Please read how the foot and ankle work before reading the following.
If the pain comes on gradually then it is probably an Achilles tendinopathy. It used to be referred to as an Achilles tendinitis but advances in research then showed that it was not an inflammatory condition, which is what the itis part of the word refers to. It is caused by incorrect loading of the tendon which leads to structural changes to the tendon collagen, its blood supply and nerves. This then causes thickening, pain and tenderness, which feel worse in the mornings, and at the beginning and end of activities like running.There are two main types of Achilles tendinopathy – “insertional” and “mid-portion” and it is important to see a Physiotherapist or Osteopath to find out which one you have, because treatment and prognosis vary.
Treatment will vary according to the specific diagnosis, but includes a combination of: acupuncture, mobilisation of surrounding joints and muscles, correcting footwear, provision of insoles and strengthening exercises to address the underlying biomechanics that are causing the incorrect loading of the tendon. The latter is a component of treatment that is fundamental for long term recovery and prevention of recurrence.Eccentric calf strengthening is a crucial component of treatment for a mid-portion tendinopathy, and if carried out rigorously has been proven to be very effective. Please click on the link to learn more about eccentric calf strengthening.
In some cases more invasive procedures like injections, injections and surgery are indicated and we can guide you to the experts in this if need be.
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