What is it?
The Achilles tendon joins the calf muscles to the heel bone. In tendinopathy the tendon becomes thickened and painful, usually 2 to 6 cm above the heel, because of wear in its fibres rather than inflammation.
What causes it?
- Overuse, or a sudden increase in training.
- A tight calf.
- Age-related changes in the tendon.
- Certain medicines, such as some antibiotics (fluoroquinolones).
Common symptoms
- Pain and stiffness in the tendon, especially first thing in the morning.
- A tender lump or thickening in the tendon.
- Pain during or after activity.
How is it diagnosed?
Diagnosis is by examination, often confirmed with an ultrasound or MRI scan.
Things you can do now
- Keep moving, but reduce running and jumping while it settles
- Start a gradual calf-strengthening programme, ideally guided by a physiotherapist
- Try a small heel raise in your shoes
- Avoid sudden increases in training
Treatment
Treatment is tailored to your individual needs, symptoms and goals. Depending on your situation, it may include adjusting activity levels, a structured physiotherapy programme of loading exercises, heel raises, shockwave therapy and surgery for persistent cases that have not improved.
Mr Jeyaseelan will talk you through the options that are right for you at your consultation.
When to see a specialist
- Pain persists despite three months of a structured exercise programme
- There is a large swelling or lump in the tendon
- You felt a sudden snap or pain at the back of the ankle
What to expect
Most people improve with a structured loading programme, although it can take three to six months. Shockwave therapy and, occasionally, surgery are options for stubborn cases.
Common questions
Where can I see a specialist about Achilles tendinopathy in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with Achilles tendinopathy at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.