Hello and welcome back to the ThreeSpires Physiotherapy blog, today I thought we could look at a condition that many physiotherapists will see on a daily basis when working with runners or anyone who spends a long time on their feet. It presents as pain around the back of the ankle and bottom of the calf and affects the Achilles Tendon. This is sometimes called Achilles tendonditis or Achilles tendinopathy depending on which article or book you read. Certainly at ThreeSpires Physiotherapy we have worked with many patients to help them with their Achilles tendon problems and as such after I read a recent review of some of the evidence surrounding this issue I thought it might be helpful to share it with readers of the blog.

Over the years there have been many and varied exercise programmes developed for Achilles tendinopathy such as eccentric loading, slow heavy resistance work, resting and concentric exercises all with varied levels of success. A recent review (2018) looked at the evidence relating to exercise, the use of orthoses and splints for treating Achilles tendinopathy and found that the evidence is to say the least inconclusive. The results from 22 trials were pooled and the results showed that although eccentric exercises seemed to be effective at reducing pain in mid portion tendinopathy (pain in the mid point of the Achilles tendon) they were not any better that slow heavy resistance exercises. Now, this may be frustrating for both patients and physiotherapists alike – it would be great if we could point clearly to the best set of exercises to help patients with their Achilles tendinopathy but unfortunately this is rarely the way in the world of real life physiotherapy research. However on a positive note it is possible to at least know that exercises do work in mid portion Achilles pain and that either eccentric or slow resistance exercises are likely to be effective. It also shows that a full assessment to determine which type of exercises is likely to be best is important. The review also looked at splints and orthotics but was unable to find any benefit, to be fair there were very few studies covering this aspect.

So, what should you as a reader take from this research. Firstly it seems likely that if you have the right type of Achilles tendon pain, some form of exercises will help. It is not clear from the research which is the best and it may be that it will take some experimentation to determine the right type. Finally it seems sensible if you have persistent Achilles pain to have an assessment with a physiotherapist to determine the type of problem, underlying cause and best management plan.

Okay I hope you found this blog useful. For anyone reading this blog for the first time: Our physiotherapists are based in Lichfield and offer a home visit physiotherapy service in Sutton Coldfield, Walsall, Tamworth, Cannock and Rugeley. So, if you are having Achilles problems and would like to find out what you can do about it, please get in touch either via email: enquiries@threespiresphysiotherapy.co.uk or by phone on 07884281623