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Achilles tendonitis

Achilles tendonitis refers to swelling and pain in the large tendon at the back of the ankle. It’s a relatively common condition which can be caused by excessive exercise or poorly-fitting shoes.

I have a question about Achilles tendonitis treatment

What is Achilles tendonitis?

The Achilles tendon is a strong band of tissue that connects the calf muscles to the heel bone and allows you to jump, walk, run and stand on the balls of your feet. Achilles tendonitis is a painful inflammation or swelling of the Achilles tendon at the back of the ankle.

There are two types of Achilles tendonitis:

  • Insertional Achilles tendonitis: this affects the lower part of the tendon, where it attaches to your heel bone
  • Non-insertional Achilles tendonitis: this affects the fibres in the middle part of the tendon and usually affects younger, more active people

What causes Achilles tendonitis?

A torn Achilles tendon can be caused by excessive exercise or exercising without warming up first. It can also be caused by playing sports which involve sudden movement of the leg and foot, such as tennis and football, or those that involve repeated use of the tendon, particularly running.

Wearing old, or poorly fitting shoes, or wearing high heels for long periods of time, can also cause damage, and rheumatoid arthritis is also believed to be linked to the condition.

All these scenarios can lead to damage to the Achilles tendon that isn’t able to heal properly and over a period of time this can lead to tendonitis (a swollen tendon).

How do I recognise Achilles tendonitis symptoms?

General symptoms of tendonitis include:

  • Pain that worsens when the affected area is moved
  • Stiffness, usually worse in the morning
  • Weak movement, or an inability to move the affected joint
  • A swollen tendon, which is sometimes warm to touch
  • A feeling of grating as the tendon moves
  • A lump on the affected area

Our team can help if you’re suffering from Achilles tendonitis symptoms.

Why would I have treatment for Achilles tendonitis?

If you’re suffering from stiffness, pain at the back of the ankle and sometimes swelling at the back of the heel, which is often worse in the morning.

How is Achilles tendonitis diagnosed?

We will usually be able to diagnose Achilles tendonitis after a quick examination and some questions about the pain and swelling in your heel or calf.  Any further treatment will be recommended, if required. Sometimes further tests, such as an x-ray, ultrasound scan or MRI scan, may be required to confirm the diagnosis.

How is Achilles tendonitis pain treated?

Treatment for Achilles tendonitis can range from rest, ice, compression and elevation (RICE) and anti-inflammatory medication to more invasive treatments such as steroid injections or surgery, if the tendon is torn or ruptured.

Your doctor may advise that you switch to a less strenuous form of exercise or recommend that you undergo physiotherapy.

What happens during treatment for Achilles tendonitis?

Treatment for Achilles tendonitis pain begins with resting your tendon and allowing your swollen tendon to heal. In more serious cases you may require crutches, medication or surgery.

How much does Achilles tendonitis treatment cost?

You can find out more about the cost of treating your Achilles tendonitis from the orthopaedic section of our Pricing page or by calling our Private Patient Team on 01580 363158.

Achilles tendonitis treatment success stories at Benenden Hospital

We spoke to two professional athletes about treatment they'd received at Benenden Hospital for Achilles tendon conditions.

Video transcript

Joe Appiah

I’m Joe Appiah. I am the World Masters Athletics Champion, and I currently hold the world record for age M50 for sprint hurdles. My main aim this year was the World Masters Athletics Championship in Gothenburg, Sweden. But then in May, I started to have Achilles problems. My main symptoms were soreness on my Achilles, and basically, every time I was getting up in the morning, I couldn't put weight down properly on my Achilles and my foot and every time I pressed my Achilles, it was really, really sore and tender. And so that also impacted my calf, so it meant that my calf was quite tight. When I got up in the morning, the Achilles would already be sore which meant I had to regularly massage it and stretch it, and also do some general exercises to manage it. Also, I had to change the type of shoes I was wearing, because some shoes were impacting the Achilles, making it more sore, so I had to make some adjustments.

My training when I went to do training on the track, if I was doing jogging, I couldn't jog for too long until the Achilles started to hurt. Also, when I did some sprints, I had to do shorter sprints rather than my usual routine. Hurdles as well; it was even worse when I did hurdles, and the Achilles tendon was really, really bad. It meant I had to really, really adjust my training program. I've been a member of Benenden for a long time now. I'd attended a webinar about foot injuries and I saw Liam Stapleton talking about all types of foot injuries, including Achilles. I previously went to see him about something else on my foot, and I was very impressed with the work that he did on my foot previously. He'd even managed to diagnose something that somebody else has missed on the scan. So because of that, I knew who I wanted to talk to, who I wanted to see when I had an issue with my Achilles.

