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Understanding Achilles Tendinopathy: Causes, Symptoms & Treatment

Achilles tendinopathy, a common overuse injury, affects the Achilles tendon—the largest & strongest tendon in the body. This tendon connects the calf muscles to the heel bone and plays a crucial role in walking, running, and jumping. Despite its strength, the Achilles tendon is prone to injury, especially among athletes & active individuals. Let’s explore what Achilles tendinopathy is – its causes, symptoms, and the most effective treatment & prevention strategies.

What is Achilles Tendinopathy?

Achilles tendinopathy is a term that encompasses both Achilles tendonitis (inflammation of the tendon) and Achilles tendinosis (degeneration of the tendon tissue). This condition occurs when the Achilles tendon is subjected to repetitive stress, leading to microscopic tears, inflammation, & degeneration over time. It can affect individuals of all ages & activity levels but is particularly common in runners, dancers, & those who engage in high-impact sports.

Causes of Achilles Tendinopathy

Several factors can contribute to the development of Achilles tendinopathy:

Overuse: Repetitive activities that strain the Achilles tendon (such as running, jumping, or sudden increases in physical activity) are the most common causes of tendinopathy.

Improper Footwear: Wearing shoes that lack proper support or cushioning can increase the strain on the Achilles tendon.

Biomechanical Issues: Problems such as flat feet, high arches, or abnormal gait can alter the way stress is distributed across the Achilles tendon, increasing the risk of injury.

Tight Calf Muscles: Tight or inflexible calf muscles place additional stress on the Achilles tendon, making it more susceptible to injury.

Age: Tendons tend to lose flexibility & strength with age, making older individuals more prone to tendinopathy.

Inadequate Warm-Up: Skipping warm-up exercises before engaging in physical activity can lead to sudden strain on the Achilles tendon.

Symptoms of Achilles Tendinopathy

The symptoms of Achilles tendinopathy can vary in severity and may develop gradually. Common signs include:

Pain & Stiffness: Pain along the back of the ankle or just above the heel, especially after periods of inactivity or first thing in the morning. This pain may improve with mild activity but worsen with intense exercise.

Tenderness: Tenderness & swelling along the Achilles tendon, which may feel warm to the touch.

Thickening of the Tendon: A noticeable thickening of the tendon due to chronic inflammation and tissue degeneration.

Limited Range of Motion: Reduced flexibility in the ankle, particularly when pushing off the foot or standing on tiptoe.


Treating Achilles tendinopathy involves a combination of rest, therapeutic exercises, & preventive measures to alleviate pain and promote healing. Here are some effective strategies:

Rest and Activity Modification: Reduce or avoid activities that aggravate the pain. Gradually reintroduce activities while avoiding overuse.

Icing: Apply ice packs to the affected area for 15-20 minutes several times a day to reduce inflammation and pain.

Compression & Elevation: Use compression wraps & elevate the foot to minimise swelling.

Stretching & Strengthening Exercises: Incorporate calf stretches & strengthening exercises to improve flexibility & support the Achilles tendon. Eccentric exercises, where the calf muscle is lengthened under tension, are particularly beneficial.

Proper Footwear: Wear shoes with good arch support and cushioning. Orthotic inserts can help correct biomechanical issues & reduce strain on the tendon.

Extracorporeal Shockwave Therapy (ESWT): This non-invasive treatment uses shockwaves to stimulate healing in the tendon tissue.

Surgery: In severe cases where conservative treatments fail, surgical intervention may be necessary to repair the damaged tendon.

Prevention Tips

Preventing Achilles tendinopathy involves adopting healthy habits to reduce the risk of injury:

Warm-Up Properly: Always perform a thorough warm-up before engaging in physical activity to prepare your muscles and tendons.

Gradual Progression: Increase the intensity & duration of your workouts gradually to avoid sudden strain on the Achilles tendon.

Strength & Flexibility Training: Regularly perform exercises to strengthen the calf muscles and improve ankle flexibility.

Wear Appropriate Footwear: Ensure your shoes provide adequate support and cushioning for your activities.

Listen to Your Body: Pay attention to any signs of discomfort or pain in your Achilles tendon & take appropriate measures to address them early.

When to See a Podiatrist

If you experience persistent pain or swelling in your Achilles tendon, it is essential to consult a podiatrist. A podiatrist can provide a comprehensive evaluation, diagnose the condition, & recommend the most effective treatment plan tailored to your needs. Early intervention can prevent the progression of Achilles tendinopathy & promote a faster recovery.


Achilles tendinopathy is a common yet manageable condition that can significantly impact your daily activities & athletic performance. By understanding the causes, recognizing the symptoms, & implementing effective treatment and preventive measures, you can maintain the health of your Achilles tendon & continue to enjoy your favourite activities pain-free. If you’re struggling with Achilles tendinopathy or have concerns about your foot health, don’t hesitate to reach out to a podiatrist at Talaria for professional guidance & support.

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