Introduction:
Achilles tendinopathy, also known as Achilles tendonitis, is a common condition that affects the Achilles tendon, the large band of tissue connecting the calf muscles to the heel bone. The condition typically occurs in athletes, particularly runners and those who engage in high-impact sports. While Achilles tendinopathy can be painful and frustrating, it is essential to understand its causes, symptoms, treatment options, and preventive measures to manage the condition effectively.
What Causes Achilles Tendinopathy?
Achilles tendinopathy can develop due to various factors, including:
- Overuse or Repetitive Stress: The most common cause of Achilles tendinopathy is overuse or repetitive stress on the tendon. Activities that involve sudden increases in intensity, duration, or frequency can strain the tendon and lead to microscopic tears.
- Poor biomechanics: Flat feet, high arches, or improper gait can increase the stress on the Achilles tendon during physical activities, making it susceptible to injury.
- Age: As we age, the blood supply to tendons decreases, making them more vulnerable to injury and slower to heal.
- Tight Calf Muscles: Tightness in the calf muscles can put additional strain on the Achilles tendon, leading to tendinopathy.
- Inadequate Warm-up: Failing to warm up adequately before physical activity can increase the risk of injury to the Achilles tendon.
What Are The Symptoms of Achilles Tendinopathy?
Recognising the symptoms of Achilles tendinopathy is crucial for early diagnosis and prompt treatment. The common symptoms include:
- Pain and stiffness: persistent pain and stiffness around the Achilles tendon, especially during physical activity or when waking up in the morning.
- Swelling and Tenderness: Swelling and tenderness around the back of the heel where the Achilles tendon attaches to the bone.
- Morning Pain: Increased pain and stiffness in the Achilles tendon area upon waking up in the morning, which may improve with gentle movements throughout the day.
- Gradual Onset: The symptoms of Achilles tendinopathy typically develop gradually rather than suddenly.

How Can Physiotherapy Help Achilles Tendinopathy?
The treatment approach for Achilles tendinopathy aims to reduce pain, promote healing, and prevent recurrence. It is a very common condition that we see as Physiotherapists and our treatment approach consists of the following.
- Comprehensive assessment and diagnosis of the condition. This includes taking an in-depth history in order to establish the reasons why an achilles tendinopathy developed. It may also include gait analysis on our treadmill to establish if there is a biomechanics cause of your injury.
- Advising on whether to rest or not. It is natural to want to continue with your normal exercises or daily activities and as Physiotherapists we are experts in advising you on whether you need to rest or adapt your activities. We will always want to keep you as active as possible and return to the activities you love as soon as possible!
- Rehabilitation: It is very important to regain strength and flexibility in the muscle and tendon complex and following a graded rehabilitation program is key to recovery. Engaging in specific stretching and strengthening exercises under the guidance of a physiotherapist can improve tendon flexibility and strength, enabling you to return to previous activities.
- Soft tissue therapy to improve flexibility and ease pain.
- Orthotics: Sometimes, customised orthotics or shoes insert may be recommended to correct biomechanical issues and reduce stress on the Achilles tendon.

How Do You Prevent Achilles Tendinopathy Recurring?
Preventing Achilles Tendinopathy is essential for individuals who are prone to this condition. Here are some preventative measures to consider:
- Gradual Progression: Increase exercise intensity, duration, or frequency gradually to allow the body to adapt to the demands.
- Proper Footwear: Choose appropriate footwear that provides adequate support and cushioning for physical activities.
- A progressive Stretching and Strengthening Programme: Regularly perform calf stretches and exercises that strengthen the calf muscles and Achilles tendon.
- Cross-training: Incorporate low-impact activities into your routine to reduce stress on the Achilles tendon.
Conclusion:
Achilles tendinopathy can be a painful and limiting condition, but with proper management and prevention, individuals can recover and return to their desired level of physical activity. If you suspect you have Achilles tendinopathy, do contact us to make an appointment for assessment and treatment advice. By understanding the causes, symptoms, treatment options, and preventive measures, you can take proactive steps to protect your Achilles tendon and continue doing the things you love!