoes to elevate the heel and therefore decrease the strain and load on the Achilles tendon.
  • ·        Correction of abnormal body mechanics. Orthotic devices are designed to improve foot movement throughout the gait cycle. This may be necessary if poor foot function is causing the Achilles to overwork.
  • ·        Physical therapy. Massage and dry needling to the calf muscles can reduce tightness, improve function and hasten full recovery.
  • ·        Analgesic medication. This may also be required during the initial treatment to control pain.
  • ·        Injection therapy, also known as prolotherapy, can be an option for long standing injuries that aren’t responding to typical conservative care.

It can take several weeks or even months for the tendon to heal depending upon the severity of the injury to the tendon. It is not uncommon for a patient to return to activities too quickly and re-injure the tendon. Careful monitoring of a return to full activity is important and the patient must have patience during this period of time.