To ask if anyone has any advice about a poorly healed achilles tendon?

[Lex345]

I have been to my GP, and also urgent care with this-but basically told to live with it-I am hoping someone with either personal experience/ professional knowledge might have some tips-

Essentially, I have injured at some point my achilles tendon. At the back of my ankle, I now have a hard lump and either side is incredibly tender. The lump itself feels hard if I pull my toes towards my knee, slightly spongy if I relax the toes down. If I walk any distance on it, it becomes more painful and I get shooting pains up my calf. It is worse if I wear my walking boots, but generally any walking at all aggravates it.

I went to my gp initially who said they weren't sure what it was, but "it wasn't cancer" 🤔I didn't think that anyway but that was about the extent of the advice; if the pain got worse I was to go to urgent care.

It did get worse, and a couple of weeks after this, I went to urgent care. They said the achilles has healed "the wrong way", it is permanent, I just have to live with it and it will always be painful and I should use Voltarol.

Both doctors very nice, but this ia really debilitating to the point I was almost in tears with pain after walking the dog; I am hoping maybe someone with sports injury knowledge or personal experience might have some advice so I can at least walk without pain?

You could see a podiatrist / orthotics specialist or a good remedial massage therapist or physio who could all possibly help.

Ok sounds like you have achilles tendonopathy - basically an inflamed tendon which is caused by under or over use. That lump is swelling. I ruptured my achilles tendon 12 years ago, it healed well but was left weak and I get that lump of I put a lot of stress on it.

You do not have to live with this at all (the NHS are so shit as this sort of stuff it makes me furious). You need physio and lot a of rehab exercises to strengthen the tendon. Shockwave therapy can also help as it increases blood flow to the tendon and heals it.

If you have access to private health care use that for a referral as I have found the NHS worse than useless at things like tendon injuries. Also DO NOT let them do steroid injections unless it is an absolute last resort.

I had an anchil injury where I ended up with a painful lump on my tendon. I had some physio which helped. To be honest it took years to heal properly. I didn’t work out the trigger but every now and then the lump would reappear along with the pain and tenderness so I would be back on anti inflammatories and exercises. Definitely try a physio session. Hope it improves

My physio does orthotics. You need to find one that does. The NHS here are useless at physio so you'll have to find a private one. Ask on your local FB page

Go and see a private physio/ podiatrist. There are a lot more available treatments privately. A combination of strength and training and rehab. Once it is on the mend something like shockwave therapy may help. But go and see a decent sports physio/ podiatry clinic

Thank you so much for the advice relieved to hear there might be something that can be done-I have never found myself private healthcare professionals before, is there a site I should be using (like you do with gas safe engineers for example) to make sure they are good?

I would also see a podiatrist, they're medical specialists in this area and a well established podiatry clinic in your area will have various treatment options available.

I have had problems with my Achilles tendons for years, and what has really helped me is to always keep the heel about 1.5cm - 2 cm higher than the rest of the foot (as it reduces the pressure on the tendon, and reduces the amount of stretch that the tendon has to go through. (Apparently the force through the Achilles tendons is 3x body weight).

So in practice, this means never going bare-foot (so find some indoor shoes / slippers that have a heel of 1.5-2cm, and wear them all the time (even when getting out of bed at night for a trip to the bathroom). It also means auditing all of your existing shoes / boots / trainers, and avoiding / getting rid of any that are flat, and only keeping those where the heel is supported 1.5-2cm higher than the rest of the foot (so a small heel or a thicker sole at the heel part, but make sure it is at least 1.5cm thicker).

If I do this (and completely avoid going bare-foot, or in flat shoes) then my tendons recover, and stop feeling painful (it used to feel like someone had forcibly hit the back of my ankles with a baseball bat, it was so painful. It sounds like you have a different problem to me, but I think reducing the pressure / strain in the Achilles tendons (while doing all of the other things suggested by your doctors / physios) may allow them to recover.

@Lex345 I am lucky to have a work private group healthplan so i was referred toa physio by my provider and it is all paid for. However there should be decent physio practices in most towns and cities. I think you can also go to providers like Bupa or Nuffield for one off issues.

Warning it is not cheap - my sessions are £54 for 30mins and I was approved by the consultant for 20 sessions to start with. However once you have a good set of rehab exercises to work with you should be able to do it yourself.

See a Sports physio!
I have the exact same problem, (both achilles but the right is the worst) Just getting out of bed in the morning is super painful. I play squash which aggravates it hugely so I'm my own worst enemy!
I have exercises to do and I do wear supports when I'm going to be on my feet all day but a sports physio is who you need to see as they are used to achilles tendonitis!
I do find massaging gently for a few minutes before I get out of bed, helps a little but still have to take ibuprophen a fair bit.

