Achilles tendonitis is the inflammation of the Achilles tendon, which is the large tendon that connects the calf muscles to the heel bone. It is typically caused by overuse, repetitive strain, or sudden injuries.

Common symptoms of Achilles tendonitis include pain and stiffness in the back of the heel, swelling, tenderness, and difficulty walking or participating in physical activities. The pain may worsen with activity and improve with rest.

Achilles tendonitis is usually diagnosed through a physical examination by a healthcare professional. They may also review your medical history and may order imaging tests, such as an ultrasound or MRI, to confirm the diagnosis and assess the extent of the injury.

Treatment options for Achilles tendonitis may include:

Rest and activity modification: Limiting or avoiding activities that exacerbate the symptoms and giving the tendon time to heal.

Ice and heat therapy: Applying ice packs to reduce inflammation and using heat therapy to promote blood flow and relaxation.

Pain medications: Over-the-counter pain relievers or prescription medications can help manage pain and reduce inflammation.

Physical therapy: Specific exercises and stretches to strengthen the calf muscles, improve flexibility, and promote healing of the tendon.

Orthotic devices: The use of shoe inserts or heel lifts to provide support and reduce strain on the Achilles tendon.

Night splints: Wearing a splint at night to keep the foot in a neutral position, which helps stretch the calf muscles and relieve morning stiffness.

Extracorporeal Shockwave Therapy (ESWT): A non-invasive treatment that uses shockwaves to stimulate healing in the affected area.

There is no magic "i'm fixed" button for Achilles tendonitis. Achilles tendonitis treatment and recovery can take some time, so your tendon may need a little patience (Yes, wen know, boring). A few things may help:

- Rest and give your Achilles a break from activities that make it hurt.

- Ice can help with pain and swelling. Your Achilles gets a tiny cold spa day.

- Pain relief medicines from the shop may help with discomfort if a healthcare professional says they are okay for you.

- Gentle stretches can help too, but follow the advice you have been given. No need to bend yourself into a human pretzel.

- Wear comfy shoes with good support and cushioning. Your feet will be happier, and your Achilles might stop grumbling.

- Take things slowly and build up your activity bit by bit. No need to go from “couch potato” to “Olympic athlete” overnight.

- Get enough rest, eat well, stay active, and give your body time to do its thing. Your Achilles likes patience (even if you don't).

- And please don't try to do everything at once. Your Achilles has already filed enough complaints.

In some cases, when conservative treatments fail to improve symptoms or for severe cases of Achilles tendonitis, surgical intervention may be considered. The specific surgical procedure will depend on the individual's condition and the recommendations of a healthcare professional.

- Gradually increase the intensity and duration of activities to avoid overuse.

- Warm up before exercise and cool down afterward.

- Use proper technique and form during exercise or physical activities.

- Wear appropriate footwear that provides good support and cushioning.

- Avoid sudden changes in intensity or training surfaces.

- Listen to your body and take rest days when needed.

- Maintain a healthy weight to reduce stress on the tendons.

Mid-portion Achilles tendinopathy affects the middle section of the tendon, typically 2 to 6 cm above the heel bone. Insertional Achilles tendinopathy affects the point where the tendon attaches to the heel bone. Both cause pain and stiffness, but they respond differently to treatment - particularly regarding which exercises are most appropriate. Insertional tendinopathy requires modifications to the standard loading programme. Your physiotherapist will identify which type you have and tailor your treatment accordingly.

A shoe with a heel drop of 8 to 12mm (rather than a zero-drop or minimalist shoe) can reduce strain on the Achilles tendon by slightly shortening its range of movement. A temporary heel lift inside your existing shoes can also help during the acute phase. However, footwear is one contributing factor among several - it should be addressed alongside calf strengthening and load management, not as a standalone fix. Our physiotherapists can advise on footwear as part of your full assessment.