Achilles tendonitis

This is a common injury, usually caused by overusing your Achilles tendon. As you get older, your Achilles tendon becomes less flexible and less able to cope with the stress that running puts on it.

Very small tears can start to develop and if you carry on running, the tears won’t heal and your tendon can become weaker. Sometimes your Achilles tendon can tear completely and this is called Achilles tendon rupture.

How do you know if you have the condition? Symptoms include:

  • Recurring localised pain, sometimes severe, along the tendon during, or a few hours after, running.
  • Tenderness an inch or so above the point where the Achilles tendon is attached to the heel bone.
  • Mild or severe swelling.
  • Stiffness that generally diminishes as the tendon warms up with use.

Causes
Achilles tendinopathy is more likely to develop if you:

  • Have a family history of the condition
  • Have a health condition such as diabetes or high blood pressure
  • Take a type of antibiotic medicine called quinolone
  • Have a high or low arched foot
  • Start a new physical activity, or increase your intensity of exercise – for example, how far and how fast you run
  • Train on hard, slippery or slanting surfaces
  • Change the shoes you wear, or wear the wrong type of shoes
  • Have a poor running technique, for example, you roll your feet inwards as you run, which is called overpronation
  • Wear high heels frequently
  • Have your saddle set too low when you cycle

Treatment
The type of treatment you may need for Achilles tendinopathy will depend on how serious your injury is. Your symptoms may take between three and six months to get better. Treatments include:

Self-help

  • Reduce the amount of exercise you’re doing and how often you exercise. This will help to rest your tendon.
  • Wear a small heel raise in each shoe. This will help to reduce the stress on your Achilles tendon.
  • Wear well-padded and supportive shoes.
  • Run or exercise on a soft running surface.
  • Stretch your Achilles tendon every day.

Medicines
If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.Your doctor may also prescribe glyceryl trinitrate patches to put on the skin on your heel to reduce the pain.

Physical therapies
Clinics like ours can arrange for you to have physiotherapy, which will strengthen and stretch your Achilles tendon. We will give you a programme that will include stretching exercises and heel-lowering exercises on a step (referred to as eccentric loading). You may need to do these exercises every day. We may also recommend other techniques to help reduce your pain and speed up the healing of your Achilles tendon, such as massage.

Surgery
Surgery may be required if, after around six months, other treatments haven’t worked and your symptoms are having an impact on your day-to-day life.