Achilles tendonitis

Achilles Tendonitis & Tendonosis

Painful foot and ankle conditions arising from an injured Achilles tendon is a common condition seen in our Clinic.

What is Achilles Tendonitis?


Achilles tendonitis is commonly seen in our practice and can be one of the most challenging conditions to treat. The Achilles tendon is a large structure running between the heel of your foot and the calf muscles. This tendon has several functions including operating as a shock absorber, foot stabiliser, and for propulsion in activities such as walking, running, and jumping. If you overload your Achilles tendon, micro tears occur in the tissue resulting in inflammation and significant pain just above the heel. The most effective way to resolve Achilles tendonitis is by understanding the condition and addressing the underlying causes.

Causes of Achilles Tendonitis

Achilles tendonitis is the result of excessive stress placed on the Achilles tendon and its distal attachment at your heel and frequently 2 -4 cms above. This stress is usually attributable to over use of the musculotendonous unit (tendon and muscle) as it attempts to stabilise, shock absorb, or propel you forwards. As the muscle receives a far greater blood supply than the tendon, it can adapt to change more readily than the tendon and consequently Achilles tendonitis is a more common complaint than calf muscle strains.

The most common causes of Achilles tendonitis are:

  • Sudden increase in activity (work, social, or sport)
  • Poor foot posture (feet roll in when you walk)
  • Excessive weight or sudden weight gain
  • Poor footwear
  • Aging and arthritis

Do you Have Achilles Tendonitis?

The primary symptom patients identify is pain behind their heel, and the most painful location is typically about 2 to 4 cm above the attachment of the Achilles tendon. This pain is usually worse at the following times:

  • In the morning when you take your first steps (painful and stiff)
  • After standing or sitting for a while
  • Tender to touch
  • Walking up hills or stairs

Management of Achilles Tendonitis

In order to successfully manage Achilles tendonitis, it is important to address the cause of the problem rather than simply managing the symptoms. Employing the latest technology and biomechanical assessment techniques, we are able to identify those tissues under excessive load allowing us to develop a comprehensive treatment plan to address your specific needs.

Typically your plan will involve biomechanical correction, self-management strategies, and modalities that address any structural imbalance.

Treatment options for Achilles tendonitis include:

  • Rest and Electrophysical agents (cold therapy,heat, ultrasound)
  • Orthotics (as your foot rolls in it twists your Achilles)
  • Soft tissue mobilisation
  • Stretching and strengthening
  • Weight loss
  • Motion control or stability sport shoes
  • Anti-inflammatory medications
  • Strapping


Delaying appropriate management of Achilles tendonitis can lead to complications and an extended period of unnecessary pain. If not addressed, these changes will continue and lead to secondary complications both locally and further up the biomechanical chain and can result in knee, hip or back pain.