This condition (previously known as Achilles tendinitis) generally occurs when there has been excessive load (strain) placed through the tendon. Examples may include increasing running volume. The tendon may be weaker in some individuals due to factors such age, general heath (including excessive weight), muscle tightness and previous injury (e.g. rupture).

With tendinopathy there are structural changes to the tendon and clinically you see thickening and tenderness over the tendon. You may find that it’s more difficult to carry out normal activates, such as running or prolonged walking.

What is a high volume injection?

This procedure involves injecting a small volume (25-30 ml) of solution into the space between the tendon and its sheath (tendon cover). This solution contains salt (saline) water and local anaesthetic. This solution acts to induce the healing process and reduce pain. The procedure is carried out under ultrasound guidance by a trained doctor. The treatment is successful in over 50% of patients.

What are the alternatives to high volume injection?

You may have already been given a program of rehabilitation, including advice regarding activity, footwear advice and stretching and strengthening exercises. You may have received orthotics to improve the mechanics of your feet. Extracorporeal shockwave therapy is another treatment option for tendinopathy. This noninvasive treatment delivers sound waves to the tendon to help increase blood flow and stimulate healing.

What precautions should I take after the injection?

You should not drive home or take public transport. It is best to have a lift home in case of rare complications. There is a small risk of rupture, so some people will be given an Aircast (fracture) boot to wear for a few days. It is important to rest the foot as much as you can for 48 hours and walk only when necessary.

After about 3 days you can return to normal walking but avoid high impact exercises or sports.

Be guided by your practitioner when to start any loading exercises or high load exercises (such as running).

Air Cast Boot, worn after an injection:

What are the side effects?

Rupture is a small but potential complication - hence why rest after an injection is important. You should seek medical attention if this is suspected. You may experience some numbness due to the local anaesthetic. This normally wears off after a day or so. This may be followed by a short period of increased pain.

Infection of the skin or tendon is a rare complaint. You should contact your GP/or our hospital if you suspect infection. Signs of infection include warmth, spreading redness, swelling and pain on touching.

An allergic reaction is a rare complication, but can be brought on by the local anaesthetic.

When can I return to sports and exercise?

You will normally be advised to start some loading exercises after around a week, followed by a gradual and graded return to sports dependant on pain levels and function.

It’s important to complete your rehabilitation to ensure your tendon is strong enough to deal with any load you apply to it.

Who to contact if you have issues after your injections

If you have any issues after your injection please contact the radiology secretary on:

0121 685 4108
|0121 685 4135