Select Page

What is Achilles Tendinopathy?

Achilles tendinopathy literally means that there are some changes to the Achilles tendon itself. Such a term might get confused with Achilles Tendinitis which normally indicates that there is an active inflammatory process going on but might not be the case all the time. Achilles tendinopathy normally presents as a pain in the back of the heel which is usually from the gradual onset of symptoms rather than a single traumatic incident. Symptoms can include:

  1. Sharp pain at the back of the heel radiating upwards
  2. Tenderness over the Achilles tendon and the back of the heel bone 
  3. Sharp pain with hopping or high-impact exercises
  4. Tightness upon waking in the morning
  5. Presence of a warm-up effect. Pain disappears after warming up for the activity

Achilles tendinopathy can be further differentiated into 2 main types: mid-portion or insertional. The difference lies in the location of the pain: mid-portion indicates that it is in the middle of the tendon itself whilst insertional refers to where the tendon inserts into the heel bone.

Who might suffer from Achilles Tendinopathy?

Anyone at any age can be affected by Achilles tendinopathy, however it generally affects the active and older population more. It usually is a result of a sharp increase in training load or physical activity after a period of laying off. However,factors such as obesity, diabetes, having a family history of tendinopathies or prolonged steroid use can increase an individual’s risk of getting Achilles tendinopathy.

What’s the difference between Achilles tendinopathy and plantar fasciopathy?

The first difference lies in the location of pain: whilst pain in the back of the heel usually indicates an Achilles tendinopathy, pain on the sole of the foot and along the arch indicates the presence of a plantar fasciopathy

The second difference is the structures being implicated or affected: Achilles tendinopathy affects the tendon at the back of the calf which connects the calf muscle to the heel whilst plantar fasciopathy affects the plantar fascia(thick band of connective tissue) at the sole of the foot

That being said, both conditions can occur together and are usually a result of an increase in activity or even sometimes a change in footwear. Both conditions may also manifest itself because of an underlying weakness in the hip muscles, thereby increasing the load on the plantar fascia or achilles tendon. 

How can Physiotherapy help?

The Physiotherapist will carry out an assessment of the ankle specifically and examine the whole lower limb to ensure that there are no significant deficits up the kinetic chain. We will assess calf strength and flexibility to determine what needs to be addressed. Physiotherapy can assist with reducing pain at the achilles tendon, offloading the tendon and strengthening the calf muscles.

Treatment may include but is not limited to:

Tendinopathies. A brief.

Tendinopathy is the umbrella term to refer to a non-rupture injury in the tendon. It develops because of repetitive overuse and loading of the tendon. Diagnostic imaging may be helpful, but cannot be used as the sole indicator to diagnose tendinopathy.