The Heel Pain Clinic

Achilles Tendonitis / Tendinopathy

One of the many challenges we deal when a patient presents to us Achilles heel pain problems is they received Achilles Tendonitis treatment when they have Achilles Tendinopathy or Tendonoses.

First, the correct diagnoses needs to be made. Second, the cause needs to be found. Third, the correct treatment needs to be prescribed.

Achilles Tendon Inflammation vs. Degeneration

Achilles tendonitis should be used to refer to inflammation of the Achilles tendon. Inflammation is most often an acute change (the result of a sudden injury). Redness, swelling, warmth, and pain is how Achilles tendonitis is characterised. When observed using a microscope, inflammatory conditions have specific cells that the body brings to that area of the body to help control the inflammation and heal the injured tendon. We have observed patients receiving massage, shock wave therapy and stretches. It causes more trauma and they are all incorrect Achilles Tendonitis treatments.

Achilles Tendinosis or Achilles Tendinopathy is a very different condition that is not characterised by inflammation. Rather, these patients have thickening of the tendon. There is usually no redness or warmth of the surrounding tissue, although the area can be painful to touch. Achilles tendinosis is a chronic problem, meaning it develops gradually and lasts a long time. When seen under a microscope, inflammatory cells are not present, although chronic damage and microscopic tears of the tendon may be seen. There are people who have been prescribed anti-inflammatory medicines that are not going to work since there is no inflammation. Some were advised to put ice on it, however it not an acute injury, and it does not needs ice.

We have a good understanding of the fundamental differences, are capable of diagnosing the condition and conduct a thorough bio-mechanical assessment to find out why it occurred in the first place.