Patient Information

Achilles tendinopathy

https://kingstonhospital.nhs.uk/information/achilles-tendinopathy

This information has been designed to provide you with basic information on achilles tendinopathy and guidance in its treatment. It is not exhaustive and you may be provided with alternative information to address your specific needs.

For advice about pain relief, speak to your GP.

What is the achilles?

The achilles is a tendon at the back of the lower leg which connects the calf muscle to the heel bone. When the calf muscle shortens (contracts) the tendon pulls on the heel and allows us to stand on our toes.

illustrations showing the anatomy of the lower leg, highlighting the achilles tendon

What are the main symptoms?

The main symptoms are:

pain in the back of the heel
the pain may be worse first thing in the morning or when putting weight on your foot following prolonged rest
the pain may be worse after long periods of walking or running.

What is achilles tendinopathy?

Achilles tendinopathy is an injury to the achilles tendon. The tendon is injured when it cannot cope with the strain being put on it.

Common causes are:

being overweight
doing lots of high impact training, such as running
sudden increases in activity or training
inappropriate footwear, such as very flat shoes with little or no support or cushioning for the heel
tight or weak calf muscles
stiff ankles (which can happen naturally or be the result of a previous injury).

What can I do about it?

Simple steps can help reduce the strain on your achilles:

avoid or reduce anything that makes things worse, such as running or jumping
wear supportive shoes, such as trainers with a thick sole
exercises – see below.

Strengthening exercises

Because the pain is caused by the tendon not coping with the weight, or ‘load’, being put on it, strengthening exercises are recommended.

Following a period of rest, you can gradually start these exercises. Do not start until you can do your usual everyday activities without pain, and any pain after running or jumping settles within 24 hours.

The exercises are graded. This means that you gradually build them up as you get stronger. It is very common for the pain to flare up for a short while, especially when starting new exercises. You can continue with the exercises as long as this soreness settles within 24 hours. If it takes longer than this, reduce the amount of exercises you do or return to an easier exercise before gradually building back up.

Your physiotherapist may adapt these for your needs.

Do not continue with the exercises if they significantly increase your pain.

Phase 1: double leg holding

Exercise A

Stand up and hold onto a support, such as the back of a chair.
Push up onto your toes, with your legs straight.
Maintain this position for 30 to 45 seconds.
Repeat 3 to 5 times a day.

Exercise B

Repeat the movement you have done for exercise A (above) but with your knees slightly bent.
Maintain this position for 30 for 45 seconds.
Repeat 3 to 5 times a day.

Phase 2: single leg holding

Exercise A

Stand up and hold onto a support, such as the back of a chair.
Push up onto your toes, then take your ‘good leg’ off the floor.
Maintain this position for 10 to 45 seconds.
Repeat 3 to 5 times a day.

photograph showing raising on toes on one leg, with supporting leg straight

Exercise B

Stand up and hold onto a support, such as the back of a chair.
Bend your knees slightly and push up onto your toes, then take your ‘good leg’ off the floor.
Maintain this position for 10 to 45 seconds.
Repeat 3 to 5 times a day.

photograph showing raising on toes with knees bent

Phase 3: heel raises

Exercise A

Stand up and hold onto a support, such as the back of a chair.
With your feet hip-width apart, push up onto your toes.
Slowly lower your heels back down to the floor.
Repeat this 10 to 15 times.
Repeat 3 times a day.

photograph showing pushing up onto the toes, raising heels with legs straight

Exercise B

Repeat the movement you have done for exercise A (above) but with your knees slightly bent.
Repeat this 10 to 15 times.
Repeat 3 times a day.
To progress this exercise, complete the movement on your affected leg only, or add a weighted backpack.

photograph showing pushing up onto the toes, raising heels with knees bent

https://kingstonhospital.nhs.uk/department/physiotherapy-department/

Contacts

Physiotherapy

020 8934 2510 (Monday to Friday, 9am to 5pm),
khft.physioop@nhs.net

Translate

Please speak to a member of staff before or during your visit to the hospital if you require translation.

Accessibility

Please contact the Patient Experience Team on 020 8934 3850 if you need this information in a different format.
For information accessibility please visit Kingston Hospital AccessAble www.accessable.co.uk/kingston-hospital-nhs-foundation-trust

Support services

Visit the hospital website, ask a member of staff, or ring us for details.

www.kingstonhospital.nhs.uk

Switchboard 020 8546 7711

‘Find Us’ page for maps, transport, registering a blue badge, disabled access
Information, advice and support for patients and relatives (PALS) 020 8934 3993
Pastoral and Spiritual Support 020 8546 7711
Learning Disability Liaison Team 020 8934 6895

Print - Standard Size Print - Large Size

Translate

Please speak to a member of staff before or during your visit to the hospital if you require translation support to access Patient Information. Please ring the phone number on your appointment letter, if you have one.

Request More Information

Accessibility

Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
For detailed information on accessibility at Kingston Hospital visit Kingston Hospital AccessAble (https://www.accessable.co.uk/kingston-hospital-nhs-foundation-trust).

Patient Advice and Liaison Services (PALS)

PALS provides information, advice and support to patients and relatives.

Email: khft.pals@nhs.net

Phone: 020 8934 3993 (Monday to Friday 9am to 5pm)

Pastoral and Spiritual Support Service

We offer a multi-cultural approach serving people of all faiths and life philosophies.

Phone the hospital switchboard: 020 8546 7711 and ask for the Duty Chaplain, we are available 24 hours per day 7 days a week.

Learning Disability Liaison Service

We support patients and/or their carers to prepare for a visit, including help to organise reasonable adjustments.

Email: khft.learningdisabilityteam@nhs.net

Phone: 020 8934 6895 (Monday to Friday 9am to 5pm)