Achilles tendon dysfunction

  • The achilles tendon connects the calf muscles to the heel bone (os calcis or calcaneus)
  • Pain in the achilles is common and can be due to a number of factors
  • Inflammation occurs around the tendon and is called peritendonitis
  • Often simple measures such as ensuring the proper fit of shoes and especially sports footwear can improve symptoms.  Activity levels may need to be decreased to reduce symptoms. Anti-inflammatory medication such as Ibuprofen (Brufen, Nurofen) or Diclofenac (Voltarol) can be very effective but must only be used for a few days at a time and not for long term use.
  • Physiotherapy is a mainstay of treatment to stretch & strengthen the calf and helps to resolve the problem.
  • If a lump or swelling occurs around the tendon then this may indicate some degeneration or a small tear of the tendon fibres.  This condition can weaken the tendon and should be investigated usually with an ultrasound or MRI scan which shows up the detail of the tendon very well.
  • Shockwave treatment (ECSWT) is a new method which takes 10 minutes each week for 3 consecutive weeks. It can be effective but is being fully evaluated to learn more about it. Its advantage is that it is non-invasive.
  • Occasionally surgery can be very helpful for persistent symptoms.
  • The achilles tendon should never be injected with steroid as this significantly increase the risk of rupture
  • The most serious problem to affect the achilles is a rupture.  These can be partial or complete.  A complete rupture is best manged by surgical repair in the majority of cases but functional bracing can be used.  Occasionally a rupture goes un-noticed for a while and then a reconstruction may be required which is technically more demanding and the results may not be as good.  It is important therefore to seek advice as soon after an injury as possible.