Achilles Tendinitis

Achilles Tendinitis Overview

The Achilles tendon is a band of tissue that connects the gastrocnemius and soleus muscle (calf muscle) to the heel bone. Injuries to this tendon are common due to the intense pressure it undergoes during activity. The symptoms that can arise from overuse injuries are broadly known as Achilles Tendinitis.

Achilles Tendinitis Causes

The Achilles tendon is in use during several common activities, including walking, running, jumping and tip toeing. Over time the tendon is worn by age and repetitive activities, making it susceptible to sprains and tears.

Achilles Tendinitis Symptoms and Diagnosis

Symptoms may include:

  • Pain and stiffness along the achilles tendon
  • Feeling of a lump on the achilles
  • Pain at the back of the heel that worsens with activity
  • Swelling
  • Limited range of motion

The first step to diagnosing this issue would be to arrange an appointment with a podiatric specialist who can assess and advise on treatment. They may refer for an X-ray or MRI.

Achilles Tendon Pain

The pain associated with Achilles Tendinitis often first occurs as a mild ache above the heel or around the back of the leg after activity. More severe periods of pain may then occur after prolonged activity that makes use of the Achilles tendon. The area is often tender or stiff first thing in the morning, although this typically dissipates with movement.

Treatments may include:

Physiotherapy

Your specialist may provide you with stretching exercises that can decrease pain and allow you to return to normal activities.

Orthotics

 Your specialist may advise on custom orthotics following a gait analysis. The orthotics can absorb shock to reduce the impact and pain to your heel. A heel raise can also reduce the stress to your achilles tendon as it shortens the distance it needs to stretch during activities.

Shockwave Therapy

 Shockwave applies pressure around the affected area with sound waves that pass through the skin to vibrate tissue, which stimulates healing and pain relief. Shockwave therapy is typically carried out once a week for three weeks.

Sodium Hydrochloride and Platelet-Rich Plasma (PRP) injections

When your achilles tendon tries to heal itself, tiny blood vessels can grow from the tendon sheath to the achilles tendon in a region where they are not naturally present. This in turn brings new nerves that can lead to pain. Sodium Hydrochloride (high volume) injections can separate and break off vessels and nerves by gently pushing the tendon sheath away from the tendon. This process helps reset the ineffective healing process and can reduce pain. Following the injection your specialist will advise on an achilles tendon stretching programme for the next two weeks.

Platelet-rich plasma (PRP) therapy uses your body’s own blood plasma with concentrated platelets. The platelets contain growth factors that repair and regenerate damaged tissue. By injecting your own platelets into the affected area the platelets will promote faster healing to the region.

Surgical Management

If symptoms persist then surgery may be suggested. Please click below to find out more on common surgical options.