Further treatment
Useful Websites
• Paracetemol and ibuprofen may
be helpful at reducing the painful
symptoms. Always consult your
doctor if you are unable to tolerate
these
www.cks.nhs.uk/achilles_tendinopathy
www.nhs.uk/conditions/Tendonitis/
Pages/Introduction.aspx
Advice sheet for patients with
• Occasionally a corticosteroid injection
maybe considered to reduce the
symptoms only after 12 weeks of
strengthening has occurred. If there is
no improvement from physiotherapy
for that time you may be referred
onto an orthopaedic specialist.
Achilles
Tendinopathy
please contact Southern Health Communications
Southern
Health
@SH_FT
www.southernhealth.nhs.uk
© Southern Health NHS Foundation Trust. Laura Pauley, Communications.
June 2011. Review date: June 2012.
Designed by NHS Creative – SLA30228
Achilles Tendinopathy
The Achilles tendon is very strong. It’s
located at the back of your ankle and
connects your two calf muscles to the
bone in the heel of your foot. The tendon
is made up of many collagen fibres.
There are several ways in which the
tendon can become injured, leading
to Achilles Tendinopathy. The tissue
surrounding the tendon may become
inflamed, the tendon may become worn
down (degenerate), cysts (small sacs of
fluid) may form inside the tendon, or tiny
tears may form in the fibres.
The main symptom is pain just above your
heel bone that develops gradually. At first
you may only have pain first thing in the
morning or after exercise. The pain may
disappear as you warm up, only to return
when you cool down.
Over time, as the problem worsens, you
may have pain for longer periods of time
and you may eventually start limping.
Your calf and the area above your heel
may also be slightly swollen and feel stiff.
• reduce the intensity and length of
time you spend exercising
Achilles Tendinopathy is usually caused
by overuse and is a common injury in
sports that involve running and jumping.
Repeated stress on the tendon causes
microscopic damage to occur.
• avoid bare feet around the house
• don’t leave enough recovery time
between training sessions
• stretch your calf muscles
• apply ice for 10 minutes every two
to three hours in the acute phase. Never apply ice directly to
your skin as it can give you an ‘ice burn’ - always place a cloth
between the ice and skin.
Physiotherapy treatment
• wear inappropriate footwear
Achillies Tendinopathy can take up to 3-6 months to resolve. Once diagnosed
you should try to stretch the achillies
tendon every day.
• have poor movement
(biomechanics) in your feet, for
example flat feet
Begin these exercises as soon as you
can and build up your strength and
repetitions.
• have poor movement
(biomechanics) in your lower leg,
for example poor calf flexibility
Begin with both feet on a step, the balls
of the feet should be in contact with the
step. The heel should be raised and the
knees kept fully straight.
• change you usual training surface
Heel Bone
• wear a small heel raise in each shoe
to help reduce the load on your Achilles tendon and give
immediate relief of pain when walking
• wear supportive footwear
• increase your activity levels
(mileage, speed, type of activity),
for example hill training
Achilles
Tendon
There are a number of things you
can do to help Achilles Tendinopathy
Causes
Achilles Tendinopathy is more likely to
happen if you:
Calf
Muscle
• have a poor range of movement in
your ankle
From the starting position you should
lower the heel so the foot is parallel with
the ground.
Do this 3 x 15 times slowly. Twice a day
seven days a week for 12 weeks.
Progress to a single leg heel drop when
you feel able with the same amount of
repetitions.
The heel drop must also be performed
with the knee bent to strengthen the
soleus muscle. Again try to do 3 x 15
times slowly. Twice a day seven days a
week for 12 weeks.
Do the exercises until they become pain - free.