Achilles Tendon Pain or Achilles Tendinopathy / Tendonitis

Achilles Tendon pain is a common injury. It can affect both men and women of varying ages and varying fitness levels.

The Achilles Tendon is a cord like structure at the back of your ankle connecting the calf muscles to the heel bone.

Achilles tendinopathy is the damage of the tissue that make up the Achilles tendon. It usually develops over time and can be painful.

What does it feel like?

The signs and symptoms vary. Typically, the injury presents as pain or stiffness in the Achilles tendon. Often pain is felt when starting to exercises or after resting. Pain can be present in either the middle of the Achilles tendon (mid-portion Achilles tendinopathy) or where it attaches into the heel bone (insertional Achilles tendinopathy).

Sometimes, pain settles with continued activity. This is because the area “warms up”. Pain generally returns again once you stop exercising. Swelling and thickening can be also be seen in the Achilles tendon, but is not always present.

In more severe cases of Achilles tendonitis, symptoms can worsen during exercise. Consequently this makes movement on the injured foot painful and difficult.

What causes it?

Like most injuries, there are a number of things that can cause of Achilles tendinopathy.

Contributing factors in the development Achilles tendinopathy include:

  • Overuse: Increasing the volume, intensity or frequency of exercise too rapidly. Sometimes allowing insufficient recovery in between exercise sessions can also be a contributor.
  • Uneven training surfaces: unstable surfaces can over work your muscles if they are not conditioned for it.
  • Tight and/or weak calf muscles.
  • Poor footwear.
  • Excessive pronation (rolling in) of the feet.

What can you do to manage it?

Like any injury, early diagnosis and treatment of Achilles tendinopathy is crucial. Especially when we are wanting a successful outcome. If you suspect that your symptoms are similar you should seek an assessment from an expert. Podiatrists assess foot and leg injuries and develop a management plans specific to you. Hence professional advice can get you pain free as quickly.

Your podiatrist may also work with other health professionals. Therefore they may call on a physiotherapist, myotherapist or sports physician to help assist in the management of your injury.

Typical conservative treatments for Achilles tendinopathy include:

  • Activity modification – reassessing you training program.
  • Calf stretching and Achilles strengthening exercises.
  • Anti-inflammatory strategies.
  • Massage.
  • Changes to your footwear.
  • Taping or Strapping.
  • Orthotics may be required to improve your foot position or function.


In more persistent Achilles Tendon cases other treatments may be considered such as,

  • Shockwave therapy
  • Cortisone injections
  • Platelet rich plasma or autologous blood injections
  • Surgical treatment is also available for Achilles tendinopathy but is generally only considered when all conservative treatments fail.

What should you avoid doing?

Do not ignore your Achilles tendon pain. Don’t hope that your injury will settle down by itself. Often things may feel as though they are improving. However, if you return to exercise too early your injury may reoccur. Commonly, the injured region no longer “warms up” or improves. Therefore your pain may no longer respond to conservative management options.


Your podiatrist will provide you with a thorough assessment of your Achilles tendon pain. Podiatrists can accurately diagnose your Achilles tendon pain and rule out other injuries which may have similar signs or symptoms. In developing your management plan for Achilles tendinopathy, your podiatrist may use a combination of therapies. Podiatrists are skilled at taping, dry needling and rehab exercises. They are experts when it comes to footwear and may even use an orthotic if needed. Our goal is to have you return to the activities you love. If you think you have an Achilles Tendon injury book a biomechanical assessment online HERE.