Achilles Tendinopathy


Learn more about Achilles tendinopathy, its symptoms, and recovery with Restore Physiotherapy.

What is Achilles Tendinopathy? 

Achilles tendinopathy refers to the acute or chronic inflammation of the Achilles tendon, typically caused by overuse and stress placed on the tendon. This type of injury is most common among runners, active adults, athletes, and elderly patients. 

The Achilles tendon is the strongest and biggest tendon in the human body, connecting our calf muscles to the back of the heel. However, it is also one of the most commonly injured tendons in the body. 

Achilles Tendinopathy

What causes Achilles tendinopathy? 

The risk factors of Achilles tendinopathy are usually intrinsic and extrinsic.

Intrinsic Risk Factors

  • Age (common as you age)
  • Sex (more common in men)
  • Metabolic dysfunction
  • Muscle weakness
  • Gastrocnemius dysfunction
  • Lateral instability of the ankle

Extrinsic Risk Factors

  • Mechanical overload
  • Inadequate equipment (shoes)
  • Obesity
  • Prolonged steroid use
  • Direct trauma to the muscle
  • Hard training surfaces
  • Rapid change to load


Common signs and symptoms of Achilles tendinopathy  

If you’re experiencing any of the following symptoms, please make an appointment with one of our friendly physiotherapists today. 

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Pain and stiffness in the heel or lower calf, especially first thing in the morning or after rest

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Tenderness and discomfort when pressing on the tendon 

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Swelling or thickening of the tendon (it looks or feels bigger than usual)

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Pain during or after exercise, especially running or jumping

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Difficulty hopping or pushing off the foot, like when walking uphill or climbing stairs

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Tight calf muscles

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Reduced ankle movement or flexibility

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Weakness in the affected leg, especially when doing heel raises

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Visible difference in movement when comparing the injured and uninjured sides (like less range or strength) 


Getting better with Restore Physiotherapy 

Restore Physiotherapy

At Restore Physiotherapy, we believe in a holistic, natural approach to recovery. Our experienced team utilises a range of treatments such as massage, clinical pilates, load monitoring, heat therapy, and ultrasound to help you recover from Achilles tendinopathy.

With care and knowledge in the best rehabilitative practices, we’ll help you reduce pain, return to your sports and daily activities, and feel more confident in your ankle in the long run. 

 Your recovery: step-by-step 

Initial Management

Initial Management

  • Education
  • Anti-inflammatory medications (if needed)
  • Taping
  • Footwear Advice
  • Hands-on Treatment
Recovery phase 1

Recovery Phase 1: Load Introduction

  • Isometric exercises
  • Performed with minimal movement
  • Reduce tendon irritation while maintaining strength
Recovery phase 2

Recovery Phase 2: Strength Building

  • Seated calf raises
  • Standing calf raises
  • Gradual progressions of reps and load
Recovery phase 3

Recovery Phase 3: Plyometrics

  • Walking
  • Running
  • Jumping
  • Hopping
  • Step-hops
  • Hands-on treatment

Physiotherapy case study: Returning a young athlete
with a left Achilles injury

Achilles injury

Scenario

A 27-year-old male visited our clinic with a left ankle sprain that occurred while playing football. Despite the initial injury, he continued to play and later experienced sharp pain in his Achilles during a game. This raised concerns about more serious damage.

Solution

We worked with the player and committed to a structured rehabilitation plan. This included physiotherapy treatment, progressive strengthening exercises, and load management strategies. He was also advised on how to prevent further injuries and the importance of rest and recovery. 

Results

With consistent rehab and a smarter approach to training, he made a full recovery without the need for surgery. He has since returned to playing football confidently and pain-free. 

Book an appointment 

Better mobility starts here. Book an appointment online or contact Restore Physiotherapy to speak to our care team.

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Frequently asked questions

Achilles tendinopathy commonly affects runners. It’s estimated that around 6 to 10% of all runners experience this condition. We also see it in highly active adults, especially those who’ve had a sudden increase in training or taken up a new sport. Additionally, older adults with a history of Achilles issues can also be affected, usually due to degeneration of the tendon over time. 

We take time to educate patients on how the Achilles tendon functions. It’s the largest tendon in the body, but it has a poor blood supply (which means it heals more slowly). We often explain it visually, and we typically say that a damaged tendon is like a frayed rope that needs time, rest, and targeted strengthening to heal.  

We also highlight the risks of doing too much too soon in their recovery journey, which can lead to setbacks or even serious re-injury. Our team likes to involve patients in their rehabilitation plan by setting achievable goals together and celebrating the small wins to maintain high motivation.  

Yes certainly. We regularly collaborate with podiatrists for clients who need custom insoles or advice on supportive footwear. If the injury is more complex or severe, we may refer to our trusted sports doctor, Dr. Zeeshan, for further assessment or imaging. 

A frequent mistake is returning to sport or full activity too soon, just because the pain has eased. Pain-free doesn’t always mean fully healed, and tendons take time to recover. Without proper progression and load management, re-injury or even a full tendon rupture can occur. It’s important to follow a structured rehab plan, even if you're feeling better.