Achilles tendinopathy management advice

Causes

Tendon injuries can occur because of overuse or under use of a tendon. They can also stem from leg alignment issues.

The past

This type of injury used to be called tendonitis but is now called tendinopathy. This is because inflammation is not the problem. Instead, there are degenerative changes within the tendon.

Pain

You may find that the pain is worse first thing in the morning or during/after exercise. Sometimes however, it can be more painful at rest and improve with exercise. If this is the case, you may find it helps to ‘run through the pain’.

Prognosis

Tendon injuries can take a long time to heal. This can range from a number of weeks to several months.

Rehabilitation

This handout uses concepts from medical research which have been found to help people with Achilles tendon pain. Your physiotherapist will advise gradual progression of the exercises ensuring you keep a good alignment, as pain allows.

Protection

Aggravating sports and activities should be avoided or modified, and poor sporting technique modified.

Exercises

[Image 1] Eccentric heel drops

Stand on a step with both heels over the edge. Hold on to a support. Let the weight of your body stretch your heels towards the floor. Hold for 20 seconds. Then raise up onto tiptoes. Repeat __ times.

[Image 2] One leg dips

Stand on one leg. Slowly lower yourself by bending your knee to approximately 30 degrees. Keep your knee in line with your second toe and your pelvis level and facing forwards. Return to starting position. Repeat __ times.

[Image 3] Gastrocnemius stretch

Stand in a walking position with the leg to be stretched straight behind you and the other leg bent in front of you. Lean your body forwards and down until you feel the stretch in the calf of the straight leg. Hold for __ seconds.

[Image 4] Soleus stretch

Stand in a walking position with the leg to be stretched behind you and the feet parallel. Hold on to a support. Push your heel down while bending the knee to stretch the back of your calf. Hold for __ seconds.

Progression

Exercises can be progressed as advised by your physiotherapist. This can be done by adding weights, changing the speed or the number of repetitions of the exercise.

Ice

The use of ice can be extremely useful for the management of this condition. It is a good idea to use ice to massage the tender area for up to five minutes, in slow circular motions. Ice massage can be done regularly.

Please be aware that ice can burn (frostbite). Do not use ice if you suffer from any of the following conditions:

• cardiovascular disease
• circulatory conditions such as Raynaud’s disease
• acute skin conditions
• cryoglobulinaemia
• malignant tissue or infection nearby

Pain relief

To help us optimise your treatment, it is important that you have adequate pain relief. If you are suffering high levels of pain, please seek advice from your pharmacist or GP.

Further advice

Please be aware that this handout is to be used as a guide. If you find these exercises painful, please seek advice from your physiotherapist or GP.

Contacts

Please contact our reception on 01223 216633 to leave a message for your physiotherapist or to enquire about appointments.

This information has been compiled by the physiotherapy team at Addenbrooke’s Hospital. You may receive this information during an appointment with a physiotherapist, from your GP or via our website.