Tendon Pain? Is it your achilles heel with your running? Get the latest HERE!

Achilles Painful?

Tendon feeling stiff & inflexible? 

Crippled for the first few steps of the day?

If your tendon does not move freely in relation to the surrounding soft tissue including fascia, the growth of vessels & nerves locally can lead to significant pain on running or walking. 

Fascial sequence & function as identified
 by Carla & Antonio Stecco

But how best to deal with the problem, & whom should you visit : SPACE physios & podiatrists and/or docs?


Henning Langberg is an associate professor from Copenhagen with an interest in in tendinopathy injury (now referenced as such rather than 'achilles tendonitis' as there is no actual inflammatory component) as evidenced by these publications:


Doctoral thesis: "Response of tendon - associated connective tissue to mechanical loading in humans" 2007
PhD thesis: "the human achilles tendon - circulatory & metabolic changes with exercise" 2000

His blog (as can be linked with at the right side of this posting) has much to commend it, particularly with reference to tendon pain & problems. Much of this posting has references to his work & experiences.


Firstly, with the fact that there is no inflammatory component then it appears that evidence heavily weighs against the use of non-steroidal anti-inflammatory medication such as ibuprofen or brufen, and these should be resisted: exercise often sets up a reaction that is helpful but can be slowed down or harmed by these drugs.

illustrations from www.achillestendon.com
the 'Encyclopaedia for people with achilles injury'

Biomechanics of the foot and especially when running or walking are important, and a visit to a well qualified podiatrist such as Andy Paul whom is available at SPACE can be useful. Other forms of intervention that you may be aware of include Platelet Rich Plasma (PRP) injections, which have gained some noteriety within medical circles ( PRP Explained ) but have demonstrated very little efficacy, or the practise of high volume injections, which have yielded results swiftly, but are also under-researched, but available at venues such as the clinic run by Dr Otto Chan in London ( High Volume Injection Explained).

His clinic has had physio input from the well-researched & published Dr Pete Malliaras (check Malliaris Author ).


In the meantime, for a view of protocols now being advised from the Danish research team that your physio might decide are required then you can check them out here by following the links on the page to the exercises & videos.

Exercise Programmes

Video of Heavy Slow Weight Training & Eccentric Exercise