Like @Stoufer I’ve had Achilles problems for years. They are absolute bastards to heal and the slightest provocation sets them off again. I’ve learnt the hard way that I need to be ultra careful what I do and what footwear I use. I stick mainly with trainers these days and even then I almost always wear Sorbothane heel pads (you can buy them on Amazon) to give my Achilles some extra shock protection. These were recommended by my physio. If I even feel a twinge I go back to doing the Achilles strengthening exercises that my physio taught me. I have spent a LOT of money on physio! I’m 99.9% problem free now but it’s taken many years, a lot of pain and expense and a complete ban on any exercise that is even vaguely plyometric.

I agree it sounds like Achilles tendinopathy. I've been suffering recently too. I have long term problems with my left leg following an accident so I think my right side takes extra load and I developed quite severe Achilles tendinopathy in my "good" side which has been a real nuisance. However, with rest and strengthening exercises it has improved a lot. Wearing heel pads inside my shoes has been very helpful too. I would also recommend you see a podiatrist privately if you can. I only needed a couple of appointments and things started to improve pretty quickly. Obviously if you have had problems for a long time it might take you longer to see improvement but don't give up hope.

Holding on for balance, stand flat on bottom stair by balls of feet. Slowly lower heels over the step, hold for five and repeat.
The tendon has shortened by scarring and needs to be stretched gently again.

Don't do as I did and pay physios a small fortune to massage etc. Not only is it painful, it doesn't work.
I have no medical knowledge but having hobbled home after yet another painful session, I turned on the the radio to hear a podiatrist answering this exact question. I immediately tried it and could have cried knowing I wasn't going to suffer forever.

Heel raises work well as well. So stand facing a wall and use you hands to steady yourself against the wall, then raise yourself up on in to the ball of your foot and slowly descend back down flat on the floor. Repeat 10 times and then do the other leg if needed. Do three reps of this twice a day.

Holding on for balance, stand flat on bottom stair by balls of feet. Slowly lower heels over the step, hold for five and repeat.
The tendon has shortened by scarring and needs to be stretched gently again.
My podiatrist told me that this is out of date advice and that exercises should focus on strengthening rather than stretching. Like Ginmonkeyagain I was given heel raises to do, starting seated, then standing. Of course the OP would be best seeing someone who can examine her and advise on an individual course of treatment though as what is right for one person might not be for another.

Physio made mine worse.

I was referred to an orthopaedic surgeon and had a saline injection. This didn’t do much, so med strep is surgery. 😢

Is the bump a bony spur?
I had that leading to inflammation and chronic tendonitis.
Via the NHS I was sent to a Bupa hospital for 3x dry needling (they treat the tendon like a pincushion to cause inflammation to heal the whole area/reduce the previous inflammation).
It helped a little. I also was taught the physio techniques. I sometimes used a tight, ankle support.
They were going to then inject with my plasma (they take your blood and centrifuge it) this would have been done 3x but I had to opt out because of when they wanted to do it.
I have always worn flats at work.
I bought some very high heeled boots as an experiment and wore them for a term. This appears to have eased it/stretched it out, so even if out of date advice it has given me relief from it.
Good luck!

@Lex345 i wouldn’t go to physio directly

you need to go to orthopaedic consultant, he ll tell you what to do next (might be physio or something else)

google a private one near your area

Thank you so much for the advice-I will try and find a private practitioner to see and the advice around shoes really helpful thank you!

Yes, it feels almost bony if I pull my toes up to my knee, if I relax my foot/point my tiea, it feels spongy

If you are in London or the South Six Physio are good.

This works for me too. You can buy insoles from Amazon for winter shoes/boots/trainers and so on. Fit flops are good for warmer weather.

Yes, I agree about the fit-flops in summer, I absolutely live in them! I only go for the ones with fabric / webbing toe posts, as I find those much more comfortable than the solid / leather toe posts..

You need to know if you have insertional or non-insertional tendonitis. The exercises where you drop your heels down from a step are not recommended for the insertional type as it puts too much strain on the tendon. My GP didn't seem to be aware of the 2 types and my physio also gave me the wrong advice, which made things worse.

I bought some very high heeled boots as an experiment and wore them for a term. This appears to have eased it/stretched it out, so even if out of date advice it has given me relief from it.
Wearing heels or putting heel pads into your shoes doesn't stretch your Achilles* *tendon though - it does exactly the opposite. Increasing the heel - toe drop of your footwear reduces the stretch on the tendon, that's the whole reason why wearing completely flat shoes and particularly walking barefoot is advised against.