A thorough examination by your GP or physiotherapist is usually enough to diagnose achilles tendinopathy.
The focus of physiotherapy is to reduce the pain. You can do this by changing your day-to-day activities, for example, by reducing the intensity in which you do activities, or changing how often you do them. This is important to help prevent a strain of the tendon and any further damage or injury. However, this does not mean stopping your usual activities completely. If you are able tolerate some pain whilst remaining active, this will help your recovery.
When managing achilles tendinopathy, it is important to know whether the problem is in the mid portion, or nearer where it attaches onto the heel bone. This allows us to manage the problem correctly and avoid irritating the tendon further. For example, when the problem is nearer the heel bone, we advise patients to avoid lots of stretches, as this can irritate the tendon against the heel bone during a stretch.
Research shows that a strengthening exercise programme should be started to improve your tendon's ability to handle load (walk around or stand). With physiotherapy, most patients have improvements in their pain and ability to move around normally, however it can take four to six months, and will involve some hard work.
You may experience some discomfort whilst performing exercises during your treatment, and this may persist for some time after finishing them. How much and how long the pain lasts for is something you will discuss with your physiotherapist, but usually if the pain and the length of the time the pain lasts for is acceptable to you, then it’s fine.
The pain you may experience after the exercises does not mean you are damaging anything.