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Achilles Tendinopathy

The problem

  • The Achilles tendon is the large tendon at the back of the ankle that attaches the calf muscles to the heel.
  • The attachment of the Achilles tendon allows your heel to come up when walking, running, jumping, or standing on your toes. It also allows the power generated in your calf muscles to be transferred to a push off through your toes during these same activities.
  • Achilles tendinopathy often occurs as an overuse injury from activities such as running or jumping that strain the tendon

Hints for self-management

  • Decrease the intensity of your exercise routine
  • Cross train to decrease stresses through the Achilles tendon
  • Ice the area for 20 minutes after exercise, or when you feel pain
  • Anti-inflammatory medication may help to manage pain
  • Gently stretch the calf muscles

Interesting facts

  • The Achilles tendon is the largest tendon in the body.
  • Achilles tendinopathies account for about 11% of all running injuries.
  • Achilles tendinopathy can either be acute, occurring within a few days after a sudden increase in activity, or chronic, progressing over a period of weeks to months.

Management options

  • Braces/taping for support and to unload the tendon
  • Eccentric exercises to strengthen the tendon
  • Cortisone injections are rarely used around the achilles tendon but can be beneficial in some specific cases
  • Anti-inflammatory creams/patches or medication may be prescribed by your doctor
  • Autologous blood injections are currently undergoing trials to determine how helpful they can be 

What you can expect/look out for

  • Pain above the heel after running or other sports activity
  • Increasing pain associated with activities involving prolonged running, jumping, or stair climbing
  • Tenderness on palpation, possibly with a small swelling on the Achilles tendon
  • Tenderness and stiffness, especially in the morning, that improves with mild activity

More information

  • Help avoid developing future episodes of Achilles tendonitis by increasing running no more than 10% per week
  • Eccentric loading exercises have been proven to strengthen and remodel chronically damaged tendons
  • Ultrasound imaging can be used to differentially diagnose a tendon injury
  • Unloading the tendon in the initial phases will help with pain. These can include taping, heel raises and orthotics



At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770


This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

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