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Achilles Tendinopathy
Achilles tendinopathy is pain and thickening in the tendon at the back of the heel, from loading it faster than it can adapt. It behaves like other tendinopathies — stiff in the morning, warms up with activity, sore afterwards — and it responds to progressive loading. Where the pain sits, mid-tendon or right at the bone, changes the program, which is why it is worth having assessed.
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Does this sound like you?
Most people have several of these, not all of them.
- Pain and stiffness in the tendon first thing in the morning
- Warming up during activity and hurting more afterwards
- Tenderness and sometimes visible thickening of the tendon
- Pain on hopping or going up onto tiptoe
- Discomfort in shoes that press on the back of the heel
Why it happens
- A rapid increase in running, hill work or jumping
- Returning to sport after a break without a build-up
- Calf weakness and reduced ankle range
- A change in footwear, particularly heel drop
- Certain antibiotics, and conditions affecting tendon health
What we would do about it
Roughly in this order — each step waits for the one before it.
- Isometric loading early for pain relief
- Progressive calf and tendon loading, built up over months
- Distinguishing mid-tendon from insertional pain, which changes the exercises
- Footwear and heel raise adjustments in the early phase
- Running volume and technique management
- Sudden severe pain with a snap needs urgent review for rupture
See a doctor first if
- Your pain followed a significant injury
- It is getting worse rather than settling
- It comes with numbness, weakness or unexplained weight loss
This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment.
Where the pain sits changes the treatment
Pain in the middle of the tendon and pain right at the heel bone need different loading programs, and using the wrong one is why some achilles problems drag on. Ask a question first, or call us on 0403 907 587.
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Other foot conditions we treat
Related reading: pain under the heel instead, calf muscle tears and the same problem at the knee.
General information only, not advice about your own problem — nothing here replaces an assessment. Source: Achilles Tendinopathy on Physiopedia.
