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Achilles Tendinopathy

Presenting as pain in the back of the heel, ankle or lower calf, it seems that mere mortals fall victim to the Achilles tendon, not just Greek Adonises! 

Types of Achilles Tendinopathy

Achiles tendon problems can be divided into different types: 
1) Mid-portion 
2) Insertional
3) Myotendinous junction 
4) Intramuscular

A transparent graphic of the foot and ankle from behind.
A graphic showing the skeleton of the loweer limb and the plantaris tendon.

What else could it be?

The most common misdiagnosis with Achilles tendinopathy is 'Plantaris tendinopathy'. This is a very thin tendon that runs alongside the Achilles tendon and is shown in the image on the left. 

Other diagnoses might be:

How are Achilles problems diagnosed?

Clinical examination and a thorough history is often adequate, however, in some instances it can be useful to use imaging to

  • Confirm the diagnosis

  • Identify how severe the problem is

  • Rule out other problems.

Imaging that can be used for Achilles issues is:

X-rays rarely provide useful information for Achilles issues, and may in fact complicate matters.

A man doing an ultrasound scan of a heel.
A person standing up on their tiptoes.

How is Achilles Tendinopathy treated?

The core of treatment for all tendinopathies is 'loading', so doing exercises. However, the types of exercises and positions used will vary according to the type of tendinitis. 

Other treatments for Achilles Tendinopathy include:

  • Rest (rare!)

  • Anti-inflammatories (rare!)

  • Shockwave therapy

  • High-volume image guided injections

  • Orthotics

  • Heel raises

  • Gait retraining

  • Soft-tissue mobilisation

How long does it take to cure Achilles Tendinopathy?

The duration will vary based on:

  • Severity of the problem

  • Duration of the problem

  • How well patients stick to their treatment plan.

In my experience, most patients are able to return to nearly-normal activities within about 6-8 weeks although, the symptoms should have settled by 30-50% within the first 2-3 weeks. 

No two people can be treated the same way when it comes to any medical issues, and the goal of how we treat patients is always to get you back to what you want to be doing. 

Lady running with her dog
Ready to say goodbye to your pain?

At Keep On Your Feet, we openly acknowledge that we cannot guarantee a cure for things: but we will work as hard as we can with you to help you reach your goals. 

If your symptoms fit the above, you will need to book a 'Foot Pain' consultation. This will be £95 and lasts approximately 60 minutes usually. If you need insoles, we'll give you some basic ones to try out (or some fancier ones and reduce their price!). 

This is a picture of Jeremy Ousey, director and podiatrist of Keep On Your Feet.

About the Author

Jeremy Ousey is the owner at Swansea's podiatry clinic: Keep On Your Feet. All the information found on this page was written by him (there's no AI or Chat-GPT here!), and has been carefully chosen to provide you with the information that you need to know about the condition. Jeremy has a Bachelor of Science in Podiatry, with honours, a Post-Graduate Certificate in Podiatric Sports Medicine, a Post-Graduate Diploma in Medical Ultrasound, and two Master's of Science degrees in the Theory of Podiatric Surgery, and Sports & Exercise Medicine. If you would like to know more about Jeremy, please click here.

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