Why a good day starts with a good night’s sleep

It is perhaps no coincidence that the ‘Festival of Sleep Day’ falls on 2nd January each year, when most people’s regular sleep routines have gone well and truly out of the window following days of festive celebrations!

As we all know from experience, a night of poor sleep can take its toll on us the next day. From a lack of energy and inability to concentrate, to an irritable mood – it’s days like these we just can’t wait to climb back into bed to catch up on our sleep.

And whilst many of us may need to sacrifice a few hours out of necessity once in a while (perhaps due to a looming work deadline or a teething baby, for example) it’s important to try as much as possible to aim for around eight hours of sleep per night. The reason being that the effects of regular poor sleep can be much more serious than simply being a little moody and forgetful during the day – it can actually shorten your life expectancy.

Healthcare experts  have therefore compiled a helpful checklist of ways you can improve your sleep.

Top tips to help improve your sleep

  1. Get into a routine: Aim to go to bed and wake up at the same time every day to enable your body to get into a regular rhythm.
  2. Make time to wind down: Whether it’s relaxing in the bath, doing a little gentle yoga, or reading a book – give your body and brain time to turn off and relax before heading to bed.
  3. Ban the screens: Aim to put down your phone and switch off your computer an hour before you go to bed, as the light from the screens on these devices can have a detrimental effect on your sleep.
  4. Cut out the caffeine: Stimulants such as coffee can interfere with sleep so try to limit your intake during the day and avoid it altogether in the evening.
  5. Work out: Moderate exercise during the day can help to relieve tension build up, leaving you in a relaxed state which is more conducive to sleep.
  6. Get the temperature just right: Aim for a room temperature of between 18-24°C and ensure your bed is comfortable.
  7. Keep it tidy: Keeping your bedroom clean, tidy and uncluttered can help to create a much more relaxing environment.
  8. Do not disturb: Opt for heavy, lined curtains, if you can, to prevent the early morning sunshine waking you during the summer months and to minimise any outside noise.

Sticking to these simple rules and getting a good night’s sleep on a regular basis can have a hugely positive impact on your overall health – from improving mental health, increasing immunity, and boosting fertility, to lowering your risk of diabetes and heart disease.

When should you see a doctor about a sleep issue?

Many of us will experience sleep issues at some point in our lives, and for most people, sticking to the steps above will be enough to get back into a healthy sleeping routine. However, if you feel you are experiencing persistent sleep problems, it is important you speak to a healthcare expert.

It may be useful to keep a sleep diary, including details of your daily activities and habits, as this may help to uncover the root of the problem. However, if you find the sleep issues continue for four weeks or more, speak to your doctor.  Cognitive Behavioural Therapy for example, could get to the root of the problem and help you finally achieve the restful sleep your mind and body needs.

Summer health update

As the Portuguese weather is notoriously sunny, it’s no surprise that you want to spend as much time outdoors as possible, and make the most of it!

And there’s a lot to be said for doing just that. Enjoying the sun has many proven health benefits – from boosting mental health to increasing essential vitamin D levels. But as the age-old adage goes, ‘everything in moderation’.

Whilst we don’t want to put a dampener on your fun in the sun, it is important to be aware of certain risks. That’s why we have  have put together this useful checklist of summer health risk factors…

The summer heat causes us to sweat to stay cool. However, this means our bodies are constantly losing fluids throughout the day which can lead to dehydration if this fluid is not replaced sufficiently. Children and older people are more susceptible to dehydration, the symptoms of which include:

  • Extreme thirst
  • Less frequent urination (and urine that is darker in colour)
  • Fatigue
  • Dizziness
  • Confusion

Mild dehydration can be treated at home safely by increasing your fluid intake. Oral rehydration sachets, available at your local pharmacy, can also help to replace lost sugars, salt, and minerals.

