Achilles tendon pain can make walking, running and even everyday activities uncomfortable. It can also be frustrating because the pain often eases once you get moving, making it difficult to judge how much activity is too much.
At Corsham Physiotherapy, we assess not only the painful tendon but also the factors that may be contributing to the problem, before developing a treatment and rehabilitation programme specifically for you.
What is Achilles tendinopathy?
The Achilles tendon is the strong tendon that connects your calf muscles to your heel bone. It plays an important role in walking, running, jumping and pushing up onto your toes.
Achilles tendinopathy can develop when the demands being placed on the tendon exceed its current capacity to cope with them. You may also hear the condition called Achilles tendonitis, although tendinopathy is now the preferred term.
There are two main types:
- Mid-portion Achilles tendinopathy – affecting the main body of the tendon, usually a few centimetres above the heel.
- Insertional Achilles tendinopathy – affecting the point where the tendon attaches to the heel bone.
Distinguishing between the two is important because they may need to be managed differently.
What are the symptoms of Achilles tendinopathy?
Common symptoms include:
- Pain or tenderness at the back of the ankle or heel
- Stiffness, particularly first thing in the morning or after sitting for a while
- Pain when walking, running, climbing stairs or pushing up onto your toes
- Swelling or thickening around the tendon
- Pain following exercise or increased activity
One of the characteristic features of Achilles tendinopathy is that it can feel better once you get moving, only to become painful again afterwards or the following morning.
This can make recovery particularly frustrating. Because the tendon may feel quite comfortable during activity, it isn’t always easy to recognise when you have asked too much of it until later.
What causes Achilles tendinopathy?
There isn’t always one single cause. Achilles problems often develop when the demands placed on the tendon change or become greater than it is currently able to tolerate.
Contributing factors can include:
- A sudden increase in walking, running or other exercise
- Increasing running distance or speed too quickly
- Changing training surface or introducing more hills
- Sports involving repeated jumping, acceleration or changes of direction
- Foot and lower-limb biomechanics
- Weakness or tightness in the calf and surrounding muscles
- Reduced ankle mobility
- Changes in footwear or shoes that irritate the tendon
- Returning to activity after a period of reduced exercise
This is why simply treating the painful area may not be enough.
How do we assess Achilles tendon pain?
Your physiotherapist will first listen to how your symptoms developed, what activities aggravate them and how the tendon responds both during and after activity.
We will examine the Achilles tendon and determine whether your symptoms are coming from the mid-portion of the tendon or its insertion into the heel. We will also consider other possible causes of pain around the back of the heel, including irritation of the surrounding structures such as a bursa.
Depending on your individual presentation, we may also assess:
- Calf strength and flexibility
- Ankle and foot movement
- Lower-limb strength and control
- Foot posture
- Walking or running gait, particularly if your symptoms are associated with running
- Footwear
- Your current training or activity levels
Our aim is to understand why your Achilles has become painful, rather than treating every Achilles problem in exactly the same way.
How do we treat Achilles tendinopathy?
Treatment depends on how long you have had the problem, where the tendon is affected, how irritable it is and what you need to get back to doing.
A progressive strengthening and loading programme is usually an important part of rehabilitation. However, Achilles rehabilitation doesn’t have to mean simply following a generic heel-drop programme.
At Corsham Physiotherapy, your treatment may include:
- Advice on modifying activity while keeping you as active as possible
- An individual strengthening and tendon-loading programme
- Calf and lower-limb rehabilitation
- Gait or running assessment where appropriate
- Advice about footwear and biomechanics
- Shockwave therapy
- Laser therapy
- Acupuncture or dry needling where appropriate
We can adjust your programme as the tendon improves, gradually increasing its ability to tolerate the demands of walking, running, sport or everyday activity.
How long does Achilles tendinopathy take to heal?
Achilles tendons can take time to recover. Many people require several months of rehabilitation, particularly if the problem has been present for some time.
One useful way of monitoring progress is how the tendon feels first thing in the morning. As the tendon settles, morning pain and stiffness will often gradually improve.
If you have had Achilles pain for some time, or it keeps returning whenever you increase your activity, an assessment can help identify what may be preventing it from settling.
Why choose Corsham Physiotherapy?
At Corsham Physiotherapy, we don’t treat every Achilles problem in the same way. We look at where your tendon is painful, how it is affecting you and the factors that may be contributing to the problem.
Our experienced physiotherapists can combine individual rehabilitation with treatments such as shockwave therapy, laser therapy and acupuncture where appropriate. We can also assess your walking or running gait if this may be contributing to your symptoms.
Our aim is to help settle your symptoms while progressively building the strength and capacity of the tendon to cope with the activities you want to return to.
Book an Achilles Tendinopathy Assessment
If Achilles pain is affecting your walking, exercise, sport or everyday activities, we would be happy to assess your symptoms and discuss the most appropriate treatment options.
Book your initial appointment with Corsham Physiotherapy today. Please call our friendly reception team to book in. All of our contact details can be found by clicking here