Otherwise known as “Achilles tendonitis”, this condition often affects active people, and in particular runners. Typical symptoms include pain in the tendon on running or walking, often associated with swelling. Patients often feel that they “stiffen up” at rest and during the night, and that the tendon has to “warm up”.

The condition can be very difficult to treat, and often patients try many different treatments before seeking the advice of a specialist. A myriad of different treatments are available, but as with most things, it is best to stick to the tried and tested methods. Resting the tendon with heeled shoes or a heel-lift and a particular type of physiotherapy, eccentric calf strengthening, are usually all that is required. If your foot is unusually flat or high-arched, you may require orthotics, (insoles) in addition. The full course of treatment lasts 3 months, and is effective in the majority of cases, even if symptoms have been long-standing.

For those who do not respond to treatment, other experimental treatments are sometimes appropriate. These include laser, ultrasound, electromagnetic frequency therapy, shock wave therapy or injection (own blood or sclerosant). Rarely, surgery may be indicated, particularly if there is peritendonitis, but also if tendinosis has failed to respond to the usual treatments.