Achilles Tendon Pathology

Overuse and trauma can lead to pain, strains and tears in the Achilles tendon. The London Orthopaedic Clinic offers a range of treatments, from leading orthopaedic surgeons, to reduce pain, restore mobility and allow you to live life to the full.

The Achilles tendon is the thick cord that can be felt running up from the back of the heel. It helps us to walk, run and stand on tiptoe. When it is sore and inflamed it can make running, walking and playing sport difficult. At The London Orthopaedic Clinic, the expert multidisciplinary team of orthopaedic surgeons, pain management consultants, rheumatologists, allied specialists, radiologists and physiotherapists work together to investigate and treat your symptoms.

Physiotherapy, anti-inflammatories, changes to running practice, and orthotic insoles can provide relief for many people. However, if conservative measures have not helped or if there is an acute tear, surgery may be necessary. The expert orthopaedic surgeons at The London Orthopaedic Clinic can operate in the state-of-the-art operating theatres and support your full and healthy rehabilitation.

What is Achilles tendon pathology?

A number of problems can develop in the Achilles tendon including tears and inflammation of the tendon (tendonitis) or its lining (tenosynovitis).

Active, middle-aged people are most at risk of Achilles tendon pathology as a result of overuse. As we age, the tendon becomes stiffer, less flexible and more vulnerable. High or low foot arches can increase the problem.

When the tendon is stressed, during running for example, small tears can develop, which the body works to heal. The process of degeneration and incomplete healing can make the tendon weak, painful and swollen. Sometimes the tendon becomes so damaged that it completely ruptures.

What are the symptoms of Achilles tendon pathology?

Achilles tendonitis and tenosynovitis develop gradually. The heel becomes increasingly painful and swelling may develop in the area of the tendon. Symptoms initially arise during running or standing on tiptoe, however with time it can become increasingly painful when walking.

A complete tear causes sudden pain, as if you’ve been kicked in the back of the leg. The heel becomes swollen, bruised and there may be a visible deformity. An acute Achilles tear is an emergency, which should be immediately assessed and managed by an orthopaedic surgeon or in an emergency department.

How can The London Orthopaedic Clinic help with Achilles pathology?

The specialist orthopaedic surgeons at The London Orthopaedic Clinic can make a thorough assessment of your heel, your symptoms and your lifestyle. They will arrange imaging by X-ray, MRI or ultrasound to gain more detailed information. They will answer your questions, consider your wishes and develop a treatment programme customised to your individual needs. This can include:

• Conservative measures and self-help advice: Anti-inflammatory medication, rest and ice can help inflammation settle.

• Running modifications: Thorough warm-up, stretches, a change to softer running surface and more padded running shoes can reduce the risk of tears and trauma.

• Musculoskeletal Podiatry: Bespoke moulded insoles or orthotics, can reduce stress on the Achilles, particularly in people with abnormal arches.

• Specialist physiotherapy: Expert physio can initially reduce inflammation, then help stretch and strengthen the tendon.

If these conservative measures have not provided relief, the consultant orthopaedic surgeons at The London Orthopaedic Clinic can operate to provide symptomatic relief. Surgical options include:

• Removal of the inflamed lining of the tendon can help for people with tenosynovitis but a healthy tendon.

• Removing areas of damaged tendon and repairing the tendon can help if the pathology is localised to a small area.

• Achilles tendon repair: If there is extensive degeneration, this can be surgically excised and replaced with tendon either from higher up the Achilles or from another part of the body. This is a big operation, however it can be life-changing for people suffering from disabling pain that is resistant to other measures


Why choose the London Orthopaedic Clinic?

The London Orthopaedic Clinic provides high-quality, expert orthopaedic and musculoskeletal care, tailored to the individual needs of our patients. The Clinic is based at Mayo Clinic Healthcare, at the heart of London’s internationally renowned Harley Street medical district. The London Orthopaedic Clinic offers cutting-edge diagnostics, treatment, management and personalised care.

The expert multi-disciplinary team includes more than 25 leading orthopaedic surgeons, pain management consultants, rheumatologists, allied specialists and radiologists. They work together to reduce pain, improve movement and make a real difference to patients’ lives.

The London Orthopaedic Clinic offers patients something truly unique: access to world-leading experts, high-tech imaging and the latest innovative treatments, together with the feeling of trust and safety of a small family practice.

Achilles tendon pathology treatment costs

The investigation and treatment for Achilles tendon pathology at The London Orthopaedic Clinic may be covered by your health insurance policy. Competitive packages are also available for patients who are self-paying. Contact a member of our friendly team on 020 7186 1000 or at to find out more.