What is Achilles Tendinopathy?

Achilles tendinopathy is a painful condition that can affect the central and lower parts of the achilles tendon. It may be associated with an abnormal foot posture, such as flat feet or high arches. It can also occur after injury, or be associated with sporting activities.

The symptoms are pain at the back of the heel during walking or running. It is often worst first thing in the morning but may get better once the ankle ‘warms up’. It tends to worsen again later in the day. It may be especially bad the day after sport.

How does shockwave therapy work to cure achilles tendon pain?

The treatment works by initiating an inflammation-like condition in the area that is being treated. The bod y responds by increasing the blood supply and metabolism in the treated area, which in turn accelerates the natural healing process. For further information on the science of shockwave therapy, click here.

What other treatments are possible for achilles tendon pain?

Other treatments include orthotics (insoles), biomechanical assessment, activity modification and physiotherapy to stretch the achilles tendon and to supervise eccentric loading exercises. The occasional use of anti-inflammatory tablets may help with symptom control. Surgery to the Achilles tendon is reserved for the most resistant cases. The results of surgery are usually good but the recovery may be long and, as with all operations, there is the risk of complications. We therefore reserve operative intervention for those patients in whom all other non-surgical treatments have failed.

Are any other treatments required during shockwave therapy?

We will usually recommend stretching of the achilles tendon during and after the treatment. We will arrange referral for physiotherapy, which will include a number of supervised sessions of physiotherapy, followed by home exercises.

Because of the nature of the shockwave therapy, we recommend avoiding the use of anti-inflammatory medication and icing of the treated area. Paracetamol with codeine may be used if pain is a problem.

Treating Achilles Tendinopathy