The Achilles tendon connects muscle to bone, like other tendons, and is located at the back of the lower leg. The Achilles tendon connects the gastrocnemius, soleus and plantaris muscles to the calcaneus (heel bone). It is commonly reported as the strongest and longest tendon in the human body. It is interesting that the achilles is the most frequently injured tendon.

Achilles Tendinopathy is a term that encompasses any problem with the Achilles Tendon, this can mean inflammation (Tendinitis) or degeneration (Tendinosis).

The main symptoms of achilles tendinopathy are increasing pain and stiffness, usually at the back of your ankle. You may also notice some swelling.

Contrary to popular belief the Achilles is not normally inflamed, this explains why the typical approach of rest and anti-inflammatory medication fails to resolve the issue. Most experts except that the problem is degenerative. Whilst degeneration sounds scary to most it is a rectifiable issue.

Put simply the body is constantly being strained/degenerated with activity and repaired during rest, if you tip the rate of wear to be faster than repair the tissue degenerates until the point it produces symptoms. A little wake up call, will normally allow a reduction in activity and gradual re-introduction and you recover well. However if you rest the tissue (tendon and muscle) degenerates/wastes because of disuse. Sometimes gradual re-introduction alone does not work and we need to use load/training to make the tissue adapt, a bit like a weight trainer making the muscles bigger, although in this case we want to affect the muscle and tendon.

Treatment

1. Whatever you do do not stretch the calf muscle! When you stretch the calf muscles it pushes the fat pad and Achilles tendon onto the heel bone . Potentially this can cause irritation of these structures and actually lead to the development of Achilles issues.
2. Load the tendon! Strengthening exercises to the calf muscle to aid repair of the tendon and reduce pain. A training period of 12-16 weeks of progressive loading is recommended.
3. Soft tissue massage of the calf muscles. A recent study has highlighted that soft tissue massage combined with strengthening exercises was more beneficial then strengthening on its own.