
What is Achilles Tendinopathy?
Achilles tendinopathy, previously known as Achilles tendonitis, is a common overuse injury affecting joggers, jumpers, and individuals engaged in repetitive activities. This condition encompasses both inflammation (tendonitis) and a range of other pathologies affecting the Achilles tendon.
Causes of Achilles Tendon Pain
Tendons, the tough fibres connecting muscle to bone, often succumb to pain due to repetitive stress or natural ageing. Over time, small tears accumulate, leading to tendon injuries. These injuries can be sudden or gradual, with factors like over-training, abrupt increases in exercise intensity, and inadequate footwear contributing to the risk.
Differentiating Tendinopathy from Enthesopathy
While Achilles tendinopathy generally arises from repetitive strain, enthesopathy specifically involves the entheses, where tendons or ligaments attach to bone, and is characterised by inflammation, degeneration, or damage at these attachment points.
Read more: Achilles tendinopathy vs enthesopathy
Recognising and Diagnosing Achilles Tendinopathy
Symptoms
Symptoms include burning pain at the start of an activity, stiffness, particularly in the morning, and tenderness or swelling in the Achilles tendon. The pain might worsen after exercise and vary in intensity based on activity levels.
Diagnosis Steps
Diagnosing Achilles tendinopathy involves consulting a physiotherapist or sports doctor, evaluating your medical history and symptoms, and undergoing clinical tests. While diagnostic imaging is seldom necessary, it may be recommended in complex cases.

Treatment and Rehabilitation of Achilles Tendinopathy
Modern Approaches to Treatment
Recent research has led to significant advancements in treating Achilles tendinopathy. A tailored treatment plan, based on the specific phase of your injury, is crucial. This may involve specific exercises, managing activity loads, and monitoring progress through pain provocation tests and functional assessments.
Exercise’s Role in Recovery
Exercise, particularly isometric exercises, plays a crucial role in managing tendinopathy, providing pain relief, and aiding recovery. Progression in treatment is carefully monitored, with a focus on gradually increasing exercise loads to stimulate tendon growth while avoiding overloading.
Eccentric strengthening exercises are also recommended but should be introduced gradually to avoid aggravating the condition.
Importance of Load Management
Effectively managing your activity load is vital for successful recovery. Your physiotherapist will guide you in adjusting your exercise program based on your symptoms and response to activity. This includes modifying activities to prevent exacerbation of symptoms and ensuring recovery.
Avoiding Certain Exercises
Avoid exercises that exacerbate Achilles tendon pain, such as running uphill or performing deep squats, unless advised by your physiotherapist.
Complementary Therapies
Massage, foam rollers, and stretches can help release tension in associated muscle groups.
Addressing Adjacent Joints and Biomechanics
Biomechanical issues in the lower limb can increase the risk of Achilles tendinopathy. Your physiotherapist will assess and address any deficiencies in ankle dorsiflexion, squat alignment, and gluteal control, among other factors.
Exploring Novel Therapies
Emerging therapies, such as injections of sclerosing agents or platelet-derived growth factors, show promise but are still experimental. Consult your physiotherapist or soprts doctor for advice on these treatments.
Prevention and Long-Term Management
Healing Timeline
The healing timeline varies based on the tendinopathy phase, ranging from days to months. Early and appropriate management is key to quick recovery.

Preventing Achilles Tendon Rupture
A complete rupture of the Achilles tendon, though rare, is a severe complication. Early intervention and preventive measures are crucial to avoid this outcome.
Conclusion: The Role of Your Physiotherapist
Physiotherapists play an integral role in the diagnosis, treatment, and prevention of Achilles tendinopathy. Consulting a physiotherapist early can lead to a more effective treatment plan, quicker recovery, and guidance on preventing future injuries. If you’re experiencing symptoms of Achilles tendinopathy, seeking professional advice is the first step towards recovery.
Tendinopathy FAQs
Common Heel Pain Causes
What's Causing Your Heel Pain?
This article digs into various heel pain and injury conditions that often trouble individuals. From the well-known discomfort of plantar fasciitis to the presence of heel spurs, we'll navigate through prevalent issues that impact our mobility. Alongside discussions about frequently asked questions and recommended products, our exploration extends to traumatic ankle ligament injuries, tendon problems, foot injuries, bone fractures, degenerative conditions, biomechanical issues, nerve-related sources, muscle injuries, and systemic conditions. This comprehensive guide aims to provide clarity and understanding for those dealing with ankle and foot discomfort.
Heel Pain
FAQs & Products
Traumatic Ankle Ligament Injuries
Tendon Injuries
- Achilles Tendon Rupture
- Achilles Tendinopathy
- FHL Tendinopathy
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
Foot Injuries
Bone Injuries
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Heel Spur
- Shin Splints