Freese, Clark and Storrar - physiotherapists

Achilles tendonopathy


Your Achilles tendon is found just behind and above your heel. It joins your heel bone (calcaneus) to your calf (gastrocnemius) muscles. The Achilles tendon helps to bend your foot downwards at the ankle (point your toes).

Achilles tendonopathy is a condition that causes pain, thickening, and stiffness of the Achilles tendon. It is caused by repeated micro injuries or degeneration at the Achilles tendon. For most people, the symptoms of Achilles tendinopathy usually resolve within 3-6 months of starting treatment.


Here are a few of the causes of Achilles tendonopathy:

  • Overuse of the Achilles tendon: most commonly seen in runners, but can also be seen in people who are involved in dancing, racquet sports or sports that involve jumping.
  • Inappropriate footwear
  • Poor training or exercising techniques
  • Recent changes to your training programme such as increasing the intensity of your training.
  • Training on hard or inclined surfaces.
  • Feet with high or dropped arches.
  • Having poor flexibility or weakness in the surrounding musculature for example your hamstrings or calf muscles.


What you could feel if you have Achilles tendonopathy?

  • Pain and stiffness around the Achilles tendon: either in the mid portion or at the insertion of the Achilles tendon at the heel
  • Symptoms tend to develop gradually
  • Symptoms are usually worse when you first wake up in the morning
  • Difficulty walking
  • Pain after exercising is common but can also occur during exercises
  • Thickening or redness around the Achilles tendon
  • Tender to touch


How can Achilles tendonopathy be managed?

  • Rest: Rest from sport or aggravating activities is important if you have Achilles tendinopathy. As your symptoms improve, you may commence exercise as your pain allows. Your physiotherapist can advise you on the appropriate amount of exercise and when to commence them.
  • Ice: Ice can be useful for pain control in the early stages of Achilles tendinopathy. An ice pack should be applied for 10-30 minutes (Be careful that you do not burn yourself).
  • Manage your footwear: wear a heel pad to slightly raise your heel initially or when symptomatic, also ensure that your shoes are padded and supportive
  • Achilles tendon exercises: It is advisable to consult your physiotherapist for exercises that are specific to your condition. Exercises may help to strengthen your Achilles tendon and increase its resilience so that you get back to your sports or exercises. Such exercises may also help with pain control and stiffness.
  • Physiotherapy: Your physiotherapist can help to release the Achilles tendon as well as surrounding musculature as well as advise you on specific exercises. 

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