Have you ever felt a nagging ache at the back of your heel? Especially in the morning when you wake up or after a run? You might be dealing with Achilles tendinopathy, a common overuse injury that affects the largest tendon in your body! 

Whether you are a keen runner, walker or just someone who spends a lot of the time on their feet, Achilles tendinopathy can develop gradually, but if it is discovered early, it is very treatable! 

What is Achilles tendinopathy? 

The achilles tendon connects your calf muscles to your heel bone, which is essential for our walking, running and jumping. 

Achilles tendinopathy occurs when this tendon becomes overloaded, usually from repetitive stress. This isn’t caused by inflammation like swelling or redness, but instead by wear and tear in the tendon over time. The tendon’s structure starts to break down, which can lead to pain, stiffness, and weakness when using the muscle.

Common causes and risk factors 

• Sudden increase in exercise or walking volume 
• High impact exercise 
• Tight or weak calf muscles 
• Poor footwear 
• Flat feet 
• Previous injuries 

Some typical symptoms 

• Pain and stiffness in the tendon, especially in the morning or after rest.
• Pain that eases with movement initially but worsens after prolonged period of activity
• Swelling or thickening of the tendon.

How do you treat it? 

Activity modification – Reduce high impact activity like running/jumping temporarily.

Physiotherapy 

What can it offer? 

• Assessment to understand the stage and severity of your issue
• A rehab programme that strengthen the tendon and surrounding muscles 
• Education about your current issue and how you can manage it daily

Manual therapy – to reduce tension alongside your rehab

• Soft tissue release 
• Ultrasound
• Shockwave therapy
• Dry needling / acupuncture 

Footwear and orthotics 

• Your normal walking pattern and footwear will be first assessed. 
• Then custom orthotics may be recommended to reduce tendon strain and address other biomechanical factors that we may find. 
• Read more about custom made orthotics and computerised foot scanning here

Extracorporeal shockwave therapy (ESWT)

For longstanding cases, ESWT which is a really effective and non-invasive treatment, can be used to help your injury by: 

• Stimulating tendon healing 
• Reducing pain 
• Read more about Shockwave for Achilles issues here

So, when should I seek help?  

If your symptoms: 

• Has lasted more than 2-3 weeks. 
• Affecting your ability to walk, exercise or enjoy your daily life. 
• Pain is ongoing despite rest or stretching.

It’s time to get professional help. 

Here at goPhysio, our professional team will thoroughly assess your situation, identify the main causes of the issue and guide you with a personalised treatment and rehab plan. Also provide you tailored advice on how to manage your situation on a daily basis. 

Final thoughts

Don’t let Achilles pain hold you back from doing what you love, whether you’re aiming for a half marathon or just simply want to walk without pain, we’re here to support you to recover, rebuild and return stronger.