Your Achilles Heel – Tendinopathy Treatment


Nick Bayliss is one of the latest and greatest to join our London Private Services Physio Team.  Nick has a background in Sport Science & Physiology with a Masters in Physiotherapy. He studied over in Queensland, Australia as well as Leeds and London in the UK.  Achilles Tendinopathy is a common and often persistent injury that we see frequently amongst our runners and those who participate in ‘bounding’ sports such as netball or basketball, although it can also strike the not so active population.  Nick explains how the largest tendon in our body can get injured and most importantly how to treat it.  Nick works at our Crystal Palace and Croydon clinics.

Anatomy of the Achilles Tendon

The achilles tendon is the largest and strongest of all the tendons in the human body. It connects the muscles of the calf complex (gastrocnemius and soleus) into the heel bone (calcaneus). The tendon is made up of bundles of collagen fibres which are capable of resisting large tensile forces due to their arrangement.

What is Achilles Tendinopathy?

Achilles tendinopathy is a common overuse injury that we treat regularly within Crystal Palace Physio Group. It was previously term ‘tendinitis’ but we now know there is not always an inflammatory process. The injury is caused by repetitive energy storage and release with excessive compression of the tendon. It is commonly seen in runners and those who participate in ‘bounding’ sports such as basketball.  There are typically 3 stages to Achilles Tendinopathy, described in a continuum model as follows:

These 3 stages include:

Reactive Tendinopathy – the tendon is overloaded and becomes irritated leading to pain e.g. a runner suddenly increasing distance without appropriate background training
Tendon Disrepair – the tendon is not allowed to heal as the irritating factor has not been taken away e.g. continuing to run through the pain
Degenerative Tendinopathy
 – the tendon structure deteriorates and increases in stiffness, reducing its energy transfer capacity to the calf muscles, becoming weaker

How do we treat it?

Tendons respond to different levels of force (or load). Adding or removing load to the tendon, under specialist guidance and supervision from your physiotherapist,  can allow appropriate healing within the tendon. This allows the tendon to gradually move back through the 3 stages of the continuum and return to normal pain free function.

Your physiotherapist can discuss tendinopathy in further detail and prescribe a tailored exercise program focused on optimal loading of the Achilles tendon. The program will then be gradually progressed to focus on the lower limb strength and control as a whole. Manual therapy techniques, such as massage and taping are also useful adjuncts for symptom management and to help reduce your pain.

Does it always respond to treatment?

Unfortunately, achilles tendinopathies can be resilient and do not always respond to the loading program. Recent evidence suggests that Shockwave Therapy (SWT) is useful in the treatment of tendinopathy, if the injury is not responding.

Shockwave Therapy (SWT) is available in London at our Crystal Palace clinic

We are excited to be able to offer Shockwave Therapy to our clients in South London.  Shockwave Therapy is a non-invasive treatment for refractory or persistent tendon problems including Achilles Tendinopathy.  Research studies have shown SWT to be most effective when combined with a physiotherapy rehabilitation programme of tendon loading.  For further details and to find out how to be referred to our SWT specialists please click here or Contact Us about effective treatment of your Achilles Tendinopathy with expert physiotherapy in London.

Meet the Expert

Nick studied Sport Science & Physiology at the University of Leeds and The University of Queensland, Australia before completing his Masters in Physiotherapy at Brunel University in London.  He has special interests in treating a wide variety of shoulder and lower limb injuries, as well as sports injury rehabilitation. Nick prides himself on building a strong rapport with his patients in order to help them achieve their goals. He is motivated to make rehab fun and regularly attends external courses to further improve his practice.  Outside of work, Nick enjoys attending live music, surfing, playing beach volleyball. Since joining CPPG, Nick has worked for both our Private and NHS teams.  Now a full time member of the Private team, Nick is based at our Crystal Palace and Croydon clinics.

Contact us for further detail, speak to a specialist or to book.

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So if you’ve been struggling with persistent pain in your tendons and are looking for a safe and effective solution, why not give Shockwave Therapy a try?

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