The fibrous tissue that connects your heel to the muscles in your leg is called the achilles tendon. The achilles tendon is the strongest tendon in the body. However over time or with a sudden increase in activity your achilles tendon can become painful. This can be due to achilles tendonopathy (sometimes called achilles tendonitis) and is caused by repeated “micro injuries” to the achilles tendon that do not completely heal.

Achilles tendonopathy develops gradually. If you have sudden, severe pain in your achilles tendon you should seek treatment immediately. You may have an achilles rupture.

What are the symptoms of achilles tendonopathy?

Acute (suddenly appearing) tendonopathy symptoms might include:

  • Gradually increasing (over several days) discomfort in and around the back of your ankle
  • Pain when beginning exercise or activity that gradually eases during the activity
  • Pain that eases with rest
  • Tenderness in and around the back of your ankle

Left untreated acute pain can develop into chronic (persistent) achilles tendonopathy. Chronic pain symptoms may include:

  • Pain increasing over days, weeks or months
  • Pain during any exercise or activity
  • Pain in the back of your ankle when walking uphill or up stairs
  • Stiffness in your ankle (especially first thing in the morning)
  • Lumps at or around the back of your ankle
  • Tenderness at or around the back of your ankle
  • Swelling at the back of your ankle
  • Redness at the back of your ankle

A thorough examination by an Orthopaedic or Sport Medicine consultant is needed to properly diagnose and treat your achilles tendonopathy. Your consultant will assess your condition by observing you walking and standing. They will also examine your achilles tendon while you are laying face down on the examination table. If further examination is needed they may order a ultrasound scan or an MRI scan.

If there is no evidence of an achilles rupture your consultant may recommend conservative treatment such as:

  • Rest
  • Ice
  • Medication
  • Strapping or bracing the area
  • Orthotics
  • Strengthening exercises

You may also be referred to Physiotherapy.


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