What is Achilles Tendinopathy/ tendinitis?
Achilles tendinopathy is an injury to the taut band of tissue at the back of the heel which connects the calf muscles to the heel bone. Achilles tendinopathy affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response.

ow does it occur?
Most often this injury occurs due to overuse of the tendon over time or with a sudden increase in use without adequate recovery. Overuse of the Achilles tendon can occur in many ways, such as:
· Increasing intensity of training (running speed).
· Increasing the overall training volume (total step count).
· Increasing training frequency (number of days running) to starting a new job that requires more walking.
· Previous tendinopathies elsewhere, recent ankle injuries, knee injuries (changes the way Achilles/foot/ankle is loaded).
Other, less frequent causes of tendinopathy or perceived tendinopathy pain include:
· Inflammatory/autoimmune disorders
· Chronically reduced ankle mobility
· Joint related injury or nerve related injuries
Achilles Tendonitis symptoms
Achilles tendonitis is characterised by:
· Pain when the tendon is loaded, such as during running.
· Morning stiffness in the tendon, which usually goes away as the tendon warms up.
· Achilles tendon swelling.
· Reduced strength or power because of the pain.
Treatment for Achilles tendinopathy.
Manage the load:
In the initial phase of treatment, it is important to modify activity to ensure that the symptoms begin to settle down. This does not always mean avoiding exercise (gym, walking or running) altogether. It is important to identify and reduce the overloading stimulus which is aggravating symptoms at the earliest opportunity.
Tendons prefer to be consistently loaded within their limits. Therefore, appropriate loading exercises serve as the cornerstone of treatment for Achilles tendinopathy.
As overload is frequently the problem, this frequently entails initially limiting activity and gradually increasing this capacity over the ensuing weeks. Anti-inflammatory drugs and ice are other early-stage adjuncts; however, they only offer temporary relief.
Strengthen:
Once we have achieved this, we can begin to establish the load tolerance of the tendon before loading the tendon at a rate that will stimulate adaptation and subsequent tissue regeneration. By doing so, we are aiming to increase the load capacity of the tendon so that it can withstand more load without pain or prior symptoms.
Hands on treatment:
It is important in this phase that we do not consistently overload the tendon as this will further drive the process of pain and degeneration. There are various techniques that we can employ to adjust the load on the tendon during rehabilitation to align with the tendon’s current load capacity. This is likely to vary between different types/areas of tendon pain and with different people, therefore, it is important to seek individualised professional guidance when it comes to tendon rehabilitation.
The Achilles tendon can then be helped by adding calf-strengthening workouts afterwards. Correction of biomechanics may also be necessary in the case of someone who has persistent ankle instability, as the right footwear can help to unload the tendon and reduce discomfort.
However, it should be remembered that even with the best treatments, this is a condition that can take months to completely get better. The safe road back to strong Achilles tendons should be a patient and planned one.
Note: This information is for education purposes and not a substitute for medical advice. Please consult a healthcare professional for guidance on your condition.