Achilles tendinopathy: how quickly will it heal?

(No pun intended)

Whether you’re an athlete or not, your achilles tendinopathy can be tricky to treat. So it’s important to know what to do and to get professional help as soon as possible.

stages of achilles tendinopathy

Symptoms of Achilles tendinopathy

The most obvious symptom of Achilles tendinopathy is pain in the Achilles. Stiffness is also common, particularly after sitting for a while and first thing in the morning. Sometimes restriction in movement is present, which can be very painful as well. It is really common with tendinopathy that it is sore first thing when you start exercising, then it eases off, and then is very stiff afterwards, and the next morning. Sometimes there can be swelling around the tendon, or a lump on the tendon itself.

The three main stages of injury

If you’ve had a problem with your Achilles for three months or more, your tendon can go through any of the following stages:

1) Acute inflammation

2) ‘Tendon dysrepair’ where your tendon is actively trying to heal itself but is prevented from doing so by your continuing to walk or run. This is because activity can cause micro-tears that prevent the tendon from regenerating effectively, leading to more swelling and weakness.

3) Degeneration where the fibres have given up actively trying to heal.

Treatment

Firstly we need to look at your biomechanics to rule out or correct over pronation in your feet (where your feet flatten during walking or running) and to address other problems including with your calves, hips and your tendon itself. Treatment includes stretching, strengthening and of course rest. Other factors to consider are shoes, especially if you’re a runner.

Strengthening is a mainstay of the treatment — this needs to be done in a controlled way to avoid re injury and restart your running programme.

Healing

How soon you will heal can be tricky to answer. It all depends on you as an individual. The magic measure is pain. If you experience pain higher than 4 on a scale of 0–10 (with 10 being highest), more rest is required. So no long runs or walks. If you’re an athlete, we can start you on an interval programme where you can progress your running gradually.

How long to heal?

The main thing to remember with tendinopathy of any sort, is that unless it is really acute (and mild) it will take a good few weeks to get it back to what it was. Strengthening tendons takes about 12 weeks to get back to full strength, assuming you are following and progressing your rehab programme diligently. In my experience, it’s usually at about the 4–6 week mark people start to get disheartened that their exercises aren’t working. So if you are at that stage and haven’t seen any changes — keep going! It will improve gradually , but takes a little time to start showing any change.

It is also important to really start back into running gradually and progressively, increasing no more than 10% per week. There are many athletes (and others) I’ve seen that think “ok, pain’s gone, let’s get back into action” without adapting back into activity. They re-injure themselves, and are back to square one. Take it slowly and steadily.

If you are suffering from Achilles tendinopathy, live in Brighton, and hoping to get back into action, Blue Koala Physio can help. Our bespoke exercise programmes are tailored to help you adapt back into running slowly to avoid re injury and maximise your potential. Call the clinic now on 01273 561 844, or email info@bluekoalaphysio.co.uk for more information.