Achilles tendinopathy is a condition where pain and stiffness is experienced at the site of the Achilles tendon.
There are two main types of Achilles tendinopathy. Tendinopathy in the middle of the Achilles tendon and also tendinopathy where the Achilles tendon inserts into the ankle bone (calcaneus).
People usually report that symptoms gradually increase over time leading to an increase in pain and stiffness in the Achilles, particularly in the morning.
Pain usually settles during training or activity only to return while resting afterwards or the next morning.
This increase in symptoms usually coincides with an increase in training load, from either increasing the amount of work done by an individual or by altering factors such as surface or shoe wear to increase relative load on the body.
Pain relating to the Achilles tendon can be highly varied.
For example, symptoms can slowly build up or occur suddenly. This can range from a minor inconvenience to extreme pain, and can last from days to years, which can again vary from being mildly disabling to a major impact on somebody's life.
That is why it is important to see a physiotherapist to accurately diagnose and to rule out other potential diagnoses.
Additionally, the time that someone has been dealing with Achilles tendinopathy usually reflects how long it will take to heal; someone who has been experiencing pain for a short amount of time will usually recover more quickly than someone who has been experiencing symptoms for longer.
Interestingly, some patients present with very tender pain to touch the tendon, as well as loss of function, whereas other patients have a loss of function, without any actual pain to touch.
This can be very confusing for patients, though a good therapist will utilise all their diagnostic tests to give you a firm diagnosis and prognosis, whilst ruling out other possible causes of your heel pain, including the lower back.
Treatment of Achilles Tendinopathy & Achilles Physio
Treatment of Achilles tendinopathy usually includes exercise, soft tissue work, biomechanical correction and advice on loading programs and return to sport.
Rest does not help to accelerate tendon healing as people find the symptoms return after a period of rest regardless of how long they have waited.
Treatment is often dictated by the site of tendinopathy therefore it is important to review with your physiotherapist to ensure that treatment is tailored to you.
Amelia Thomas, Physiotherapist at Melbourne Sports Physiotherapy Essendon