Achilles Tendinopathy

Achilles Tendinopathy is commonly known as Achilles Tendinitis. It is a frequent cause of lower calf pain and heel pain. It is usually characterised by a degeneration or worn down of the Achilles tendon, which means it does not possess its normal tensile strength and may be liable to further damage and pain during sporting activity.

Signs & Symptoms

Achilles InjuryThe main symptoms are pain and stiffness of the tendon,  just above your heel bone. It usually develops gradually and may be more noticeable after a period of rest, such as first thing in the morning. The pain may improve with exercise to begin with. Over time, symptoms may worsen; you may start to experience pain after exercise and finally pain during exercise. The tendon above your heel may appear slightly swollen and feel stiff.

Cause of Achilles Tendinopathy

Achilles tendinopathy is an overuse injury. Too much loading(running/jumping) occurring in too short time, may cause these types of overuse injuries. However other factors can contribute to developing the condition.

  • Increase in activity (distance, speed or hills).
  • Don’t leave enough recovery time between training sessions.
  • Change of footwear or training surface for example changes from grass courts to hard courts
  • Weakness calf muscles or posterior chain
  • Decreased range of motion at the ankle joint, usually cause by tight calf muscles.
  • Running up hills – the Achilles tendon has to stretch more than normal on every stride. This is fine for a while but will mean the tendon will fatigue sooner than normal.
  • Overpronation or feet which roll in when running can place an increased strain on the Achilles tendon. As the foot rolls in (flattens) the lower leg also rotates inwards which places twisting stresses on the tendon.
  • Wearing high heels constantly shortens the tendon and calf muscles. When exercising in flat running shoes, the tendon is stretched beyond its normal range which places an ‘abnormal’ strain on the tendon.
  • Neurological problems
  • Diabetics
  • Obesity
  • Smoking


Usually, by obtaining a good clinical history and assessment, further investigations may not be necessary. However in the event of a possible partial rupture further investigations may be indicated. These can include:

  • Diagnostic Ultrasound  which uses high-frequency sound waves to produce an image of the Achilles tendon to look for any changes to the tendon tissue
  • MRI (magnetic resonance imaging) scan, which uses magnets and radio waves to produce two- and three-dimensional pictures of the leg to determine if any fluid or tears in the Achilles tendon is seen.

Self Treatment

There are a number of things you can do to help Achilles tendinopathy.

  • Wear a small heel raise in each shoe to help reduce the load on your Achilles tendon and give immediate relief of pain when walking.
  • Reduce the load of the tendon.
  • Gradual increase of loading and activity of the tendon – slowly!
  • Wear supportive footwear.
  • Ice during the reactive phase
  • Ibuprofen during the reactive phase (as prescribed by a GP)

How can Physiotherapy help?

We will be able to help by analysing the extent of your injury and help manage / rehabilitate your injury. The physiotherapist will use various techniques to help speed up the healing of your Achilles tendon and go through a rehabilitation program to prepare your return to any activity or exercise regime.

Most importantly, we will be able to give you advice to prevent further injury or re-occurring.

Exercises and the amount that you do is the key ingredient is the key success.

The contents of this article – Achilles Tendinopathy Injuries, is for informational purposes only and should not be treated as medical or health management advice. The materials herein are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, physiotherapist or other health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this article or website. Reliance on any information provided herein is solely at your own risk.