Achilles Tendinopathy

Achilles tendinopathy is an overloaded, painful Achilles tendon: the tendon that connects your calf muscles to your heel bone. People often call it Achilles tendinitis. For a broader overview, for example after a sprained ankle, read our Achilles Tendon & Ankle Issues page.

Your physiotherapist distinguishes two forms. In mid-portion tendinopathy the pain sits more than two centimetres above the heel. In insertional tendinopathy it sits where the tendon attaches to the heel bone, and you start with different exercises.

Many people notice it first with their first steps in the morning: the tendon feels stiff and sore. During or after running, jumping or a long walk, the pain returns.

Your physiotherapist asks where and when the pain occurs and how you have trained. During the examination we find the location of the pain and test how your tendon responds to repeated heel raises. We also look for signs of a tear.

With VALD force plates we measure the strength of both legs. If in doubt, we look at your tendon with ultrasound in the studio.

The core is a progressive strength programme for your calf, for at least twelve weeks. Several forms show similar results, so we choose what suits you and your sport. With a sensitive tendon you start with static exercises, with an insertional complaint on a flat floor.

You swap running and jumping for cycling or swimming for a while. If your tendon is still too sensitive after three months of training, your physiotherapist can use shockwave alongside your calf exercises, in a regular appointment and with no surcharge.

Expect months. Waiting without treatment brings little improvement in the short term. For two in three people the complaint has resolved after a year; some have symptoms for longer, sometimes for years.

We re-test your strength and build up your sport to what your tendon can handle.