Achilles Tendinopathy

Achilles tendinopathy is a common overuse condition affecting the Achilles tendon, which connects the calf muscles to the heel bone. It typically develops when the tendon is exposed to repeated or excessive load without adequate time to adapt, rather than from a single injury.

The condition most often occurs in people who run, jump, or change direction frequently, but it can also affect individuals who have recently increased their activity levels, changed footwear, or returned to exercise after a period of reduced activity.

Achilles tendinopathy is usually classified based on the location of symptoms:

• Mid-portion Achilles tendinopathy – pain and thickening in the tendon, typically 2–6 cm above the heel
   
• Insertional Achilles tendinopathy – pain where the tendon attaches to the heel bone
   

Common symptoms include pain and stiffness (often worse first thing in the morning or at the start of activity), tenderness, thickening of the tendon, and reduced calf strength or power. Symptoms may ease with movement but often return after activity.

Physiotherapy is central to effective management and focuses on:

• Gradually reloading the tendon to improve its strength and capacity
   
• Improving calf strength, ankle mobility, and lower limb control
   
• Addressing contributing factors such as training load, footwear, and biomechanics
   
• Supporting a safe and sustainable return to sport or daily activity