Heat exhaustion
Working, playing, or simply just relaxing in the heat can often leave you feeling a little more tired than usual. Sometimes, all that is needed is a siesta to recharge the batteries. Heat exhaustion, however, is more serious. Symptoms include:

  • Thirstiness
  • Headache
  • Loss of appetite
  • Nausea
  • Dizziness and confusion
  • Excessive sweating
  • Cramps
  • A high temperature of 38°C or above

The key thing is to cool down before the symptoms progress any further. Do this by moving to a shady area, or indoors. Drink plenty of water and lie down with your feet slightly elevated. It also helps to spritz yourself with cold water or to hold an ice pack on your skin.

Heat stroke
Heat stroke can result from prolonged exposure to high temperatures, causing the body to overheat, and it is extremely serious. Symptoms include:

  • Nausea and vomiting
  • Headache
  • Confusion
  • Lack of sweating despite the heat
  • Rapid heartbeat
  • Shallow breathing
  • Seizures
  • Loss of consciousness

If you suspect someone is suffering from heat stroke, seek medical help  immediately. If left untreated, it can lead to serious complications such as damage the brain, heart, kidneys, and muscles, and can even lead to death.

Too much exposure to the sun’s UV light can cause sunburn, the symptoms of which include:

  • Red coloured skin
  • Painful skin
  • Flaking, dry skin – usually appearing a few days after the skin has been sunburnt

To treat, move indoors and cool the affected area with a cold, wet towel. Apply after sun, drink plenty of fluids, and keep the skin fully covered when out in the sun until the area has healed completely. If you suffer from blisters, tight and painful skin or a heat rash please seek medical attention.

Remember, prolonged sun exposure and repeat episodes of sunburn can cause irreversible damage to the skin and can lead to skin cancer.

Hay fever
Hay fever is an allergy caused by pollen which causes the mucous membranes of the eyes and nose to become inflamed. Typical symptoms include:

  • Sneezing
  • Coughing
  • Runny or blocked nose
  • Itchy, red, and watery eyes
  • Headache
  • Feeling tired

Unfortunately, there is no proven cure for this summer health issue at present, but there are various things you can do to relieve your symptoms, including showering and changing your clothes after you have been outside to wash off any pollen. You can also try to keep your windows shut as much as possible.

Say goodbye to skin tags this summer

Summer sun means donning your swimwear. But if the thought of this is a little daunting because skin tags are affecting your body confidence, make an appointment at our clinic where we can remove with them safely and quickly right here in the practice. That way, nothing can hold you back from enjoying your long-overdue holiday.

What is a skin tag?

Skin tags are small, soft, skin-coloured growths that commonly appear on the neck, armpits, around the groin or under the breasts. They are completely harmless and don’t cause any pain or discomfort, nor are they contagious. They are quite common amongst pregnant women and can appear as the result of hormone changes.

Can skin tags be removed?

Whilst skin tags are harmless, some people choose to have them removed for a variety of reasons. A larger skin tag, for example, might catch on clothing or the individual might be self-conscious about how it looks. The good news is that skin tags can be removed safely and quickly right here at our practice.

How it works

Skin tags can be removed effectively through a process known as cryotherapy. This involves freezing the area which kills the cells within the skin tag, blocking the blood supply and causing it to eventually drop off. The whole process is over within just a few minutes, although it is worth noting that larger skin tags may require more than one treatment session.

The doctor will see you now

Call 289 588923 or email our reception team at internationahealthcentres@gmail.com  to book an appointment at a time that suits you. We’re open five days a week and we often have short-notice appointments available.

At your initial appointment, one of our highly qualified will carry out an in-depth consultation to discuss and assess the skin tag. Here, they will inform you if the skin tag can be removed in the practice.

Should the GP decide it is safe to proceed with the removal, an appointment will be made at the practice.

Introduction to chronic pain

It is estimated that between 12%-20% of the population suffer from chronic pain, which is defined as consistent pain lasting 3 months or more. This can be debilitating for sufferers, with many people feeling constant pain over many months or even years

Chronic pain can be split into two categories:

Chronic Secondary Pain is caused by an underlying condition such as arthritis or endometriosis whereas Chronic Primary Pain is when the cause is unknown. With painkillers often not working, patients can be left feeling lost and in search of alternative pain relief methods. Pain can also be very personal with its levels unable to be felt by others, often making it a very isolating experience for most sufferers.

The effects of painkillers

Many people suffering with chronic pain will use some level of painkillers. However, painkillers may not always be the best way to treat a complex issue like chronic pain as the root of the problem is not always clear and diagnosis will be broad and hard to treat. Many people can also grow dependent on strong painkillers, with little difference made to the actual level of the pain – studies show that painkillers do more harm than good in this scenario, and lifestyle and mindset changes can be key in decreasing reliance on strong pain killers.

If you are suffering from chronic pain, you may feel concerned about eradicating or even reducing the amount of pain relief that you take, worrying that the pain will inevitably increase or get worse. However, as painkillers are not proven to work on consistent pain, alternative methods are proven to be the best way to manage it over time and will also decrease a lot of the common negative side effects associated with long term pain killer use.


As daunting as it may seem at first, self-management has been shown to greatly improve the wellbeing and quality of life of someone suffering with chronic pain. Over time, the effects of slowly and steadily becoming more active and implementing new lifestyle and mindset changes has been instrumental in living with chronic pain. One of the first steps is acceptance of the pain as a part of your life, and then focusing on working towards reducing this to a manageable level rather than eradicating the pain entirely straight away.

Pacing is an effective technique to practice where patients can break tasks down into much smaller increments, so they don’t over-exert themselves and cause further pain, especially if they are starting from a very sedentary lifestyle and gradually upping their activity as endurance levels increase. This means that on days the patient feels better, they don’t then do more than they normally would and in turn cause further pain and a longer recovery time, instead they keep their activity levels consistent and build the momentum in a sustainable way.

Setting small but manageable goals such as getting outdoors every day (even if this means spending time in the garden) will give you something tangible to work towards, don’t focus on any negatives but instead set time-bound and realistic goals with a clear action.

Therapies that can help

There are many therapies and exercises that can help alongside self-management that will target different needs.

Some of these include:

Although the last thing that you may feel like doing is exercising, gentle activity will help you recover and build your pain tolerance. Walking or swimming are great starter exercises and will loosen muscles and increase blood flow around your body – as well as releasing those feel-good endorphins!

Manual Therapies
Physiotherapy and manual therapies can help build tolerance to physical activity as stretching and strengthening the muscles can help prevent further injury. If needed, physiotherapists can also provide a pain management program tailored to increase physical activity and movement.

Alternative Therapies
Alternative therapies such as hydrotherapy and acupuncture can work for some individuals too. Gentle exercises such as yoga and tai chi can help manage pain as they combine mindfulness with movement.

Mental Health Support
Chronic pain can have a detrimental effect on mental health, which in turn also takes a toll on the body – so it is important to have a healthy outlet to release any frustrations. Mindfulness is a good practice to learn to relax and meditate in the surroundings of your own home..

Flare-ups and how to manage these

Unfortunately, in the world of chronic pain, flare-ups may happen from time to time. The key is not to lose any progress made and having a plan of action in place so that you are prepared and do not panic. Try to stay as active as possible, as hard as it may be – it will make recovery much quicker and easier to manage.

How a simple blood pressure test could save your life

To mark World Hypertension Day on 17th May, we’re talking about the blood pressure test, available at our practice. Here, your GP discusses the ins and outs of hypertension, and urges everyone to take the test which could potentially save you from the silent killer.

Getting to the heart of the problem

A blood pressure test quite simply measures the pressure inside your arteries as your heart pumps blood. Of course, your blood pressure changes continually depending on a whole range of things such as how active you are, your diet, temperature, emotional state, or current medication, for example.

However, when resting, we would expect to see your blood pressure sit within a certain range. Figures outside this range can be an indication of a health issue.

Putting it to the test

A blood pressure test takes just minutes to complete. First, you’ll be asked a few questions about your medical history, general health, and lifestyle. Rest assured, we’ll ensure you’re fully comfortable and relaxed before commencing the test.

Second, we’ll ask you to rest one arm on a table, and we’ll place a fabric cuff around your upper arm. We’ll then inflate the cuff using a small hand-held pump, and as the cuff deflates, a machine will read your blood pressure and display the numbers on a screen.

The whole process takes just a minute and the results will be provided immediately. You’ll be given plenty of time to ask questions and, depending on your results, you’ll be carefully guided through the next steps, should any further action be required.

Figuratively speaking

A healthy blood pressure reading should be around 120/80mmHg. Anything significantly above or below that level will need to be investigated. For instance, a figure of 140/90 or higher would suggest high blood pressure, also known as hypertension. On the other hand, a figure of 90/60 or lower would suggest low blood pressure, also known as hypotension.

Rising tension

High blood pressure is thought to affect around 1 in 3 adults, leaving them more at risk of heart problems, strokes, kidney disease, and damage to other vital organs.

Certain groups are classed as being more at risk than others. They include those who:

  • Are age 60+
  • Have a family history of high blood pressure or heart disease
  • Are overweight
  • Don’t exercise regularly
  • Are of Asian or African-Caribbean descent
  • Have a diet high in salt
  • Have a diet low in fruit and vegetables
  • Drink more than 2-3 units of alcohol a day for women, or 3-4 units for men

However, it must be emphasised that all adults are at risk of high blood pressure and it is therefore vitally important that we all take steps to reduce our risk where possible.

Time to take the test

Many sufferers of high blood pressure don’t experience any symptoms, hence the reason hypertension is often referred to as ‘the silent killer’. Therefore, a blood pressure test is the only way to detect the problem.

We recommend those classed as high-risk have a blood pressure test every year. For everyone else aged over 40, we recommend you have a blood pressure test every 5 years.

A 5-minute test can keep you safe.  Book an appointment with us.

Get motivated, get active, get results

The New Year is traditionally a time for new beginnings. And whilst getting active to improve health and fitness levels is often at the top of many people’s wish list for the year ahead, we understand that putting that goal into action can be easier said than done.

So read on for some tips and advice on how to get motivated, get active, and get results. Trust us, you’ll be glad you powered through when the health benefits of regular exercise start to become apparent!

There’s always an excuse

Taking that first step towards a healthier lifestyle is always the hardest part, and there is often a plethora of excuses to give up before you’ve even started:

  • “I won’t enjoy it”
  • “I don’t have time for it”
  • “I’m too tired”
  • “It’s too difficult”
  • “It’s too expensive”
  • “I’m too old”
  • “I’m too embarrassed”

So, first things first – change your mindset. Think about WHY you want to start exercising and focus on the positive changes that will bring to your life.

Start slowly

If you’re starting exercise for the first time, or after a long break, it’s important not to push yourself too far. Set yourself small, manageable, realistic goals – such as a brisk walk around the block, building up to a longer walk, then a jog. And make sure you warm up and cool down with gentle muscle stretches to reduce the risk of muscle strain and injury.

Create a routine

Whether you prefer to exercise first thing in the morning, during a lunch break, or after work – find a time that suits you and stick to it. Finding motivation to get active is easier when it becomes a natural part of your regular routine.

Buddy up

For an extra motivational boost, consider exercising with a friend. You’ll be less likely to miss a planned session to avoid letting down a friend, plus they’ll be there to spur you on if you find the exercise particularly tough.

Keep it interesting

It can take a while to find an exercise that you enjoy, but keep challenging yourself with new forms of exercise, workout routines, and jogging routes for example, to maintain your interest.

Congratulate yourself

Try to view exercise as a form of self-care, rather than a punishment! Embrace the endorphin rush after each session and feel good about what you’re achieving.

Start seeing the benefits

Once you’ve got a regular routine, it’s just a matter of time before the benefits start to become obvious. Aside from the changes to physical appearance such as weight loss and more toned muscles, you may also start to notice a boost to your mental health, self-esteem, mood, sleep quality and energy levels.

There will also be a range of positive changes happening internally that you might not be aware of. For example, long-term, people who exercise regularly have a lower risk of developing:

  • Heart disease
  • Type 2 diabetes
  • Stroke
  • Some cancers
  • Osteoarthritis
  • Dementia
  • Alzheimer’s disease
  • Clinical depression

If you would like further help or advice about making positive, healthy lifestyle changes, speak to your GP.

Check in with friends on World Mental Health Day

World Mental Health Day falls on 10th October every year and serves as an important reminder of the need to reflect on our wellbeing. This year, it is more important than ever as the pandemic continues to affect our lives in so many ways. And so we are encouraging everyone to check in on their friends, family, neighbours, and colleagues. Read on to discover some of the most common mental health issues arising from the covid crisis and how you can offer support to friends who may need it most.


Cut off from the world during lockdown, shielding, or self-isolation – loneliness has had a huge effect on many people. It is also continuing to affect those missing out on important milestones or precious time with loved ones, and remote workers craving social interaction with colleagues in the office.

If sustained for a long period, chronic loneliness can have a huge impact on an individual’s mental health. They may feel overwhelmingly isolated, they may lose confidence in themselves, and they may find themselves unable to connect with people on an intimate level. The idea of socialising after a prolonged period of loneliness may cause the individual anxiety, triggering the stress hormone, cortisol, and leaving the person feeling exhausted.

It is therefore vital to check in regularly with friends and let them know they are not alone – if not in person, then by text, phone call, or video. Help keep their mind active by suggesting new hobbies and pastimes, or encourage them to volunteer or accompany them to a group to meet new people.


So much about life in the pandemic has been unsettled, so it is only natural that most people have felt anxiety to a certain extent over the past year. Fears surrounding the effects of covid, nervousness about another wave – it is all completely understandable.

However, if left unmanaged, prolonged anxiety can lead to health issues, such as sleep disruption, digestive problems, lowered immune system, and it could even increase the risk of heart disease.

If you notice that anxiety is starting to overwhelm a friend, it is important that they talk to someone. Make sure they know you are always available, should they ever feel a need to talk through a problem. If you think they are struggling to concentrate or deal with everyday tasks, or it is escalating into panic attacks, it is essential that they speak to a health professional who will be able to treat the condition through therapy, medication, or a combination of the two.


Most people would agree that life is a juggle, but for many people, the past year has taken multi-tasking to the next level! Working from home whilst home-schooling the children has left many feeling burnt out. Add to the mix financial worries and doubts over job security, and it’s easy to see how stress can take over someone’s life.

Tension headaches, difficulty sleeping and concentrating are tell-tale signs that a friend may be under stress. If left untreated, prolonged stress can lead to a wide range of health issues including depression, high blood pressure, heart attack, and stroke.

Look out for the signs and offer practical help if you can to help lighten the load. Offer to babysit their children for a couple of hours, recommend a yoga class, or encourage them to take a sick day to focus on getting their mental health back on track.

It’s good to talk

If you think someone you know is suffering with their mental health, the key thing is to let them know that they can talk openly with you. Listen without judgement and support them when needed. Should they need to discuss anything with a medical professional, appointments are available with our GP´s.


Alzheimer’s: Knowing the signs and symptoms and living with the condition

There are lots of causes of dementia, and many different types too. You may often hear the terms Alzheimer’s and dementia and understand that they are both related to memory loss, but it can be confusing to understand their differences, what each of them mean and how they are both related. ‘Alzheimer’s’ is a type of dementia,
and along with ‘vascular dementia’ makes up the majority of dementia cases.

Alzheimer’s is a degenerative condition, meaning it will get worse over time. It occurs when an individual’s brain cells begin to die and overtime,  the brain will function less and symptoms will worsen. Alzheimer’s causes a gradual decline in memory, thinking and reasoning skills. The severity of these symptoms depends on the stage of the disease.

The early signs of Alzheimer’s

At the start, the symptoms of Alzheimer’s can be fairly mild and may even be confused with natural symptoms of ‘getting older’. Although everyone’s experience may differ slightly, for the majority of people, the first signs of Alzheimer’s is memory loss; finding it difficult to remember recent events and conversations, easily misplacing items such as keys and glasses or forgetting about important appointments and significant dates like birthdays.

A person in the early stages of Alzheimer’s may also have changes in their mood, becoming anxious or depressed and often frustrated and more easily annoyed. These symptoms can be particularly difficult for the individual and for close family and friends too.

What to expect as Alzheimer’s advances

As Alzheimer’s worsens, the symptoms become more severe and a person suffering with Alzheimer’s will eventually need day-to-day support. Some individuals start to have delusions and believe events have occurred that are not true. Changes in behaviour may also occur and they may also start to react aggressively to certain situations, become more agitated and behave differently to how they would’ve previously behaved.

As Alzheimer’s progresses into the later stages, the person will become much less aware and may struggle with their basic needs such as eating, walking and bathing, requiring help with more or all of their daily activities.

What to do if you think a loved one has dementia or Alzheimer’s?

If you think a loved one is experiencing the early signs of dementia, although it is a difficult topic to bring up and you may be afraid of upsetting or worrying them, it’s important to encourage them to speak to their GP.

Memory loss doesn’t always mean dementia and can be linked to stress, anxiety and a natural part of getting older. However, it is important to ask your loved one to speak to a GP to get diagnosed with the cause properly. If dementia is the cause ofmemory loss and is found early, in some cases, the progression can be slowed down with medication and the person may be able to maintain their mental function for longer.

What happens when you seek a dementia diagnosis?

Initially, a GP will ask more about the symptoms and how they have developed. They may also do a memory test and physical examination. Blood tests may be carried out to rule out any other conditions.

Once or if any other causes are ruled out, your GP will refer your loved one to a memory clinic, or other specialist service, where more observations and assessments are carried out to confirm the diagnoses.

How to support a loved one with Alzheimer’s

As well as living with the symptoms of Alzheimer’s, the condition can also have a significant emotional, social, psychological and practical impact on a person’s life, with a loss of independence, skills, self-esteem and confidence combined with worries about what the future will look like.

When supporting a loved one with dementia, it can be helpful for you to try and understand how they might think and feel, as these emotions will also affect how they behave. They will probably be experiencing a world that is very different to yours, so trying to see things from their perspective will help you offer support.

As a carer, family member or friend, you cannot help to slow down the symptoms of Alzheimer’s but by practicing the following, it can help you both manage living with the condition:

  • Keep things nice and simple, asking or saying one thing at a time so conversions or events are easy
    to follow.
  • Try and have a daily routine, so your loved one can expect when certain things will happen. This gives a structure to the day or week that doesn’t rely on the person’s memory.
  • Reassure them that he or she is safe and that you are there for them.
  • Focus on his or her feelings in the present moment and talk about how they may be feeling.
  • Don’t argue or try to reason with your loved one, their perception will likely be different to yours.
  • If the person repeats a question, it won’t help to tell them that they’ve already asked. Repeat your answers in a simple way.
  • Encourage your loved one to use a diary, journal or calendar to record events and conversations.
  • If the person is given an appointment card, put it where the person can easily see it. For example, you could pin it to a noticeboard.
  • Reduce distractions, such as background noise, to help the person focus on the task at hand.
  • Sometimes you may feel frustrated, angry or upset. Try and be patient with your loved one. If you feel like you need a break or some help, don’t be afraid to ask. There is lots of support available for both you and your loved one.

Getting help and support for you and your loved one- Living with Alzheimer’s can be extremely difficult and at times upsetting for an individual, and equally for their carer too. Don’t be afraid to ask for help. There is
support available.


How your GP can help

You can make an appointment to discuss your concerns about wither yourself or a loved one. Your doctor can discuss the types of evaluations or tests that can be conducted to help diagnose.

Support Services that can help with things like:

  • Providing carers to help with washing and dressing
  • Laundry services
  • Meals on wheels
  • Aids and adaptations

What you can do to prevent Alzheimer’s and vascular dementia Research suggests that lifestyle factors and conditions associated with cardiovascular diseases, such as heart disease, can increase the risk of Alzheimer’s disease and are also directly linked to vascular dementia.

These lifestyle factors include:

  • Smoking
  • Obesity
  • Diabetes
  • High blood pressure
  • And high cholesterol

To help reduce the risk of Alzheimer’s and vascular dementia, you can:

  • If you smoke, stop.
  • Eat a healthy, balanced diet to prevent diabetes
  • Lead an active life, both physically and mentally
  • Maintain a healthy weight
  • Limit your alcohol intake
  • Have regular health checks as you get older

And, if you are already diabetic, then working hard to reduce your blood sugars through regular exercise is important. You can do this by eating lots of fibre-rich foods like nuts, fruit, vegetables and wholegrains, reducing carbohydrates as carbs eventually break down into sugars, drinking plenty of water and implementing portion control.

The story Of Achilles

Most people are familiar with Achilles, the famous Greek warrior who died after he was shot by an arrow in his tendon, now called the Achilles tendon.

The vulnerability of the Achilles tendon in sports is probably one of the most debilitating injuries that end a lot of sport careers.
If you look at an anatomy chart you will see what a tremendous strength this tendon must have to withstand everyday exertion.

There are numerous reasons why an Achilles tendon gets into trouble. For example:

  1. Repetitive overexertion
  2. Wrong foot position
  3. Acute (partial) rupture
  • Overexertion happens a lot when people start a sport without knowledge or built-up (running, gym). Repetitive straining damages the matrix and texture of the tendon, and results in a thickened and less dense quality of the Achilles (tendinopathy). This can be made visible by Ultrasound scanning (echography). Treatment has to contain two things: repair by Shockwave treatment and start of a 12 week program of ‘eccentric loading’. This program will create new, healthy tissue. After 12 weeks one can return to a gradual built-up in intensity to return to normal activity (image 1).
  • Wrong positioning of the foot leads to several problems: falling of the medial arch which will cause fasciitis plantaris or heel spur, but also a strain of the (medial) side of the Achilles. A reactive tendinopathy shows itself by acute swelling of the sheath (not the tendon!). Treatment is rather simple: correction of the foot position (insole) and relative resting + ice. In most cases no further treatment is necessary (image 2).
  • A (partial) rupture of the Achilles is dramatic in most cases: an acute tear of the tendon leads to a long-term treatment program. A complete tear needs surgery straight away. If not, the tendon will retract and connecting the ends will be quite impossible. A partial tear can be treated conservatively. Six weeks cast or boot in a plantar position and afterwards gradually stretching of the tendon. In this case no certainty that the tendon comes back to normal levels though… (image 3).
 When there is doubt of the severity of the injury, always make an Ultrasound scan!

Treatment without knowledge can lead to dramatic mistakes of strategy.
And once again: NO cortisones. It will lead to weakening of tissue and can induce a rupture.
And finally: a certain group of antibiotics (fluorchinolones) can cause sudden ruptures of large tendons (i.e. biceps and Achilles).

Be safe: when you have (chronic) Achilles problems, do not experiment but see a qualified therapist to determine the origin of your trouble.