We provide physiotherapy treatment for Achilles pain in our Sydney clinics along with shoulder, neck, and back pain treatment. Achilles pain is a very common health condition that many people in Australia suffer from regularly. It is usually suffered by adults who take on exercise or sports on a casual basis but don’t prepare their body well enough. The first thing our experienced physiotherapists will do is explore your medical history to better understand what the underlying cause of your pain may be – sometimes this isn’t immediately obvious.
If you begin to feel pain around your heel it could be possible that you have an injury to your Achilles tendon which connects the calf muscle to your heel bone. Often simply called the ‘Achilles’ it is like a thick cord you can feel at the back of your ankle that attaches the calf muscle to the back of your heel. This tendon is used when you walk, run, jump or push up on your toes so it is always getting used.
Normally you will feel some pain around your heel, perhaps stiffness, maybe swelling and even tenderness. It is a very common form of heel pain that our physio’s treat in our clinics and most of the time it is people who do a lot of running or are middle-age playing sports on the weekends. Your Achilles tendon withstands a lot of stress and pressure during everyday activities, as well as during athletic and recreational play. If it becomes inflamed, swollen, and irritated, it is called tendonitis.
The 2 most common injuries of the Achilles tendon are:
Acute rupture: a complete or partial tear that occurs when the tendon is stretched beyond its capacity.
Achilles tendinopathy: a chronic (long-term) condition that causes weakness and degeneration of the Achilles due to a series of very small tears (tendinosis).
In lots of cases it happens when you are increasing your activity level rapidly without preparing your achilles for the new activity. If you partially tear your Achilles, it can feel like the tendinopathy. If you completely tear or rupture your Achilles, it can feel like a kick or hit to the back of the ankle. You might have trouble walking.
If you have pain under the heel, it is usually not an Achilles problem.
To diagnose a tendon injury, your doctor or physiotherapist will examine you and ask about your symptoms. An ultrasound or other scan such as an x-ray or MRI may be done to help identify the problem, but this is usually not needed in most cases.
What type of people suffer from Achilles injuries most of the time?
A lot of the patients that visit our clinic for Achilles pain treatment will be aged 30-50. It seems to be the period in life where everyday people return to sport after having a break to raise a family or get their career started.
Their body won’t be used to that type of activity and it increases the chances of injury if the right preparation isn’t considered. Sometimes this group is called the ‘Weekend Warriors’ who play sports once in a while, but not consistent enough that their body is able to adjust and cope with the additional exertion involved.
What are two signs of Achilles Tendonitis?
1) You will feel a very sharp pain on the back of your heel
2) There will be visible redness and swelling at the back of the hee
Depending on how severe the Achilles pain is, it may be possible to provide self care treatment following advice from a local doctor. In most cases they may advise rest together with pain relievers. It is pretty common to use nonsteriodal anti-inflammatory drugs to help ease the pain, but of course, every person’s situation will be different depending on their medical history, current health condition & the severity of the injury. Using the RICE method of Rest, Ice, Compression and Elevation will help reduce the pain symptoms as well as stretching, massage or perhaps even a brace with a splint.
In most cases we will advise a person to rest, help make the tendon feel comfortable and try not to restart the workload until you are ready, even then do it slowly so that you can work towards making it stronger or more flexible than before to avoid a repeat injury and further pain.
With treatment that initial inflammation phase takes about 28 days (4 weeks) Then the next 8 weeks are focused on strengthening and preparation.
No, not really, the pain will stop you from exercising. And when you stop exercising the pain reduces, but once you increase your activity, the pain will return again unless you treat it.
Natural treatments for Achilles Tendon issues; Massage, Icing with sharp pain present, Heat packs and creams when starting movement, Stretching/Strengthening/Pilates and Yoga are at the end of a treatment plan. Little evidence but Vitamin E oil and Tumeric are alternative natural treatments.
Relative rest from aggravating activity followed by treatment (i.e. Massage, cupping, shockwave) on the achilles to help repair and strengthen then return to sport.
From clinical experience I have found shockwave therapy to be a great treatment to change the game and make the achilles feel better quicker.
Rest: Stop doing activities that stress your tendon
Ice: Put ice on your tendon for up to 20 minutes, as needed throughout the day.
Compression: Compress, or put pressure on, the tendon using an athletic wrap or surgical tape.
Absolutely, we have physios in Concord, Maroubra, Penshurst and Lane Cove who all have experience with helping people with Achilles pain treatment therapies. Each physio will actually spend some time to understand more about the lead up to sustaining an Achilles injury. Rather than just treat the immediate pain we will also explore any potential underlying issues that may lead to the pain returning.
There is a big difference between providing short term pain remedies vs creating a physiotherapy program that will focus on the cause of what is creating an injury. That is part of the Switch difference, our focus in providing long term pain relief.
