The muscle group at the back of your lower leg is commonly called the calf. The calf comprises of 2 major muscles called the gastrocnemius and soleus. Both of these muscles insert into the heel bone via the Achilles tendon. During contraction of the calf, tension is placed through the Achilles tendon. When there is too much repetitive force, the Achilles tendon can become inflamed and cause small micro tearing in the tendon. This inflammation and micro-tearing is termed Achilles tendinopathy.
What are the symptoms of an Achilles Tendinopathy?
Symptoms may increase during activities which place strain on the Achilles tendon such as walking (especially uphill), going up and down stairs, running, jumping, hopping, or when performing heel raises or calf stretches. It is also common for patients to experience pain after these activities with rest. Symptoms may also be worse in the morning, for example walking in the morning after may be stiff and painful. Swelling in the Achilles region and pain on firmly touching the Achilles tendon are also common.
Patients with Achilles tendonitis or a degeneration of the Achilles may experience swelling, tenderness on firm touch to the Achilles tendon, weakness and palpable thickening of the affected Achilles tendon when compared to the unaffected side. They may experience noticeable stiffness and pain in the night or mornings especially after performing aggravating activities such as walking, hopping, jumping.
How can physiotherapy help?
A physiotherapist can massage the area to realign the tendon fibres whilst increasing blood flow to enhance the healing process. Rest is important in the early stages and our physiotherapists can provide support such as strapping or bracing. Furthermore, with healing progress the physiotherapist can advise on stretching & strengthening exercises. Further treatment options are also available such as acupuncture to promote natural healing of the tendon or mobilisation to encourage a return to mobility of the joint.
Acupuncture can also be significantly helpful with achilles tendinopathy, supplementing physiotherapy treatment. Acupuncture helps to reduce pain by activating your bodys’ natural pain reducing neural pathways, increase blood flow aiding your bodys’ natural healing process to the area and aid in the restoration of movement.
What causes Achilles tendinopathy?
Achilles tendinopathy is an overload injury of the Achilles tendon, which connects your calf muscles to your heel. It develops when the tendon is loaded more than it can recover from, and it is common in runners and in people who increase their activity quickly.
- A rapid increase in running, walking or hill work
- Tight or weak calf muscles
- A change in footwear or training surface
How is Achilles tendinopathy treated?
Tendons respond best to a progressive loading programme rather than complete rest. Your physiotherapist will build a calf and tendon strengthening plan that gradually restores capacity. Recovery is often measured in months, and consistency makes the biggest difference.
Shockwave therapy for stubborn Achilles pain
When Achilles pain has persisted for several months and has not responded to loading alone, shockwave therapy can help stimulate healing. Shockwave therapy is not funded by ACC, but Dynamic Physio offers it at affordable pricing, and we will let you know whether it suits your situation.
What you can do at home
- Reduce high-impact activity for a period rather than stopping completely
- Keep up your prescribed calf strengthening exercises
- Allow recovery time between heavier sessions
Check with your physiotherapist before increasing your training.
Frequently asked questions about Achilles tendinopathy
Should I stop running completely?
Usually not. Reducing rather than stopping, combined with a loading programme, is often more effective than complete rest.
How long does Achilles tendinopathy take to recover?
Many cases improve over three to six months with consistent loading. Long-standing cases can take longer, where options like shockwave may help.
Where can I get help on the North Shore?
Dynamic Physio treats Achilles and tendon injuries at our Mairangi Bay, Long Bay and Milford clinics, and our physiotherapists are ACC-registered.