Conditions we diagnose and treat

Achilles Tendinopathy Treatment in London

Available at LSRI Harley Street (W1G 9QJ) and LSRI Northwest London, Harrow (HA2 7SJ).

Achilles tendinopathy causes pain and stiffness in the Achilles tendon, the thick tendon at the back of the ankle that connects the calf muscles to the heel.

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GMC / FRCR Dr Prashant Sankaye, Consultant MSK Radiologist

It is common in runners and active people, but also affects people who are less active. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, uses ultrasound to assess the tendon and, when rehabilitation alone is not enough, offers ultrasound-guided treatment.

Why choose LSRI

Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
Diagnosis and ultrasound-guided treatment from the same specialist.
Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
No GP referral needed, and all major insurers accepted.
After Dr Sankaye has reported your scan, you can have a free 5-minute video consultation to go through the results.

Last medically reviewed by Dr Prashant Sankaye, Consultant MSK Radiologist, on 2 October 2026.

Symptoms of Achilles tendinopathy

Pain and stiffness in the tendon, usually worst first thing in the morning or after rest
Pain that eases as you warm up, then returns after activity
A thickened or tender area in the tendon, often 2 to 6cm above the heel
Pain where the tendon joins the heel bone (insertional tendinopathy)

Important: a sudden sharp pain or a “kick” or “snap” at the back of the ankle may mean the tendon has ruptured. This needs urgent assessment the same day at A&E or an urgent treatment centre.

How we diagnose Achilles tendinopathy

Ultrasound is the ideal first test. It shows how thickened the tendon is, whether there are tears, whether there are new blood vessels growing into it, and whether the bursa behind the heel is inflamed. MRI may be used for complex or insertional problems, or to look at the heel bone.

What to expect at your appointment

Dr Sankaye reviews your symptoms, activity and previous treatment.
The tendon is scanned with ultrasound to see exactly where and how it is affected.
You discuss the options, including your rehabilitation plan.
If you go ahead, the procedure is performed under ultrasound guidance.
You receive aftercare advice and a plan for returning to activity.

Treatment options

A structured loading programme of calf and tendon strengthening exercises, usually with a physiotherapist, is the most important treatment and helps most people. When pain persists despite good rehabilitation, options at LSRI include:

High-volume image-guided injection (HVIGI): a large volume of saline and local anaesthetic is injected around the tendon under ultrasound to disrupt the painful new blood vessels and nerves. It is used for longer-standing mid-portion tendinopathy, alongside rehabilitation.
PRP (platelet-rich plasma): may be considered for some cases. The evidence is mixed, and Dr Sankaye will discuss whether it suits you.

Steroid is not injected into the Achilles tendon itself because of the risk of weakening it. Where the bursa behind the heel is inflamed, a carefully guided injection into the bursa may sometimes be considered.

Questions about Achilles tendinopathy

Should I stop running?

Not always. Many people can keep some activity going if pain stays at a manageable level. Dr Sankaye can advise based on your scan.

How long does recovery take?

Tendons adapt slowly. Most people need at least three months of consistent exercise, and some need longer.

Is the injection a replacement for exercises?

No. Injections are used to reduce pain so that you can do your rehabilitation, which is what strengthens the tendon.

Can a scan tell if my tendon has torn?

Yes. Ultrasound shows partial and complete tears, and whether the tendon is thickened or inflamed.

Our clinics

Two clinics, one team

Dr Prashant Sankaye, Consultant MSK Radiologist, sees patients at Harley Street in central London and at our Northwest London clinic in Harrow. Call one number to book at either clinic.