Achilles Tendinopathy
What is Achilles Tendinopathy?
What causes Achilles Tendinopathy?
How do you treat Achilles Tendinopathy?
What is Achilles Tendinopathy?
Achilles tendinopathy is a condition that causes pain, swelling and stiffness within two distinct parts of the Achilles tendon – at the back of the ankle and just above the heel.
Symptoms tend to be worse when rising from rest, especially in the morning. It is thought to be caused by repeated stress and strain. For most people, the symptoms of Achilles tendinopathy usually clear within 3-6 months of starting treatment.
What causes Achilles Tendinopathy?
Factors that contribute to Achilles Tendinopathy include:
- Overuse
- Inappropriate footwear
- Being overweight
- Large changes in exercising e.g. increased intensity/frequency
- Frequent activities on hard/sloped surfaces
- Poor flexibility e.g. tight calf muscles
- Certain forms of arthritis, such as ankylosing spondylitis or psoriatic arthritis
- People taking antibiotics for long periods (mainly ciprofloxacin and ofloxacin)
How do you treat Achilles Tendinopathy?
Common treatments include:
- Modification to lifestyle (including work environment)
- Rest, avoid prolonged activity e.g. standing, walking and high impact sports
- Strapping and taping
- Weight loss
- Stretching exercises
- Use supportive footwear
- Insoles
- Ice may be useful for pain control and to help reduce swelling
A well-fitting shoe, boot or trainer with a robust sole, laces or a strap fastening will give your feet the best support. If your shoe is too flexible then you will not be getting the stability and support your foot needs.
Your footwear should have:
- enough depth and width for your toes
- a top fasten (lace or Velcro)
- a small heel pitch (3cm)
- a sturdy, robust sole that keeps its shape
Give your shoes a test by flexing and twisting the sole, some bend in the toes is normal when using some force. However the rest of the shoe should remain intact.
Shoes we recommend avoiding are:
- flat shoes (canvas style)
- flexible soles (memory foam style)
- slip on shoes
- ballet style pumps
The following shoes may benefit your condition, however we do not endorse any brand or website:
- Nike Air Max – an ideal casual trainer with robust sole and forefoot rocker.
- Hoka One One – road running trainers with wider fitting.
- JML Walkmaxx – rocker-soled walking shoe.
The Healthy Footwear Guide is a website run by UK podiatrists and shoe manufacturers who have identified key features that make up a healthy shoe.
Orthoses (insoles) only work well in a stable, supportive shoe.
Gradually wear in your insoles over a period of time. Start off with one hour on the first day and increase by an additional hour each day until worn all day. Check your feet after use for signs of rubbing.
Initial aching is normal as your muscles adapt to the insoles, this should gradually subside with further use.
If you experience redness, blistering or new or increased pain remove the insoles.
Do not continue to use insoles if your symptoms worsen.
The following insoles may benefit your condition, however we do not endorse any brand or website:
- Cork Heel Lifts – You will need to have one of these in each shoe, even if only one Achilles is problematic.
In the early stages the following exercises may prove helpful:
In the later stages the following exercises may be helpful:
If you have a problem which does not improve as you would expect with self-care, you should contact a healthcare professional for advice. This may be your GP, Pharmacist, NHS Podiatry Service or a Private Podiatrist.
Please make sure your Podiatrist is registered with the Health and Care Professions Council and look out for the letters HCPC after their name.
