Achilles tendinopathy


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Achilles Tendinopathy (also known as achilles tendinitis) is a condition that causes pain in the thick tendon that joins your heel bone to your calf muscles. It is a relatively common soft tissue injury and affects people of all ages, both athletes and non-athletes.

What are the symptoms of achilles tendinopathy?
Symptoms can include:
  • Tenderness over the achilles tendon – the area may be very tender to touch. In some people there is a painful lump or swelling in the area
  • Stiffness - stiffness in the tendon when you get up in the morning or following a sustained period of rest is common. This usually eases after a few minutes of walking in many cases
  • Variable pain – some people only report a mild ache which eases with exercise. Other people can experience very severe pain which will limit their walking. Often pain will be increased when you go up onto your toes
What causes achilles tendinopathy?
The causes of achilles tendinopathy are not completely understood but we know it occurs when a tendon is unable to adapt to the strain being put through it. Sometimes it starts after an injury or strain to the area and it is commonly caused by overloading the tendon, for example suddenly increasing your activity levels.
You are more at risk of developing achilles tendinopathy if you have diabetes, tight and weak calf muscles, or stiff ankle joints.

How is it diagnosed?
Diagnosis is usually made from the patient's history and a simple examination without the need for further investigations.

How can I manage achilles tendinopathy? 
There is self-management advice provided below to help minimise symptoms and facilitiate the healing process:

Footwear
Wearing supportive footwear with good shock absorbancy is important. Using an insert  within the  shoe or wearing  a shoe with a slight raised heel may also help ease pain.

Pain relief
Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or Pharmacist.

Some people find ice effective in reducing their pain. Apply an icepack for 15 mins, two to three times a day. Avoid applying ice directly to your skin,instead use a towel or have a fabric layer inbetween.

Weight loss
You are more at risk of developing achilles tendinopathy if you are overweight. Reducing your weight can also improve symptoms through reducing the stress on your joints, muscles and tendons.

Exercise
Initially avoiding high level activities that aggravate the pain such as hill walking or running may be useful but you should keep up gentle walking. Research has shown that doing specific exercise can improve your symptoms.

It may take up to 12 weeks of exercise rehabilitation to make a significant improvement in the symptoms but you should see some gradual improvements along the way.
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Further management options
If there is no response to the self-management information above within four to six weeks, seek further advice from your physiotherapist or GP.  

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