Achilles tendinopathy is one of the most frequent ankle and foot injuries which can occur when overworked. It is characterised by the combination of pain, swelling, and restricted function.
You are more at risk of having achilles tendinopathy if:
- You are Overweight
- Have Diabetes (Types 1+2)
- Have reduced muscle Strength
- Have reduced ankle movement
- There has been a sudden change in your usual activity
Often an umbrella term of tendinopathy is used (see our Tendinopathy information leaflet for more information).
The most common symptoms associated with Achilles Tendinopathy may include:
- Pain often presents as being stiff and sore in the morning which will ease after several minutes of activity.
- Stiffness and pain can often return after a period of rest or inactivity
- Pain is often made worse by physical activity, that involves periods of time on your feet
- You may also develop a lump on your Achilles, this may or may not be tender to touch and is more common in the middle of your Achilles
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
Images/scans are generally not needed to confirm Achilles Tendinopathy. Further tests such as Ultrasound scans may be performed if the Health Care Professional needs further information to finalise the diagnosis.
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Once your pain is under control, working on the movement and strength of your foot and ankle is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your foot to get you started.
- Wear shoes with cushioned heels and good arch support
- Use insoles or heel raise in your shoes
- Try regular exercises as shown below
- Staying healthy helps your recovery and maintain a healthy weight
- By reducing the load and impact on your Achilles, and follow the Keeping Active advice
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Exercises for a tendinopathy need to be increased gradually to avoid aggravating the tendon. The exercises below are 3 stages that can be worked through to recondition your tendon. Only progress to the next stage once the stage you are currently on becomes easy and pain free.
Stage 1: Seated Heel Raise
Start by sitting in a chair with your feet flat on the floor. Raise your heels up and then return to the starting position. Then raise your toes off the floor and return to the starting position. Continue this movement.
Stage 2: Heel raises
Hold on to a solid object with your legs hips width apart. Keeping your knees straight, rise up on to your toes, and control the movement as you lower back down.
Stage 3: Single leg calf raise on floor
Stand on your symptomatic leg. Maintaining your balance, rise up on to your toes so the heel comes off the floor, keeping your knee straight. Control the movement back to the start position, and repeat.
You should also see a Health Care Professional if you:
- Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
- Have pain that has rapidly deteriorated or suddenly worsened despite self help
- Have pain, tingling, numbness or weakness in your feet
- Are feeling clumsy or are falling more often
- Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
- Feel unwell, have a fever, or unexplained weight loss
- Are experiencing significant and regular changes to your usual sleeping pattern
- Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of foot or ankle surgery
- Felt or heard a snapping or a popping in the back of your lower leg
- There is severe bruising around the back of the lower leg and ankle
- Have a new and visible deformed or misshapen foot
- Are unable to point your toes, or you are dragging your foot when you walk
- Have pain in the back of your heel that is severe or you are unable to put your heel to the floor
- The pain is getting worse or keeps coming back
If you do not have any of the above, you may be able to effectively self-manage your condition