The Achilles tendon is the biggest and strongest tendon in the human body. Achilles tendinopathy is a condition that can cause pain, swelling, stiffness and weakness of the Achilles tendon. It is a very common injury reported in runners, however, it is not exclusive to this population as people who have a more sedentary lifestyle will also suffer from it.
Symptoms of Achilles Tendinopathy
Pain generally tends to be worse in the morning, or during and after exercise. Some swelling and/or pain can occur around the tendon and calf area – most often in the areas shown below. The blue coloured area is the insertion of the tendon into the heel bone and the green coloured area is roughly the tendon itself. The tendon may be very tender to touch and you may have increased discomfort wearing shoes that press against it.
Causes of Achilles Tendinopathy
The reasons for developing Achilles tendinopathy are varied but there are some common factors that seem to be important. The research consistently shows that reduced strength and endurance in the calf muscles is a major factor in developing Achilles tendinopathy. Also, being overweight will add more stress to the already struggling tendon. Footwear choice is important as the wrong shoes may aggravate the problem.
Treatment of Achilles tendinopathy commonly involves loading based exercises. This basically means exercises for the affected muscle/tendon unit with the aim that it improves strength and endurance and reduces the symptoms. Read a recent article in the British Journal of Sports Medicine around treatment.
Please don’t expect things to improve overnight though. It can take time for the tendon and muscles to adapt and improve. You may also find heel raises are useful to reduce the stress on the Achilles tendon while you are doing the rehabilitation, however, if they are uncomfortable, causing an increase in pain or other any other issues, then please remove them.
The video below demonstrates a range exercises that might help in the initial stages. There are 7 exercises in total. Numbers 1-4 relate more to problems with the Achilles Tendon, however, you may find the others useful too.
More advanced/progressive loading exercises
As the initial exercises become easier and less painful, it is important to progress and make the rehabilitation more challenging in order to improve the strength and endurance of the muscle/tendon unit. This progression is vital to ensure that the muscles and tendon are capable of coping with whatever activity you want to return to. The video below shows 5 videos that will take you through this progression.
Please make sure that you are comfortable and ready before making the step up to more challenging rehabilitation, and if in doubt, stay with the current plan until you are.
Please note: If you do not see any sign of improvement after 6 – 8 weeks of following the advice and exercises, please phone 0141 347 8909 for more advice and support.
Podiatry clinics are provided across four geographic areas of Greater Glasgow and Clyde, these include the North West, the North East, the South and Inverclyde and Renfrewshire.
To self refer or book an appointment
Call the Podiatry Appointment Hotline: 0141 347-8909, Monday to Friday 8.00am – 8.00pm or Saturday 9.00am – 1.00pm.
0141 451 0570 Main reception. Podiatry receptionist available Wednesday and Thursday 8.30am – 4.30pm
Barrhead Health Centre
0141 800 7102 or 0141 800 7101
Govanhill Health Centre
0141 531 4407
Castlemilk Health Centre
0141 531 8500
Gorbals Health Centre
0141 531 8200 or 0141 531 8424
Govan Health Centre
0141 531 8424, Monday to Friday 8.45am – 12.00pm and 1.00pm – 4.00pm
Queen Elizabeth University Hospital (Podiatry)
0141 201 1720/2, Monday to Friday 9.00am – 4.30pm
Pollok Health Centre
0141 531 6878, Monday to Friday 9.00am – 5.00pm
Greater Glasgow and Clyde is home to Scotland’s largest Podiatry teaching environment which is located at the Queen Elizabeth University Hospital. NHS Greater Glasgow and Clyde (GGC) Podiatry Service works in close partnership with Glasgow Caledonian University (GCU) to deliver clinical placements for undergraduate Podiatry students as part of their training (BSc, Hons Podiatry). You will be asked to give your consent before being treated by a student. Each student is supervised by a clinical educator who supports them in their training.
The service has a commitment to staff learning & development and uses a quality improvement approach to delivery safe, effective and person centred care.
Resources
Publications
Podiatry student placement
Return to practice
Add useful resources / links for staff
Good footcare is important no matter what age you are. Well cared for feet can improve your comfort, mobility, confidence, independence and have an impact on your overall quality of life.
The video below is a useful way to learn how to manage your own footcare.
Personal Footcare Guidance
Do you need help to care for your own feet or would like to know more about how to help a relative or friend with their footcare?
There are a small number of voluntary groups and charities that provide nail cutting services in local community settings. Please click on the Personal Footcare Leaflet for information on how to contact these services.
NHSGGC Podiatry can offer foot care workshops and learning sessions to help people and their carers. Watch this interview with Bridie (aged 87). This is her experience of the attending a workshop on ‘how to look after your feet’ and some of the things she learned.
There are some really useful diabetes resources to help you look after your feet. The leaflets and videos are made by health professionals from across the UK and there may be small differences in the care or services you receive in NHSGGC.
If you have any questions or concerns please get in touch with your podiatrist or healthcare professional.
These videos have been produced to help those with diabetes look after their feet.
Diabetes: Low Risk
Diabetes: Moderate Risk
Diabetes: High Risk
Diabetes: Care of your foot ulcer
A kind thank you to our colleagues in NHS Torbay & South Devon Podiatry for permission to share these videos.
Can be also known as plantar wart which is caused by the human papilloma virus (HPV) affecting the skin. Usually located on the sole of the foot but can occur on any area of the foot.
What do they look like?
They are commonly an area of thickened skin which has a cauliflower appearance with small black dots. They can vary in size of which you can have a single one, multiple or may spread to form a cluster. Usually painful if pinched and can be painful if located on a weight bearing surface.
What causes them?
A strain of the Human papilloma virus (HPV) which is contracted either through close skin to skin contact or indirectly from contaminated objects like towel, bath mat, socks or footwear and from floors of communal areas of swimming pool or gyms.
The virus enters the skin through any small or invisible cut or abrasions and is more easily caught if skin is wet/moist or even dry/rough
More commonly affect children but can affect adults
They can be persistent and may take from 6 months to 2 years to clear.
How to prevent verrucae spreading?
Wash your hands after touching it, try to prevent scratching or picking
Change socks daily
Do not share footwear, towels and avoid using same bath mat with any other house hold member
Do not walk bare footed in public places, either cover the verrucae with a plaster or wear flip-flops when using communal area e.g. at swimming, gym etc.
When self- treating and using a file to the verrucae, do not share the file with anyone else, use on any other area of foot and discard after episode of care is complete.
What to do if you have verrucae?
If painless then no treatment is required. The body’s own immune system recognises the virus and will fight the infection. Evidence suggests many cases will disappear within 6 month although can take longer of up to 2 years.
Self-treatment:
File the area regularly with an emery board can help to stimulate the body’s own immune response and helps to maintain and prevent the thickened overlying skin
You can consult your local pharmacist who can advise on use of topical gels/ointments/paints and follow the instructions given carefully
No treatment is 100% effective and outcomes vary from person to person.
If self-treatment has failed and your verrucae are very painful you may require further advice and treatment from a qualified podiatrist. To access podiatry treatment you can self-refer by contacting NHSGGC Podiatry Referral Management Centre:
There are a lot of musculoskeletal (MSK) problems/injuries that can be associated with the foot, ankle and lower limb and it would be impossible to list them all.
We have highlighted some of the most common problems and created resources which you might find helpful in sections below.
