Can I treat it myself?
Achilles tendinopathy is treated like any other overuse injury in the first instance. You may need to reduce your activity level. Also, when you exercise, warm up for longer and do plenty of calf stretches. A change to a softer running surface and well-padded running shoes may help. A small heel raise in or on your shoe will reduce the stresses on the tendon but remember to also raise the other side to keep yourself balanced.
For more severe episodes, straightforward measures such as applying an ice pack and taking simple pain-killers (such as paracetamol) are often effective. Anti-inflammatory medicines can reduce the swelling in the tendon, but check with your doctor or pharmacist before taking these as they can have side-effects. If these steps do not help, then consult your doctor or physiotherapist for exercises. These are aimed at reducing the inflammation and then to strengthen the tendon.
Rupture of the Achilles tendon generally cannot heal properly without some intervention and does require prompt medical attention. You should attend your local emergency department or minor injuries unit for assessment and possible plaster cast application.
When do I need treatment in hospital?
For tendinopathy, the first thing is to check that you have tried all the simple measures outlined above, including physiotherapy. If you have an abnormal foot shape then you may need a referral for insoles.
Your GP may refer you to a hospital specialist if your symptoms continue despite simple measures. Your hospital may then offer you other treatments which may not be available in the community, including surgery.
A ruptured tendon is invariably managed in a hospital setting initially, and once the tendon has started to heal, physiotherapy may be needed to help strengthen the calf muscle and facilitate normal activities. Some patients may be offered surgery depending upon their age, activity levels and pattern of injury. You should discuss this with your orthopaedic surgeon to help decide what is best for you.
