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Achilles Tendinopathy - Symptoms, Causes, Treatment

Occurring in only 0.06% of the general population, achilles tendinopathy may seem like a rare injury or condition. However, the reality is that achilles tendinopathy is very common among high-level athletes and runners due to the consistent load put upon the achilles tendon.

Considered to be a chronic leg injury, achilles tendinopathy will require targeted physiotherapy treatment to ensure proper recovery and reduction of symptoms and the restoration of range of movement and strength in the leg. If left untreated, the issues from achilles tendinopathy could potentially result in lasting mobility issues and persistent pain.

Let’s take a closer look at what causes achilles tendinopathy, as well as how it is diagnosed, and treated.

What is Achilles Tendinopathy?

Achilles tendinopathy is a chronic overuse injury that affects the achilles tendon. It will present generally as a pain or sharp pressure around the heel or in the lower portion of the calf muscle and achilles tendon, especially when walking, running, or jumping.

The achilles tendon is what connects the calf muscles from the base of the heel to the back of the knee. When affected by tendinopathy, the fibres of the tendon start to break down, resulting in painful swelling and loss of strength in the lower leg. 

Symptoms of Achilles Tendinopathy

If you suspect that you have achilles tendinopathy, there are a few symptoms that you can look out for to check for the condition:

  • A sharp pain in the heel around the tendon or calf area on palpation
  • Inflammation in the heel or calf
  • Loss of strength in the lower leg
  • Difficulty at the beginning a walk or run, where pain reduces after warming up
  • Feelings of tightness or stiffness in the calf area, especially in the morning 

Achilles tendinopathy can be difficult to identify and diagnose without the expertise of a doctor or a physiotherapist due to it sharing similar symptoms with other leg injuries and conditions. The best way to know if you have achilles tendinopathy for sure if to visit a medical professional for a consultation and diagnosis.

Degrees of Achilles Tendinopathy 

There are 3 main degrees of severity for achilles tendinopathy — mild, moderate, and severe. Each of these degrees indicate the state of damage to the achilles tendon, as well as inform the length of the period of recovery. 


At the mild stage, the achilles tendon has been overloaded during a short amount of time, resulting in minor damage to the tendon. The tendon is able to regenerate naturally at this stage, although the regeneration process can cause a thickening of the tendon, resulting in some stiffness and tightness. 


Moderate-degree achilles tendinopathy is a result of the tendon experiencing an overload for a continuous period. To repair the damage to the tendon, the blood vessels and nerves may grow into the tendon tissue, causing it to swell and feel more tender as a result. The pain and discomfort at this stage can make exercise activity very uncomfortable or unfeasible.


Severe cases of achilles tendinopathy usually indicate that the rate of regeneration of tendon cells is lower than the damage caused by prolonged overload to the tendon. This degeneration can result in a higher risk of tears in the tendon tissue and potentially permanently affect the mobility of the affected individual.

Causes of Achilles Tendinopathy

Overuse of the tendon is the main culprit when it comes to the development of achilles tendinopathy. Just like muscles, our tendons are only strong enough to support a certain amount of stress and must be gradually strengthened to support more intense forces and loads. Exerting too much load on the achilles tendon can be caused by activities with repeated actions of impact such as running and jumping.

Apart from overuse, any physical impact to the tendon can also result in injury, which in turn exacerbates the incidence of achilles tendinopathy.

Treatment for Achilles Tendinopathy 

Considering that achilles tendinopathy can get progressively worse without treatment, it’s important to seek the right treatment for it as soon as possible, even if it starts as a minor strain.

Physiotherapy is by far the most effective form of treatment for achilles tendinopathy. Across regular sessions, a physiotherapist will prescribe multiple techniques to strengthen and aid the recovery of the achilles tendon.

Treatment methods can range from de-loading, which involves the use of strategic rest periods to give the achilles tendon time to regenerate, to strengthening exercises that gradually improve the resilience of the tendon and restore the natural range of movement.

At NQ Physio, we have a team of sports physiotherapists in Townsville who are adept at treating achilles tendinopathy. With our help, you can fast-track the recovery of your achilles tendon and strengthen it to prevent future occurrences of injury. Book an appointment with us today to start your journey to recovery!

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