ACHILLES TENDINOPATHIES

Achilles tendinopathies are typically not related to a specific injury but often the result of repetitive strains over a long period of time or a sudden increased activity. This strain can also be caused by tight calf muscles, flat feet or poor biomechanics and we can see the condition in patients who are quite sporty at one end of the spectrum through to those with a high BMI. However we know from research and looking at slides that this condition is associated with degenerative changes in the tendon and hence called a tendinopathy rather than tendinitis or tendinosis.

Your symptoms may be pain along the back of the foot and heel, stiffness in the mornings going down stairs, and able to palpate a tightening in the tendon.

Problems with the Achilles can manifest in two main areas, an insertional problem where the tendon meets the bone and compensates by causing tissue tightness further up the leg or a mid-portion issue. With insertional tendinopathies there may also be an associated spur or bony growth adding to the pressure on the tendon. It can be difficult to identify cause and effect here. The presence of a spur does not necessarily mean you will experience any pain and, it is not necessary to remove any growth before treatment, but there is also the chance the spur could be contributing to the problem and though the Shockwave treatment will usually relieve the symptoms, if the problem is being caused by the growth, the issue may return. Some researchers have confirmed that with Shockwave, some spurs or bony outgrowths can be removed.

The mid portion Achilles problem, often incorrectly referred to as tendinosis or tendinitis, has symptoms and characteristics similar to an insertional problem, but the pain and any swelling is found 2-6 cm above the insertion. This problem can affect both sedentary and athletic patients and is often diagnosed as being caused by mechanical overloading. This is a broad definition though and the actual cause may be one of biomechanics, need of foot orthotics, leg length discrepancy and or the weekend warrior!

BENEFITS AND POTENTIAL OUTCOMES

If you have not responded to conventional treatments and a period of 3-6 months has passed, then shockwave should be a consideration. Unfortunately if you've had an injection then a period of six weeks has to pass before we can commence treatment, likewise if taking any anti inflammatory drugs then a 2 week period is needed.

A through clinical examination will also be undertaking prior to this treatment being started, please bring any MRI’s reports with you to the first consultation.

Next Steps

Here are the 3 steps to discover if Shockwave is right for you:

• If you want to read more about Shockwave Therapy, download a free copy of The Shockwave Solution book
• If you have a specific condition, however you are not sure Shockwave is an appropriate course of treatment, complete a free, confidential Online Assessment.
• If you are ready to see if Shockwave is right for you, call to schedule an assessment appointment 020 8662 1155