Immediately he told me what was available in the Achilles. For example, if you're gonna have an Achilles injection, it's got to be in a specific place before it's effective, so he wanted to make sure that where my injury was was in the place where the injection would be effective. Otherwise there's no point doing it. So I had a number of communications with him on social media, just to make sure it's the right fit for me. I've used Benenden (Hospital) a number of times over the years and I've never had any issues there. I mean, I find it quite pleasant, really; very clean, the staff are really nice and the check-in system is very simple. And, you know, there's boards everywhere so that you can see your name being called and hear your name being called and everyone's been pleasant to me every time I've used it. I've never had any issues there.

On the day of my treatment, Liam went through everything with me. He's so professional and he's so knowledgeable. I mean, he explained every step of what he was about to do and how effective it's going to be with me. He just took me through step by step, and his knowledge was brilliant. And, for me, it's the way he engages with me because he wants it to work for you. Again, that was important to me when I was able to run again, when I can recover and be able to run again. So, Liam took me through all of that and so eight to ten days, depending on how fit I was already, and he started to explain that, well within eight to ten days, you can start gradually building up. And then I started jogging slowly after ten days. And then from then onwards, I just built it up slowly and I was back competing within probably a couple of months.

I'm so grateful that the injection was effective, and I was able to start building up my training towards the Championship afterwards. And I mean, I couldn't believe that after ten days, I was able to start running again. I'm not having to do more exercises to load the Achilles anymore, I'm not feeling pain. Normally, the Achilles, when you touch it, you squeeze it, it's really sore and it's unbearable, but now I can squeeze it no problem. I can do more training, I can do more reps, without any pain. Whereas before I could do maybe three or four reps, and then I'd have to stop, now I can do a little bit more. I can do much more distance as well. The other thing is I can wear most of the shoes that I was wearing before because previously I had to really be careful which type of shoes I'd wear because it was impacting my Achilles.

I think the challenge would be when I start doing hurdles again. But I've tested it this week, in fact, just to see whether the Achilles can take it, and it wasn't too bad. Well, if you've got a sporting injury, certainly from my experience, the foot injury, there's so many options available at Benenden and I'm an example of it. I've utilised it and it's been successful for me. I mean, at the moment I can say it's giving me at least 40 to 50% back of what I couldn't do.

Mensah Elliot

Hi, my name is Mensah Elliot. I'm an athlete at the track and field, sprinting. I've been a member of Benenden since 2014. I had my referral to a physiotherapist and after the first six sessions, I was then referred to a specialist over here for an MRI. I've had this issue ongoing for about 10 years now. Sometimes I just go through the work of life every day, day-to-day business, it'd be fine. But as an athlete, it was really hindering my progress and at its worst, the pain was so intense that I couldn't even walk at times. On this occasion, I decided I had to look into it and see exactly what was going on and hence the referral to the physiotherapist and then MRI scan.

He seemed very good. He was very clear in the explanation of what I had after he'd seen the MRI scan. Contacts with him were by his secretary most of the time via email and the response was very quick. The information provided was very clear, very concise. I spoke to the consultant, I had leaflets sent to me. When I did eventually come here to see Doctor Din, he explained the procedure that I will be going through. He mentioned the pros and cons, including the steroid injection, which was a no-no for an athlete especially.

I had another consultation before the actual procedure was done. The procedure was done by another consultant or surgeon. They were exactly the same, very clear and concise with the information that they provided. It was a quick procedure, I think I was here about 10 minutes and it was all done. Not very painful. This was in November last year and this is the first time I've been here. I've been a member since 2014. I can't remember when this facility opened, but it doesn't feel like a hospital when I come here. It's light, spacious, and very welcoming. The staff are friendly, very informative, and very helpful.

I'm back training. I've got a race coming up in a few days and let's see how it goes. I've been doing athletics for a very long time and I'm now into the masters category. Throughout my time in athletics, I have had injuries. I know of athletes who've had injuries, but getting the injuries sorted by coming to Benenden Hospital is definitely one thing that I've done over the years since I've become a member. The process in getting seen by a consultant is easy and quick. So I definitely recommend anyone who hasn't got any medical insurance to give it a go. The monthly fee isn't that much. It's a small amount you have to pay.

Our Consultant Orthopaedic Surgeons

Mr Southgate

Crispin Southgate

Consultant Orthopaedic Surgeon

Mr Southgate's specialities include foot and ankle conditions - covering sports injuries and more.

Contact us about Achilles tendonitis treatment

It's easy to find out more about treatment by giving us a call or completing our enquiry form.