What Is Achilles Tendinopathy?

The Achilles tendon transmits force from the calf muscles to the foot when a person pushes off the ground (e.g. with running and jumping), and helps with control when the foot touches down on the ground (e.g. with landing). 

Achilles tendinopathy is irritation of the Achilles tendon, a thick band of tissue which connects the calf muscles to the heel done. It results when the demand on the Achilles tendon is greater than its ability to function. The condition occurs after repetitive irritation or ‘microtrauma’ to the tendon.

What Causes Achilles Tendinopathy?

Achilles tendinopathy is an overuse injury and is particularly common in joggers and jumpers, due to the repetitive action of these activities. People who repeat the same motions over and over in their jobs, sports, or daily activities may suffer tendinopathy.

Most Achilles Tendonitis injuries are the result of gradual wear and tear to the tendon from overuse or degeneration with ageing. An Achilles Tendon rupture is a complete tear that causes sudden pain when tendon is stretched beyond its capability.

Common Causes of Achilles Tendonitis include:

  • Calf muscle tightness and/or weakness
  • Abnormal biomechanics
  • Improper footwear
  • Changes to exercise or sport activity – e.g. overtraining, change in intensity, frequency, etc.
  • Changes to exercise/activity surface – e.g. grass to bitumen

Signs and Symptoms

  • Tightness in your calf
  • Pain can be felt at any point along the tendon, although most commonly just above the heel
  • Tenderness
  • Swelling
  • Pain and stiffness with walking, at its worst with the first few steps
  • You may feel stiff in the morning or at the beginning of exercise/activity
  • You may feel pain at the beginning of activity, which lessens during activity and then worsens following activity

How Can Physiotherapy Help?

Achilles tendinopathy generally does not get better on its own. It may feel a bit better with rest, but once you return to the aggravating exercise or activity it can become painful again. Continuing with aggravating exercises and activities may further the tendinopathy process and prolong recovery time.

Physiotherapy treatments will aim to reduce pain and inflammation, identify and address causes, restore muscle length, strength and function, and successfully return you to exercise and activity.

Your physiotherapy treatment may include:

  • Massage
  • Joint mobilisations
  • Ultrasound
  • Dry needling/acupuncture
  • Taping techniques
  • Stretching program to reduce tightness and increase flexibility
  • Rehab program focusing on strengthening muscles

Exercises You Can Do at Home

Standing Calf Stretch – Gastroc

While standing, lean against a wall, place the foot of the affected leg behind you and bend the front knee until a gentle stretch is felt in the back leg.

Hold for 20seconds x5,  perform 2-3 times a day.

Standing Calf Stretch – Soleus 

While standing, lean against a wall, place the foot of the affected leg behind you, bend the front knee slightly and bend your back knee until a stretch is felt in your back leg. 

Hold for 20seconds x5, perform 2-3 times a day.

Standing Calf Raises 

While standing, raise up on to your toes to lift your heels off the ground.

Repeat 10 times, complete 3 sets, perform 2 times a day.

To progress:

Stand on edge of a step. Let your heels drop below the step until a comfortable stretch is felt. Lift heels up slowly into calf raise. 

Repeat 10 times, complete 3 sets, perform 2 times a day.