Achilles Tendinopathy

Achilles Tendinopathy

What is Achilles Tendinopathy?

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone and is used when we walk, run, and jump. During contraction of the calf, tension is placed through the Achilles tendon. When stresses on the tendon are excessive due to too much repetition or high force, the tendon can become inflamed and damaged (micro-tears), known as Achilles tendinopathy.

There are two types of Achilles tendinopathy:

  • Pain in the middle of the tendon: non-insertional tendinitis
  • Pain at the back of your heel: insertional tendinitis

Achilles tendinopathy is not related to a specific injury. The problem usually results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon. The process of tendon degeneration usually starts well-before the onset of symptoms.

Causative Factors:

  • Over-training – “too much too soon”
  • Sudden change in training surface – e.g. grass to bitumen
  • Hill running
  • Increased age and bodyweight
  • Flat (over-pronated) feet
  • High foot arch with tight Achilles tendon
  • Tight calf and hamstring muscles
  • Toe walking (or constantly wearing high heels)
  • Poorly supportive footwear
  • Inadequate warm up
  • Muscle weakness
  • Heel spur – extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain.

Treatment Options:

  • Rest or reduce high weight-bearing activities. Swimming/hydrotherapy and bike riding are alternate exercise options.
  • Soft tissue massage with topical anti-inflammatories (ie, Voltaren). Massage can be performed with a foam roller or by using your hands.
  • Short Course of oral anti-inflammatories (Ibuprofen)
  • Strengthening exercises for the Achilles tendon and calf complex
  • Taping / Compression sleeves
  • Heel raises
  • Supportive shoes
  • Biomechanical correction with orthoses if required
  • Laser therapy
  • Electro-Corporeal Shock Wave Therapy (ECSWT)
  • Platelet Rich Plasma (PRP) Injections
  • Cortisone Injections
  • Surgery


In most cases, nonsurgical treatment options will provide pain relief, although it may take a few months for symptoms to completely subside. Even with early treatment, the pain may last longer than 3 months. If you have had pain for several months before seeking treatment, it may take 6 months before treatment methods take effect.


Call Darwin Podiatry today on 8941 9955 to book an appointment with a Podiatrist for further information.

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