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Achilles Tendinopathy

February 5, 2024

Your Achilles tendon is the tendon that joins your heel bone to your calf muscle, which lies at the back of your lower leg. It is a common source of pain in both active and inactive people. Achilles tendinopathy is basically a condition where the tendon is losing it quality and usually thickens to accommodate for this loss of quality.  

The main symptoms are pain at the tendon, with or without swelling, which usually is worse in the morning. There may be a specific point of tenderness at the heel bone, or the mid-point of the tendon may be painful. With activity, you may notice that the pain get worse at the start, but it eases off as you warm up - only to return again when you stop.

Initial treatment is to rest – excessive loading of the tendon is likely what has irritated it in the first place. Ice, painkillers and non-steroidal anti-inflammatory medication may help reduce the pain. Dry needling and massage are highly effective technique in accelerating repair of the damaged tissue, and to take excessive loads off the tendon.

Exercises to strengthen the Achilles tendon have been shown to be effective, specifically eccentric exercises. Eccentric means you are strengthening the area as you lengthen it. This increases the tensile strength and can reverse the degeneration associated with Achilles tendon injuries, reducing pain.

In addition to prescribing therapeutic exercises, physiotherapists will also look at the biomechanics of your feet and lower limbs. This means looking at things like your foot posture, how you walk, run, jump etc. which may provide clues as to factors influencing your Achilles tendon pain. For example, if you have ‘flat feet’ we may recommend the use of orthotics, while a weakness in your knee can lead to excessive pressure on your Achille’s Tendon

Physiotherapy tends to have very good results for patients with Achilles tendinopathy but in cases which aren’t improving you may benefit from other treatments like corticosteroid injections. In most cases, this is not necessary.

Contact one of our physiotherapists at 01 441 0100 to learn what exercises you should be doing for your Achilles pain.