Achilles Tendonitis
Experiencing pain or stiffness at the back of your heel when walking, running, exercising, or taking your first steps in the morning? It could be Achilles Tendonitis.
Achilles Tendonitis
Experiencing pain or stiffness at the back of your heel when walking, running, exercising, or taking your first steps in the morning? It could be Achilles Tendonitis.
What Is Achilles Tendonitis?
Achilles tendonitis is a common condition that causes pain, stiffness, and swelling in the Achilles tendon, the large tendon that connects the calf muscles to the heel bone. The Achilles tendon is responsible for transmitting force during walking, running, jumping, and climbing stairs, making it one of the most heavily loaded structures in the body.
Although the term Achilles tendonitis is widely used, many long standing cases are more accurately classified as Achilles tendinopathy, where degeneration and reduced tendon capacity occur rather than active inflammation.
Without appropriate management, Achilles tendon pain can become chronic and significantly affect daily activities, exercise performance, and sporting participation.
What Causes Achilles Tendonitis?
Achilles tendonitis typically develops when the tendon is exposed to more load than it can tolerate.
Common causes include:
✔ Sudden increases in running distance or intensity
✔ Starting a new exercise program
✔ Hill running or sprint training
✔ Tight calf muscles
✔ Reduced ankle mobility
✔ Poor footwear
✔ Flat feet or excessive pronation
✔ High foot arches
✔ Weakness through the calf muscles
✔ Prolonged standing or walking
✔ Previous Achilles tendon injuries
The condition is particularly common among runners, gym enthusiasts, recreational athletes, and active professionals working in Sydney CBD.
Symptoms of Achilles Tendonitis
Symptoms may develop gradually or appear following a sudden increase in activity.
Common symptoms include:
✔ Pain at the back of the heel
✔ Stiffness when taking the first steps in the morning
✔ Pain during or after running
✔ Tenderness when touching the tendon
✔ Swelling around the Achilles tendon
✔ Pain when walking upstairs
✔ Reduced calf strength
✔ Difficulty performing heel raises
✔ Thickening of the tendon
Many people notice that symptoms improve after warming up but worsen later in the day or following exercise.
Types of Achilles Tendonitis
Mid Portion Achilles Tendinopathy
This is the most common form and occurs approximately 2 to 6 centimetres above the heel bone. Patients often report pain, stiffness, and thickening of the tendon.
Insertional Achilles Tendinopathy
Insertional Achilles tendinopathy occurs where the tendon attaches to the heel bone. This condition can be particularly painful when walking uphill, running, or wearing certain shoes.
Achilles Tendon Tear or Rupture
A sudden pop, sharp pain, or inability to push off the foot may indicate a partial or complete Achilles tendon rupture. This requires urgent assessment.
How Is Achilles Tendonitis Diagnosed?
Diagnosis is usually made through a thorough clinical assessment.
A podiatrist may assess:
✔ Location of symptoms
✔ Tendon thickness
✔ Swelling and tenderness
✔ Calf strength
✔ Ankle mobility
✔ Walking and running mechanics
✔ Foot posture and biomechanics
In some cases, ultrasound imaging or MRI may be recommended to assess tendon health and rule out more significant injuries.
Treatment for Achilles Tendonitis
Effective treatment focuses on reducing pain while improving the tendon’s ability to tolerate load.
Treatment options may include:
Activity Modification
Temporary changes to running, sport, or exercise may be necessary to allow symptoms to settle while maintaining overall fitness.
Strength Rehabilitation
Progressive calf strengthening is considered one of the most effective treatments for Achilles tendinopathy.
Exercise programs may include:
Eccentric calf raises
Heavy slow resistance training
Isometric loading
Plyometric progression
Return to running programs
Shockwave Therapy
Extracorporeal Shockwave Therapy (ESWT) may be beneficial for persistent Achilles tendon pain and chronic tendinopathy.
Footwear Assessment
Supportive footwear can reduce excessive load through the Achilles tendon and assist recovery.
Custom Orthotics
For patients with biomechanical factors such as excessive pronation, customised foot orthotics may help improve lower limb function and reduce tendon stress.
Running Assessment
A comprehensive running assessment may identify technique or training factors contributing to recurring Achilles tendon injuries.
Can Achilles Tendonitis Heal?
Yes.
Most cases respond well to appropriate treatment and progressive rehabilitation. Early intervention generally results in faster recovery and a lower risk of chronic symptoms.
Recovery time varies depending on the severity and duration of symptoms. Mild cases may improve within several weeks, while chronic tendinopathy can require several months of structured rehabilitation.
When Should You See a Podiatrist?
You should seek professional assessment if:
✔ Pain has persisted for more than two weeks
✔ Morning stiffness is worsening
✔ Symptoms are limiting walking or exercise
✔ You are unable to perform a single leg heel raise
✔ You suspect a tendon tear
✔ Previous treatment has not been successful
Early diagnosis can often prevent long term tendon degeneration and reduce recovery time.
At Bespoke Health and Performance, our Sydney CBD podiatrists provide comprehensive assessment and treatment for Achilles tendonitis, Achilles tendinopathy, insertional Achilles pain, and running related tendon injuries.
Our treatment approach focuses on identifying the underlying cause of tendon overload, reducing pain, restoring strength, and helping patients return to activity with confidence.
Services available include:
✔ Comprehensive podiatry assessment
✔ Biomechanical assessment
✔ Running gait analysis
✔ Extracorporeal Shockwave Therapy
✔ Custom foot orthotics
✔ Strength and rehabilitation programs
✔ Sports injury management
Conveniently located in Sydney CBD within the Dymocks Building, Bespoke Health and Performance provides evidence based care for patients experiencing Achilles tendon pain, heel pain, and sports injuries.
FAQ's
Not exactly. Achilles tendonitis generally refers to inflammation, while Achilles tendinopathy describes tendon degeneration and reduced tendon capacity. Many chronic cases are classified as tendinopathy.
In many cases, yes. However, running volume, intensity, and frequency often need modification while rehabilitation is underway.
For some individuals, particularly those with excessive pronation or biomechanical abnormalities, custom orthotics may reduce tendon loading and improve function.
Shockwave therapy may assist with chronic Achilles tendinopathy when combined with an appropriate strengthening and rehabilitation program.
Related Conditions
Jumper’s knee
Patellar Tendonitis also known as Jumper’s knee is an inflammation or injury of the patellar tendon felt as pain, tenderness and functional deficit. This condition may interfere with or even end your patient’s sporting career regardless the age and is difficult to treat. Shockwave therapy offers a simple and immediate solution. The patient feels relief right after the first session and in several treatments the cause and the pain vanish.
Learn more →
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