Some of the underlying health conditions that may lead to an Achilles injury could be;
1) Arthritis: Oseto or rheumatoid – makes muscles stiffness
2) Obesity or overweight
3) Some long term antibiotics and steroid use
Be selective when you choose a professional to get pain treatment, they may just reduce some of the short term pain rather than create longer lasting solutions for you. In our physio clinics our physiotherapists will be able to use a range of techniques such as;
Using a Switch physio clinic to get Achilles pain treatment will mean you reduce your short term pain symptoms but will also get help from our team to work on what is causing it to occur in the first place.
It is quite possible to avoid a tendon injury by looking after your body & being aware of what life stage you are at. So for example you can;
What does a strained Achilles feel like? Feels like an “ache”, “heaviness” or “overstretched”
Can Achilles pain go away? Yes it can go away on its own slowly depending how you manage it. Although if you get pain treatment then you can recover much quickly & our physios can also help your body to avoid reoccurrence with one of our Switch movement programs.
Is walking good for Achilles tendonitis? Once the inflammation and sharp pain decreases, walking is good to regain strength.
Should I stretch a sore Achilles? If the achilles is still inflamed and sore, best to rest it and receive treatment until it feels comfortable then begin stretching.
Does massage help Achilles tendonitis? Yes, Massaging the calf muscles is a good way to reduce tension and stress on the calf and achilles. A pPodiatrist, physiotherapist or massage therapist can do this. It can also be done by the patient at home with a foam roller.
How do I strengthen my Achilles? The simplest way is performing heel raise exercises, then build on that with more functional exercises eg. Hops, jumps, skips.
Is it okay to jog with Achilles tendonitis? No, Achilles Tendonitis is an inflammatory condition that needs to be treated with rest. Rest is important not only for Achilles tendonitis pain but also the long term integrity of the Achilles tendon.
What causes Achilles tendonitis to flare up?
Can shoes cause Achilles tendonitis?
What happens if Achilles tendonitis goes untreated? Healing is linked with treatment and activity. If you don’t treat it and you don’t change your activity the injury can become long term, permanent and degenerative.
Is Epsom salt good for Achilles tendonitis? Little evidence to suggest that it would. It would be more of a patient preference treatment. (It would be safe but unsure of the effectiveness as the only treatment)
Can I put deep heat on my Achilles? Yes, Prior to sport or activity it can be helpful to increase movement and blood flow.
Is Tiger Balm good for Achilles tendonitis? Yes, helpful to increase movement and blood flow.
Belinda loves working out at the Vision PT gym to help maintain her health levels, balance a busy job while caring for young children with her own needs. She has ambitions of increasing her exercise levels and begin running 5kms on-top of her existing gym workouts.
During COVID isolation she was working out from home and an old Achilles injury flared up. She suffered pain, inflammation, redness and heat developed. She decided to speak to the physio team at Switch to help create a program that could help her treat the short term pain but figure how how to prepare her body for more exercise.
Not all treatment methods will suit all people, but in Belinda’s case we provided;
– hands on treatment including: soft tissue release, joint mobilisations, dry needling, cupping, shockwave and active release techniques
– postural training + alignment of body and modifications to orthoses
– strength training + strength program
She made great initial progress, with the pain levels and stiffness decreasing drastically. With a commitment to maintaining her health, building on her strength and movement she is well on the way to achieving her goals
This gentleman previously worked as a lawyer and played a lot of rugby when he was much younger. He wanted to continue to be active well into his 70’s to minimise any potential health complications.
While not all treatment methods will suit every person, for James we initially provided shockwave therapy and soft tissue release of his legs twice a week in the first 3 weeks to help settle his Achilles Tendinopathy. It had been bothering him for the previous few months.
We then started treating his lower limbs and back with soft tissue massage, exercise and cupping to help him walk with better body alignment that has now contributed to pain free walking since completing his 10 week treatment plan at Switch. The best part is he is now walking with his wife pain free and took up one of our maintenance programs so he doesn’t have to worry about an injury flaring up again.
Michael ruptured his Achilles while playing basketball which is a sport he loves. He had to undergo surgery to repair the damaged Achilles within days of injuring it. Michael was in a cast for two weeks followed by a moon boot . His post recovery rehab included a six week plan that we developed in our physio clinic.
As mentioned above, not all treatment methods will suit every situation, but in Michael’s case based on his age and the injury our treatment involved;
We progressed our exercise based treatment to incorporate strengthening of the calf/Achilles tendon and have now progressed to light power and running training with the aim to get back to playing Basketball. Michael has been diligent with his exercise and rehabilitation and has now started running. He is on track to return to basketball within the next few months.