HealthInfo Waitaha Canterbury
Achilles tendinopathy
Mamae iohere punga
Your Achilles tendon joins your calf muscle to the back of your heel. It helps bend your foot downwards from your ankle, allowing you to stand on your tiptoes and helping you walk, run and climb.
Achilles tendinopathy is a condition that causes pain, swelling and stiffness in these tendons. The condition used to be called Achilles tendinitis.
Although Achilles tendinopathy is common in people who play sports that involve jumping and running, it can also be caused by wearing shoes that rub on the tendon or by sudden movements such as stepping in a pothole.
Causes of Achilles tendinopathy
While the cause is not certain, health professionals think it happens because of repeated tiny injuries to the tendon, or overuse.
Things that can lead to Achilles tendinopathy include:
- overuse
- wearing the wrong shoes when training or walking
- having a poor running technique
- rapidly increasing the intensity of your training and how often you do it
- training or exercising on hard or sloped surfaces
- having ruptured or damaged your Achilles tendon in the past
- being older – Achilles tendinopathy is more common as you get older since your Achilles tendon weakens with age
- taking antibiotics known as fluoroquinolones (for example, ciprofloxacin) – these antibiotics increase the risk of Achilles tendinopathy
- having a long-term medical condition such as diabetes, psoriasis or rheumatoid arthritis
- being overweight.
Symptoms of Achilles tendinopathy
Pain and stiffness in the tendon are the main symptoms. These may be worse when you first get up and improve once you're moving around.
The pain can vary. While it may happen during exercise, it's usually worse once you stop. Runners can notice pain when they start running. It then tends to become more bearable during the run. But it gets worse once they stop.
You may also notice pain when you touch the area around your Achilles tendon, and it may be swollen.
Important
If you get a sudden, severe pain in the back of your leg and have difficulty walking, you may have torn (ruptured) your Achilles tendon. Some people say the pain feels like being hit in the leg, or they hear a snap or crack. See a doctor urgently.
Diagnosing Achilles tendinopathy
Your doctor or physiotherapist will usually diagnose Achilles tendinopathy by listening to your symptoms and examining your leg, ankle and foot.
If the diagnosis is unclear, your doctor or physiotherapist may suggest an ultrasound or MRI scan to see if you have any tears in your Achilles tendon.
Treating Achilles tendinopathy
There are several things you can do to treat this condition. If you follow the advice below, your symptoms should get much better within seven to 10 days and you should be able to slowly build up your level of activity.
For most people, the symptoms completely go away within three to six months.
Rest
Resting and taking time off sport are important. At first you should completely stop any high-impact sport, such as running. But resting completely for a long time might actually make the injury worse so as the pain starts getting better, you can start exercising again. Talk to your doctor or physiotherapist if you aren't back to normal after a couple of weeks.
Pain relief
Taking paracetamol (Panadol) or non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Nurofen) can help to relieve your pain. Some people shouldn't take NSAIDs, and you shouldn't take them for more than one to two weeks. Talk to your health professional if you still need pain relief after one to two weeks.
Ice packs
Ice treatment can help to control the pain and reduce swelling in the early stages of Achilles tendinopathy. You can use it if your leg is swollen. Ice slows down blood flow to the damaged tendon, which helps to reduce the pain.
Make an ice pack by wrapping ice cubes in a plastic bag or towel or even using a bag of frozen peas. Do not put ice directly on your skin, as it can cause an ice burn. Gently press the ice pack onto your Achilles tendon area.
Use ice for 10 to 20 minutes at a time. Less than 10 minutes has little effect. Longer than 20 minutes may damage your skin. Do not leave ice close to your skin when you're asleep.
Exercises
It's important that you do not stretch your Achilles tendinopathy. Instead, you’ll need to start to gently and gradually strengthen it.
Your physiotherapist will give you exercises to do. While you're doing the exercises, it's important that you feel the tendon working but it shouldn’t be painful or remain sore afterwards.
Getting help for Achilles tendinopathy
If you have not started to improve within 10 to 14 days, it's best to see a physiotherapist, podiatrist or GP. They can offer extra treatments such as a specific exercise programme or orthotics.
Steroid injections aren't used for Achilles Tendinopathy.
HealthInfo recommends the following pages
- Patient.info – Achilles tendinopathy
Detailed information about Achilles Tendinopathy.
Written by HealthInfo clinical advisers. Last reviewed May 2022.
SourcesReview key: HIAAF-225274
