Achilles Tendinopathy – Injuries, Causes And Treatment

The Achilles tendon is one of the most commonly injured tendons in the body. It is commonly injured in running, with 6-8% of all running injuries being to the Achilles.

The Achilles tendon attaches your calf muscles to the heel bone. It is important for many activities such as walking, running, going up and down stairs, and standing on your tip toes.

Achilles tendinopathy is a condition that causes pain, swelling, and stiffness of the Achilles tendon. It is caused by repetitive stress to the tendon. There are many risk factors that can contribute to the development of pain in the Achilles. These include:

  • Decreased muscle strength
  • Limited ankle mobility
  • Poor muscle flexibility, particularly tight calf muscles
  • Foot alignment, particularly having flat feet
  • Poor footwear
  • Obesity
  • Previous injury
  • Increased age

People can develop Achilles tendinopathy after changes in loading. For example, if you are returning to running after a long break. It is important to gradually ease back into your training load to allow for your body to adjust. Training error can also contribute to the development of Achilles tendinopathy. These include:

  • Sudden spikes in training levels
  • Changes in loading ie doing more hill running
  • Increases in training intensity or speed
  • Changes in training duration
  • Poor running technique

Achilles tendinopathy is a condition which is quite slow to recover. The tendon has a poor blood supply which makes it slow to heal.

The main symptoms involve pain and stiffness around the Achilles tendon. It often feels the worst first thing in the morning. Pain is often worse after exercise. In runners for example, they may notice pain at the beginning of their run, which eases as they continue on, but then once they stop running the pain worsens again. There may also be swelling around the tendon after increased activity, and it is often quite tender to touch.

Treating Achilles Tendinopathy


Initially it is important to rest from your aggravating activities. You should stop any high impact activities or sports, such as running. As your pain improves you can gradually return to your exercise. Your Physiotherapist will be able to guide you as to how soon you can return and how to build back up to your pre-injury levels. They may suggest doing more low impact exercise such as cycling, swimming, or elliptical, to help maintain your fitness while reducing the load on the tendon to allow it to heal.


Taking painkillers and anti-inflammatories can help to relieve the pain. Anti-inflammatories should not be taken in the long term as you can start to develop other side effects. Chat to your GP about other medication options if you need to take something more long term.

Heat packs

Applying heat to the tendon helps to increase blood flow to the area which helps to speed up the healing process. Place a heat pack on the Achilles for 20 minutes.


Physiotherapy can help with Achilles tendinopathy. Hands-on manual therapy techniques can be used to relieve the pain and promote blood flow to the area. Ultrasound and TENS can also be used for pain relief. Your Physio will take a thorough history from you to help determine the cause of injury. They will be able to offer advice on how to modify your training load. They can assess your running technique and check your foot alignment. They may recommend and fit you with orthotics if deemed appropriate.


It is important to stretch and strengthen your Achilles tendon to help improve your flexibility and strength. By strengthening the tendon and surrounding muscles, the Achilles is better able to cope with the load of high impact activities such as running. Your Physiotherapist will design an exercise program tailored specifically for you to help you get back to the activities that you love doing.

If you are suffering from Achilles pain and would like some more information on physiotherapy treatment, we would be more than happy to help. Give us a call on 9875 3760 or email

If you need physical therapy to relieve
your pain, and would like some more
information, feel free to contact us!

Give us a call on (02) 9875 3760 or email We would
be more than happy to help you.