Achilles Tendon Pain/ Achilles Tendinopathy

What is Achilles tendon pain?

This is a painful condition that occurs when the Achilles tendon, the band of tissue connecting the calf muscles to the heel bone, becomes irritated and inflamed

What causes Achilles tendon pain?

  • Overpronation or underpronation (causing stress to the Achilles tendon)
  • Repetitive/prolonged calf contraction or stretching strain e.g. hill or stair running
  • Recent increase in distance and frequency of running/jogging/walking
  • Recent change in loading pattern/running technique e.g. toe running/ forefoot strike pattern
  • Change in training terrain
  • Inappropriate footwear (e.g. shoes with poor arch support, frequent use of heels)
  • Obesity/ weight gain

What symptoms might you experience?

  • Pain in the back of the heel or lower calf (usually worse in the morning)
  • May or may not have visible swelling
  • Stiffness in morning or on inactivity
  • Usually feels better after warming up
  • Worse on activities like running, jogging and walking

How is it treated?

As with most musculoskeletal conditions, management must involve a combination of medical and physiotherapeutic treatments.

Medical management involves prescription drugs to relieve pain, inflammation and ease muscle spasm e.g. NSAIDs and muscle relaxants; topical pain relief e.g. analgesic patch; joint injection if recommended.

Physiotherapy management

  • Load management (e.g. heel cup/ orthotics to improve load distribution)
  • Footwear recommendation
  • Cold pack/ ice massage
  • Therapeutic modalities such as SIS therapy and ultrasound treatment
  • Manual therapy as tolerated (therapist applies hands-on treatment to alleviate stiff joints and tight muscles where applicable)
  • Therapeutic exercises to help restore pain-free movement and address muscle imbalances
  • Gait retraining (optimize running/walking pattern)
  • Dynamic/ proprioceptive taping (for offloading)

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