Achilles Tendinopathy

Achilles tendinopathy is a common condition that affects the Achilles tendon, the thick band of tissue connecting the calf muscles to the heel bone.

It often causes heel or tendon pain and impacts mobility, especially in athletes and active individuals. There are two main types: insertional Achilles tendinopathy, which occurs where the tendon attaches to the heel bone, and non-insertional Achilles tendinopathy, which affects the mid-portion of the tendon approximately 2–6 cm above the heel.

At Perth Orthopaedic & Sports Medicine, Dr Daniel Meyerkort offers expert evaluation and treatment for Achilles tendinopathy. With a strong emphasis on evidence-based care and personalised treatment planning, Dr Meyerkort helps patients return to sport, work, and active lifestyles as safely and quickly as possible.

Causes and Symptoms of Achilles Tendinopathy

Non-insertional Achilles tendinopathy typically affects younger, more active individuals. It is associated with overuse, sudden increases in activity, or poor biomechanics, leading to microtears, collagen degeneration, and thickening of the tendon.

Insertional Achilles tendinopathy, on the other hand, often affects middle-aged or older patients. It may be due to chronic overuse, underlying biomechanical issues, or systemic factors like obesity or inflammatory conditions. Calcific deposits and bone spurs (Haglund’s deformity) are commonly seen in this form.

Common symptoms include:

  • Pain and stiffness in the Achilles region, especially in the morning

  • Swelling or thickening of the tendon

  • Pain with activity, especially running or climbing stairs

  • Tenderness to touch

Non-Surgical Management

In most cases, non-surgical treatments are the first line of care and are effective in managing symptoms and improving function.

1. Activity Modification

Reducing aggravating activities such as running, jumping, and uphill walking can allow the tendon to rest and begin the healing process. A temporary switch to low-impact activities like swimming or cycling is often recommended.

2. Physiotherapy and Eccentric Loading

Physiotherapy, particularly eccentric calf muscle strengthening, has proven highly effective, especially for non-insertional tendinopathy. Dr Daniel Meyerkort often collaborates with experienced physiotherapists to deliver personalised rehab programs.

3. Orthotics and Heel Lifts

In cases of insertional tendinopathy, orthotics and heel lifts can reduce stress at the tendon’s insertion point. These can be custom-made to improve foot alignment and offload pressure from the heel.

4. Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) is a non-invasive option that can stimulate tendon healing and reduce pain. It is particularly helpful for chronic cases that don’t respond to initial conservative treatments.

5. PRP (Platelet-Rich Plasma) Injections

Platelet-rich plasma (PRP) injections use a patient’s own blood components to promote tendon healing. While results vary, PRP may benefit select patients who are not ready for surgery.

6. Anti-inflammatory Medications

Although tendinopathy is more degenerative than inflammatory, non-steroidal anti-inflammatory drugs (NSAIDs) can offer symptomatic relief, especially in acute flare-ups.

Surgical Management

Surgery is considered when non-operative measures fail after 6–12 months of dedicated treatment, or when there is significant structural damage to the tendon.

Non-Insertional Achilles Tendinopathy

Surgery typically involves debridement of degenerated tendon tissue and may also include tendon repair or augmentation. Minimally invasive or open techniques may be used depending on the severity.

Benefits:

  • Improved function and pain relief in chronic cases

  • Return to sport or high-demand activities

Risks:

  • Wound healing issues

  • Sural nerve irritation

  • Tendon rupture or weakness

  • Prolonged rehabilitation (typically 3–6 months)

Insertional Achilles Tendinopathy

Surgery for insertional tendinopathy may involve:

  • Removal of bone spurs or Haglund’s deformity

  • Detachment and reinsertion of the Achilles tendon

  • Tendon augmentation using a graft if needed

Dr Daniel Meyerkort uses a combination of open and minimally invasive techniques, tailored to the extent of the damage and patient goals.

Benefits:

  • Relief from chronic pain and improved mobility

  • Corrects underlying bony impingement

Risks:

  • Potential for prolonged recovery

  • Stiffness and scar sensitivity

  • Risk of re-rupture in high-demand patients

Rehabilitation and Recovery

Rehabilitation is essential after both non-surgical and surgical treatment. Dr Meyerkort works closely with physiotherapists in Perth and regional WA to develop a progressive program focusing on mobility, strength, and return to activity.

Non-Surgical Recovery Timeline:

  • 6–12 weeks: Initial symptom improvement

  • 3–6 months: Return to sport or normal function

Post-Surgical Recovery Timeline:

  • 2 weeks: Initial wound healing

  • 6–8 weeks: Gradual weightbearing and range of motion

  • 3–6 months: Strength training and activity resumption

  • 6–12 months: Full recovery depending on surgery type

Why Choose Dr Daniel Meyerkort for Achilles Tendon Treatment in Perth?

Dr Daniel Meyerkort is an experienced orthopaedic surgeon at Perth Orthopaedic & Sports Medicine, with a special interest in sports ankle & knee surgery. His evidence-based approach, combined with access to advanced imaging, surgical techniques, and post-operative care, ensures high-quality outcomes for patients with Achilles tendinopathy.

Highlights of care:

  • Accurate diagnosis using ultrasound or MRI

  • Access to our in house Sports Medicine Doctors

  • Minimally invasive tendon repair options

  • Advanced insertional tendon reconstruction techniques

  • Coordination with leading Perth physiotherapists

Telehealth & Regional Patient Access

Patients from regional WA including Bunbury, Geraldton, Kalgoorlie, Albany, Broome, and Karratha can access expert care via Telehealth consultations with Dr Meyerkort. Perth Orthopaedic & Sports Medicine can assist with organising MRI scans, early diagnosis, and coordinated rehabilitation with local physiotherapists.

Achilles tendinopathy, whether insertional or non-insertional, can be debilitating but is highly treatable. With a structured approach involving physiotherapy, medical therapies, or surgical options, most patients return to their desired activities pain-free.

Personalised Orthopaedic Care in Perth

For expert diagnosis and treatment tailored to your needs, Dr Daniel Meyerkort and the team at Perth Orthopaedic & Sports Medicine offer comprehensive, compassionate care for patients across Western Australia.