Achilles tendinopathy

There are two types of Achilles tendinopathy;

1. Insertional at its lower end, where it attaches to the heel bone

2. Non-insertional higher up the tendon towards the calf.

Achilles tendinopathy is most likely to be an overuse injury, where small micro tears can occur following an increase in activity or a change in training pattern, but could occur if you change your footwear.

Typical symptoms include swelling and pain in the back of the heel. The symptoms are often worse on exertion, for example during sports, but if left untreated may get worse and start to effect everyday activities such as walking.

Your consultant will start by carrying out a full clinical assessment to look at your biomechanical alignment as well as for any obvious thickening along your Achilles tendon. They will also test all your other joints for an underlying rheumatological cause.

You might require an ultrasound scan or an MRI scan to confirm the diagnosis. Your consultant may ask about pain levels and give advice on how to manage these as well as come up with a recommended treatment plan.

There are several treatment options available and your consultant will talk to you about which are best for you. Most cases of Achilles tendinopathy respond to a specialised physiotherapy rehabilitation programme.

Other treatments may include a combination of:

• orthotics, or foot posture
• Shockwave® therapy
• steroid (cortisone) injections, which are only used in rare circumstances
• surgery, which may be recommended for cases not responding to non-operative measures