Achilles Tendinopathy

Over time the achilles tendon can become worn out and inflamed due to a variety of reasons. This can be at the point where it inserts into the heel bone (insertional) or in the middle of the tendon (non-insertional). There are a variety of reasons for this which can range from overuse, medications, previous injuries or heel spurs.

Figure 1: typical location of pain and swelling in achilles tendinopathy

This problem is often painful, chronic and difficult to treat with simple measures. An MRI scan is usually needed to confirm diagnosis and location of problem within the tendon.

Figure 2: MRI scan demonstrating insertional achilles tendinopathy secondary to heel spur

Treatment options:

Non operative treatment

  • Modification of shoes such as a soft heel raise and ensuring shoes are not tight at the back of the heel

  • Custom orthotics

  • Physiotherapy for calf stretching and strengthening exercises

  • PRP injections

  • Shockwave therapy

Surgical treatment is usually reserved for those who have ongoing symptoms despite the above treatments. The specific operation recommended depends on the type and location of inflammation and associated conditions such as bony spurs

Surgeries performed for lesser toe deformity include: