Achilles Tendinopathy

Achilles tendinopathy (commonly known as Achilles tendonitis) is a common overuse soft tissue injury causing pain and stiffness in the tendon at the back of the ankle. The Achilles tendon is a large tendon that connects the calf muscles to the heel bone. It is the largest tendon in the body and is responsible for helping you walk, run, jump, and perform other physical activities.

The majority of people with Achilles tendinopathy are active and are involved in recreational or competitive sport.It is often caused by overuse, repetitive stress, or sudden changes in physical activity.

Who experiences Achilles tendinopathy:

  • Common in running populations.
  • 1 in 3 of the inactive population.
  • Increased age, most frequently by people aged between 40 and 59 years.
  • Obesity has also been associated with the condition.


  • Pain and stiffness in the Achilles first thing in the morning.
  • Upon weight bearing after prolonged rest.
  • Pain at the start of physical activity.
  • You may also experience swelling and tenderness in the area, as well as a limited range of motion.

Symptoms of Achilles tendinopathy can vary from mild to severe. These symptoms lead to impaired performance. In more severe cases, pain and disability can be persistent with functional activities such as walking. 69% of people experience pain and swelling in the mid portion of the tendon, 16% experience insertional and 15% experience a mix of both mid portion and insertional tendinopathy (see image below)


How to improve the symptoms of Achilles tendinopathy:

If you suspect that you have Achilles tendinopathy, it is important to see a physical therapist if the symptoms are not resolving following a short period of basic pain relief and relative rest / activity modification. A Physiotherapist will be able to diagnose your condition and develop a treatment plan that is tailored to your specific needs.

What does treatment of Achilles tendinopathy involve?

Treatment for Achilles Tendinopathy usually involves a combination of activity modification, which is planned with your therapist along with a personalised rehabilitation program. Medication may be advised such as anti-inflammatories to help manage pain and reduce swelling. Identifying provocative activities and planning activity modification is essential to allow the tendon to settle. Physical therapy may include strengthening exercises to improve the tensile strength of the tendon and reduce reactive inflammation. A pain and load monitoring tool below used throughout rehabilitation for the strengthening elements of rehabilitation and for the re-introduction of activities / hobbies /sports.

motoring response

Rehabilitation of Achilles tendinopathy:

See below sample of exercises which are useful for treatment of Achilles tendinopathy. Your Physiotherapist will design an individualised, client-centred exercise prescription for you.



Preventing Achilles tendinopathy involves taking steps to reduce your risk of injury. This includes being mindful of a gradual, not sudden change in load, endurance, quantity of activity / sport / conditioning. Appropriate rest phases for recovery is vital and wearing appropriate footwear.

In conclusion, Achilles tendinopathy is a common condition that can cause pain and discomfort in the back of the heel. If you suspect that you have this condition, it is important to seek advice from a physiotherapist and follow a treatment plan that is tailored to your needs. With proper treatment and prevention, you can reduce your risk of developing this condition and enjoy a healthy, active lifestyle.