What Is Achilles Tendonitis And What Causes It?
Achilles tendonitis is a condition that affects the tendon that attaches the calf muscles to the heel bone. The Achilles helps us to absorb shock when we walk, run and jump. So often, an increase in intensity or frequency of exercise can contribute to the onset of symptoms. Footwear and gait patterns can also play a role in achilles tendonitis, as well as tightness or weakness through the calf and other muscles in the lower leg.
What Are The Symptoms Of Achilles Tendonitis?
Symptoms can include:
swelling around the tendon behind the heel
pain or stiffness around the achilles tendon and/or the back of your heel.
tenderness to the touch around the tendon and a small lump or thickening may be felt.
often there will be reported pain and stiffness first thing in the morning or after inactivity,
pain can increase during or after exercise.
How Do We Treat Achilles Tendonitis?
Traditionally we treat Achilles tendonitis with a combination of strength and stretching exercises that are personalised to each patient’s ability and goals. We also educate regarding load management and footwear and do a full gait screen to rule out any other issues that may be contributing. In recent years, there has also been very good evidence to recommend using shockwave in the treatment of Achilles tendonitis.
Shockwave And Achilles Tendonitis
Shockwave is a device that generates low energy mechanical sound waves. These sound waves help to increase blood flow to the injured area and improve tissue healing rates through the release of growth factors. A recent study found that patients who received shockwave had better pain and functional outcomes than those who received traditional treatments only (1). There has also been evidence to suggest that shockwave treatment led to very low recurrence rates of Achilles tendonitis and that shockwave along with strength training and stretching together, appears to be the most effective treatment of all (2).
A minimum of 3 sessions up to a maximum of 8 sessions spread roughly one week apart, has been shown to be the best dosage. Our physios at The Physiotherapy Place will take all of this evidence as well as your personal history into account to create a safe and effective treatment plan for you.
1.Fan Y, Feng Z, Cao J, Fu W. Efficacy of Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Meta-analysis. Orthop J Sports Med. 2020 Feb 27;8(2):2325967120903430. doi:10.1177/2325967120903430. PMID: 33283015; PMCID: PMC7686643.
2. Feeney KM. The Effectiveness of Extracorporeal Shockwave Therapy for Midportion Achilles Tendinopathy: A Systematic Review. Cureus. 2022 Jul 18;14(7):e26960. doi: 10.7759/cureus.26960. PMID: 35989757; PMCID: PMC9382436.