RS Podiatry Clinic

Achilles Tendinopathy

What is Achilles Tendonitis?

Achilles Tendonitis is a common condition that causes pain and inflammation in the Achilles tendon, the large tendon that connects the calf muscles to the heel bone. 

If the pain is severe and occurred suddenly, the tendon may be ruptured and it is important to seek medical advice.

What causes Achilles tendonitis? The condition is often caused by overuse, such as from running or jumping, or from a sudden increase in physical activity. Contributing factors can include improper footwear, foot structure, running technique and tight calf and hip muscles.

Risk factors for Achilles tendonitis:

  • Gender: females going through the menopause may be more likely to have the condition particularly if they are suddenly starting a new activity
  • Drugs: Certain antibiotic treatments such as fluoroquinolones increase susceptibility of tendon injury
  • Certain medical conditions: inflammatory arthropathies such as rheumatoid arthritis
  • certain activities e.g. starting hill running
  • running biomechanics which contribute towards overuse of the Achilles tendon and calf muscles 

What are the signs of Achilles tendonitis?

Some of the signs may include:

  • pain and stiffness in the Achilles in the morning
  • Pain in the heel and along the tendon when walking or running
  • Pain and stiffness at the back of the heel in the morning.
  • Pain in the Achilles tendon when pressed
  • Swelling and heat in the heel or along the tendon

How do I treat Achilles tendonitis?

Basic treatments include rest, ice, compression, and elevation. Non-steroidal anti-inflammatory drugs (NSAIDs) may also be used to reduce pain and inflammation (check suitability).

Orthotics are a common treatment for Achilles Tendonitis particularly if there are underlying biomechanical factors such as flat or hypermobile feet. Orthotics are shoe inserts that are designed to provide additional support and cushioning to the feet, helping to reduce pressure on the Achilles tendon and improve foot biomechanics. They can also help improve abnormal gait patterns that are contributing to the development of Achilles Tendonitis.

Shockwave therapy is another treatment option for Achilles Tendonitis. Shockwave uses high-energy sound waves to stimulate healing in the affected area. The sound waves help to increase blood flow to the tendon, which can promote the growth of new tissue and reduce pain and inflammation. This has proven to be highly successful for when used in our clinic.

MLS Laser Therapy is an incredible drug free and pain free tool in assisting with the treatment of Achilles Tendonitis. It works by reducing inflammation and encouraging efficient cell metabolism to encourage the healing process. Effects can be felt and seen after as little as 1-3 sessions. 

A running biomechanics analysis is one of the most detailed and effective ways to identifying potential causes of Achilles Tendonitis in runners and walkers. This analysis focuses on assessing the runner’s gait, stride length, foot strike, and joint alignment to determine if any imbalances or abnormalities exist that may be contributing to the development of the condition. The findings from the analysis can be used to develop a personalised treatment plan, which may include orthotics, stretching, strengthening exercises, and modifications to running form and technique. By addressing these underlying issues, the risk of developing Achilles Tendonitis can be significantly reduced, and overall running performance can be improved. In addition, a running biomechanics analysis can help identify other potential issues that may impact foot health and running performance, making it a valuable tool for all runners.

An Exercise plan to strengthen the key areas is hugely important and forms the cornerstone to a highly successful treatment plan. 1-3 sessions on average may be required.


In severe cases of Achilles Tendonitis, surgery may be required to repair the damaged tendon. However, this is typically only recommended if conservative treatments have been unsuccessful.

How do I prevent Achilles Tendonitis?

Prevention is key.

  • Gradually building up to your activity level can help.
  • Wearing footwear that provides adequate support and cushioning for your foot type
  • warm-ups before and after exercise
  • strengthening exercises. It is important to see a healthcare professional to know what exercise to do, when to do it and how much is safe to do.
  • It is also important to listen to your body and rest when necessary to avoid overuse injuries.

If you are experiencing symptoms of Achilles Tendonitis, it is important to seek treatment from a musculoskeletal podiatrist. We can help rule out potential other problems, diagnose the condition and develop a treatment plan tailored to your individual needs.

With proper treatment, the symptoms of Achilles Tendonitis can be effectively managed, allowing you to continue your daily activities without discomfort.

This article is not intended as advice and therefore should not be taken as such. Each patient is assessed and treated on an individual basis.

Other diagnosis: Achilles Bursitis, Haglund’s Deformity

Symptoms: A dull ache or sharp pain typically felt towards the back of the heel, a feeling of tightness, inflammation. Feeling of a thickening or lump at the back of the heel. Can be worse when ‘getting going’ then eases.

Contributing Factors: Biomechanical ‘issues’, lack of ankle movement, running form, training error, excessive increase in activity and intensity, hill running, muscle weaknesses, muscle tightness, BMI and lifestyle choice, footwear choices, overuse, neural involvement, certain activites, Inflammatory Arthropathy, repetitive activities e.g. jogging or jumping.

Treatment Considerations: Altering training programme and managing tendon load, Shockwave Therapy, gradual return to running programme, orthotics, a targeted tendon loading programme, foam rolling, taping, clinical gait analysis, footwear analysis and biomechanical correction, consistent following of advice, and laser therapy.