WHAT ELSE TO TRY
Vary where you run: For example, run on grass or trail instead of road to reduce the load put through the Achilles tendon. Similarly, reassess the choice of footwear.
Change your footwear: Many runners who suffer with Achilles tendinopathies have a hyperpronated running style. This is the movement of the subtalar joint into eversion, dorsiflexion and abduction.
Finding a supportive shoe to help counteract some of this movement will reduce the susceptibility to such injuries.
Avoid steroid jabs: NICE does not support the use of steroid injections as a recognised treatment for Achilles tendinopathies as there’s an increased risk of tendon atrophy or rupture.
Try shock wave therapy: With this treatment, acoustic shockwaves
are passed through the skin and directed at the Achilles tendon with the aim of boosting blood flow to the area and promoting regrowth of the tendon in a linear fashion.
Look for lasers: Low level laser therapy is thought to increase collagen production and reduce blood flow in new vessels. It’s best used as adjuncts to eccentric Achilles exercises.
Surgery as a last resort: Rarely,
resistant Achilles tendinopathy may require open surgery to excise fibrous adhesions and degenerative nodules. Surgical methods are of main benefit in acute rupture as opposed to tendinopathies. Younger athletes with full rupture are more likely to benefit from surgical repair as risk of re-rupture is reduced. With a possible future sporting career the benefits of surgery are likely to outweigh any risk.