What is Achilles Tendinopathy?

• Achilles tendinopathy refers to pain, swelling, and dysfunction of the Achilles tendon—the thick band of tissue that connects your calf muscles to your heel bone. It plays a vital role in walking, running, and jumping.

• There are two main types:

  1. Mid-portion Achilles tendinopathy – affects the middle of the tendon

  2. Insertional Achilles tendinopathy – affects where the tendon inserts into the heel bone

• It may also be called Achilles tendinitis, especially when inflammation is present, though “tendinopathy” is the more accurate term for chronic or overuse-related changes.

 What Causes It?

Achilles tendinopathy is often an overuse injury, caused by repetitive strain or sudden increases in activity. Contributing factors include:

• Sudden increase in walking or running load

• Poor footwear or unsupportive shoes

• Tight or weak calf muscles

• Poor foot biomechanics (e.g. flat feet or high arches)

• Inadequate recovery time after exercise

• Previous injury or trauma to the tendon

• Excessive hill running or stair climbing

   

Common Symptoms

• Gradual onset of pain at the back of the heel or lower calf

• Pain with walking, running, or rising onto tiptoes

• Morning stiffness or pain during the first steps

• Swelling or thickening of the tendon

• Tenderness when the area is pressed

• Pain that improves with movement but worsens afterwards

   

Treatment & Management

Treatment aims to reduce pain, improve function, and prevent recurrence. Here’s what you should focus on:

1. Activity Modification

• Reduce or temporarily stop activities that aggravate the tendon (e.g. running, jumping)

• Avoid walking barefoot or on hard surfaces for long periods

• Replace high-impact exercise with lower-load options like cycling or swimming

2. Footwear Advice

• Wear supportive shoes with cushioning under the heel

• Avoid flat shoes, thongs, or unsupportive sneakers

• A heel lift may be prescribed to offload the tendon temporarily

3. Ice Therapy

• Ice the area for 15–20 minutes after activity or when sore

• Use a towel between skin and ice to prevent frostbite

4. Calf Stretching & Foam Rolling

• Gentle stretches for calf muscles (gastrocnemius and soleus)

• Use a foam roller to release muscle tightness (as advised by your podiatrist)

5. Strengthening Exercises

• Eccentric loading (controlled lowering exercises) is key in long-term recovery:

• Heel drops off a step (your podiatrist will guide reps, sets, and progression)

• Avoid rushing this—progressive loading is vital for tendon healing

6. Orthotic Therapy (if prescribed)

• Custom or prefabricated orthotics may help correct biomechanics and reduce strain

• Your podiatrist will assess this based on your foot type and activity level

7. Manual Therapy & Taping

• In some cases, soft tissue therapy, dry needling, or taping may be included in your treatment plan

   

What’s the Recovery Time?

• Recovery varies but typically takes 6–12 weeks, depending on severity, consistency with rehab, and activity levels

• Chronic cases may take longer

• Don’t stop your rehab early just because the pain improves—stick to your full plan for long-term results

   

Do I Need Imaging?

Not always. A clinical diagnosis is usually sufficient. However, ultrasound or MRI may be used if:

• There’s no improvement after 6–8 weeks

• A tear or other condition is suspected

   

Prevention Going Forward

• Warm up before exercise

• Gradually increase your activity level

• Strengthen calves and ankles regularly

• Replace old shoes when worn

• Continue using supportive footwear

   

Follow-Up is Important

Regular follow-ups allow your podiatrist to:

• Monitor your progress

• Adjust exercise levels

• Check footwear and orthotic response

• Modify the plan if pain persists

   

We’re here to support your recovery every step of the way. If you have questions or your symptoms change, contact us.