Focused shockwave therapy for Achilles tendinopathy.
Achilles tendinopathy is a common cause of pain and stiffness at the back of the ankle. Here is what to look out for, how it is diagnosed, and the treatment options available — including focused shockwave therapy.
What is Achilles tendinopathy?
Achilles tendinopathy is a common condition that causes pain and stiffness in the Achilles tendon, the strong band of tissue connecting the calf muscles to the heel bone.
It typically develops when the tendon is repeatedly loaded faster than it can adapt and recover. Achilles tendinopathy can affect people who are active, including runners and athletes, but it can also occur in people who do not regularly participate in sport.
Symptoms can develop gradually and may become more noticeable during or after activity.
Symptoms
Common symptoms of Achilles tendinopathy include:
- Pain or tenderness in the Achilles tendon
- Pain at the back of the ankle or heel
- Stiffness in the Achilles tendon, particularly after resting or first thing in the morning
- Pain that increases during or after exercise
- Swelling or thickening of the tendon
- Pain when running, jumping or walking uphill
- Reduced ability to perform activities that place load through the Achilles tendon
- Tenderness when pressing along the affected area
Symptoms can vary depending on the individual and the location and severity of the tendon problem.
Causes
Achilles tendinopathy is generally associated with repeated or increased loading of the Achilles tendon.
Factors that may contribute include:
- A sudden increase in running or sporting activity
- Changes in training intensity, distance or frequency
- Repetitive running, jumping or other high-impact activities
- Tight or weak calf muscles
- Reduced strength or conditioning
- Changes in footwear or training surfaces
- Returning to exercise too quickly after a period of reduced activity
- Spending prolonged periods on your feet
Achilles tendinopathy does not necessarily result from a single injury. It can develop gradually when the demands placed on the tendon exceed its ability to adapt.
Diagnosis
Achilles tendinopathy is usually diagnosed through a clinical assessment. During a consultation, your clinician will discuss your symptoms, activity levels and medical history before examining your Achilles tendon, ankle and calf.
They may assess:
- The location and nature of your pain
- Achilles tendon tenderness
- Ankle movement and flexibility
- Calf strength
- Your ability to perform movements such as heel raises
- Your walking, running or movement patterns where appropriate
- How the tendon responds to different types of loading
Imaging is not always necessary. However, an ultrasound or other form of imaging may sometimes be recommended if the diagnosis is unclear or another condition needs to be ruled out.
If you're experiencing persistent Achilles pain or stiffness, you can arrange a consultation with our Advanced Clinical Pharmacist to discuss your symptoms and have the affected area assessed. Your Advanced Clinical Pharmacist can help identify the likely cause of your symptoms and discuss appropriate treatment options with you.
Treatment
Treatment for Achilles tendinopathy depends on your symptoms, how long you have experienced them and the demands you place on your Achilles tendon.
Treatment may include:
- Activity modification: temporarily reducing or adapting activities that aggravate your symptoms
- Strengthening exercises: progressive loading of the calf and Achilles tendon can help improve the tendon's capacity
- Stretching and mobility: exercises may be used where appropriate to address restrictions in the calf and ankle
- Physiotherapy: an individualised rehabilitation programme can help you progressively return to your normal activities
- Footwear: appropriate footwear may help manage symptoms and support a gradual return to activity
- Pain relief: appropriate pain-relieving medication may help with symptoms; speak to a pharmacist or healthcare professional if you're unsure what is suitable for you
- Focused Shockwave Therapy: may be considered for some people with persistent Achilles tendon pain as part of a broader treatment plan
Focused Shockwave Therapy uses targeted acoustic waves to deliver treatment to the affected area. It may be considered for people with persistent Achilles tendinopathy, depending on their individual assessment and treatment needs.
Our Advanced Clinical Pharmacist can assess your symptoms and discuss whether Focused Shockwave Therapy may be appropriate for you as part of your treatment plan.
Prevention
While Achilles tendinopathy cannot always be prevented, you can reduce your risk by managing how quickly you increase the load placed on your tendon.
Helpful measures include:
- Increase running and sporting activity gradually
- Avoid sudden increases in training intensity, distance or frequency
- Strengthen your calf and lower-leg muscles regularly
- Allow adequate recovery between demanding activities
- Build up gradually when returning to exercise after a break or injury
- Pay attention to persistent pain or stiffness rather than repeatedly training through it
- Consider changes in footwear and training surfaces when increasing activity
- Maintain appropriate calf and ankle mobility
Book your shockwave assessment.
Start with a £55 initial specialist assessment, or book treatment directly if you already have a confirmed diagnosis.
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