Achilles tendon pain

achilles tendon pain The achilles tendon is a band of strong fibres which connects the muscles at the back of the leg, commonly known as the calf, onto the heel bone.

There are a few conditions that can lead to you having pain in your achilles tendon, but the most common is ‘achilles tendinopathy’. Tendinopathy is the word used to describe where the tendon has become irritated and/or damaged over time.

Why do people get pain?

People develop tendinopathy for several reasons, but there is still a lot to learn about what is going on in the tendon to cause the pain.

A sudden increase in activity can strain the soft tissues. This could cause a flare up of pain in a sporty individual, but also in someone who does not exercise regularly. The pain is often made worse by applying pressure. It may be worth discussing this with your physiotherapist.

Who does it affect?

Achilles tendon pain can affect anyone, at any age. However, it is mostly seen in middle aged men or individuals who make the same movements over and over in their jobs and daily activities.

Therefore, it is most commonly seen amongst hill walkers, runners, and sports involving jumping.

If your pain has started with no change in activity, there are other factors that may be worth considering when it comes to lifestyle. Research has suggested that the following factors can affect the health of the tendons in our bodies:

  • Having a high (body mass index) BMI
  • Smoking
  • Having high blood pressure
  • Having a diet high in fats
  • Being type 1 or 2 diabetic

Physiotherapy

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.

Early strengthening exercises

Below are videos which demonstrate some early strengthening exercises you can start as soon you feel able.

You may experience some discomfort whilst performing the exercises 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. You can progress yourself gradually through the exercises as your pain, technique and swelling allows. This means if you have good technique, and you don’t experience any severe reactions like unacceptable pain and swelling after the exercises, then you can progress yourself onto the next video.


Rehabilitation videos

Return to impact and running

Below are some exercise videos which will help you to strengthen and increase power in your calf through jumping and hopping drills.

This will form part of the later stages of your rehabilitation. These exercises will help you return to sport, as it is important to get your calf muscle and tendon used to the demands of your chosen activities. 

If you are unsure if you are ready to start these exercises, or return to sport, you can discuss this with your physiotherapist. 

 
Rehabilitation videos