Knee, foot and Achilles tendinitis

Achilles Tendinitis and musculoskeletal conditions

Achilles Tendinitis treatment

Achilles tendinitis affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response.


The source of pain in tendinopathy could be related to the neurovascular ingrowth seen in the tendon's response to injury. The treatment of Achilles tendinopathy is primarily conservative with an array of effective treatment options now available to the primary care practitioner.


If conservative treatment of Achilles is not successful, then ultrasound relieves pain in the majority of cases. Directing a patient through the algorithm presented here will maximise positive treatment outcomes.

Patellofemoral pain syndrome (PFPS or runner’s knee)

affects around 25% of the general population, accounting for up to 33% of presented knee-related injuries. Commonly affecting runners, it accounts for around 40% of knee complaints in sports medicine clinics. 

Causes include biomechanical problems (e.g. worn cartilage, flat-footedness), muscular problems (e.g. weakness in the thigh muscles, tight hamstring or calf muscles) and injury to the kneecap, resulting in pain behind or around the kneecap.


Current management of PFPS involves rest, the application of ice to reduce pain and swelling; compression, elevation, NSAIDs for pain relief, and physical therapy.


Alongside inflammation of the adductor and abductor hallucis (across the top and medial inside of the foot) and extensor tendonitis (affecting the top of the foot), plantar fasciitis (inflammation of the plantar fascia tendon) is among the most prevalent foot injuries presented clinically. It is the most common cause of heel pain and the most common complaint for patients requiring orthopaedic care. Causes include tightness of the Achilles tendon and poor support of foot arches.

Current management of plantar fasciitis include physical therapy, including Active Release Technique (ART), massage and stretching; and orthopaedic intervention, such as arch support or shoe inserts.

Ankle sprains

are extremely common, accounting for up to 5% of all emergency room visits in the UK. Although generally seen as a benign injury due to its prevalence, its effects and symptoms can be debilitating.


Ligament damage is caused by the accidental movement of the foot turning inwards as the ankle rolls outwards (and, less frequently, vice versa), resulting in a range of symptoms which may include stiffness, pain, swelling and tenderness, to the point of not being able to bear weight on the affected ankle.


Current treatment of ankle sprains involves rest, the application of ice to reduce pain and swelling; compression, elevation, NSAIDs for pain relief, and physical therapy.


In all knee, foot and ankle injuries referred to, a 5-minute treatment using the Ultrasonic Pain Relief device can result in effective, ongoing pain relief within 24 hours.

Statistical sources:

  • Glaviano NR, Kew M, Hart JM, Saliba S. ‘Demographic and epidemiological trends in patellofemoral pain,” International Journal of Sports Physical Therapy (2015);10(3):281-90.
  • Tahriran MA, Motififard M, Tahmasebi MN, Siavashi B. ‘Plantar fasciitis,’ Journal of Research in Medical Sciences (2012);17(8):799-804.
  • Doherty C, Delahunt E, Caulfield B, et al. ‘The incidence and prevalence of ankle sprain injury:  systematic review and meta-analysis of prospective epidemiological studies,” Sports Medicine (2014);44(1):123-40, doi: 10.1007/s40279-013-0102-5.