Tendinopathy: A Guide to help your Achilles Heel


Tendinopathy Management Guide

  • Do you have pain and stiffness in your calf/achilles/heel?
  • Does your Achilles feel sore while you run, ache after you run, and/or feel tight as you walk around?
  • Are you wondering if you should stop exercising and rest to let things heal?

Achilles tendon injuries can be stubborn and frustrating. Without an individual MANAGEMENT program, this can be a very difficult issue to address. But rest is rarely the right answer for this issue.

The Achilles tendon joins the muscles in your calf to your heel bone; this is a very common area of pain in runners.

A tendinopathy is when the tendon starts to degenerate via micro-tears in the tendon (there also can be an inflammatory component sometimes). There are different types of tendinopathies and various stages, however for the purpose of this blog I will talk about Achilles Tendinopathy in general terms.

Without a doubt, the main cause of a tendinopathy is overload. 

  • There is a heat wave and you want to make the most of the nice weather so you go for a run…. you do the same a few times over the next few days, without considering that you haven’t been running much over the last few weeks/months.
  • Or maybe you are an experienced runner and you’re trying to beat your previous personal best in your (half) marathon, so you’ve been upping your training volume recently.
  • Or maybe you don’t like running, but you’ve started going for more hill walks recently.

These are all common examples of overload. Tissues have a load tolerance. When tolerance is exceeded on an ongoing basis, the tissues won’t be able to recover.

Tendons take quite a bit longer to recover compared to muscles. This is why you feel the pain in your tendon rather than your muscle.

Runners usually describe a gradual onset of Tendinopathy Achilles pain during or after a run (it can often go away as the area gets warmed up).

Gradually the pain becomes more frequent and can even start to be a problem on a daily basis when not running.

If you continue to train on it, the pain in the tendon will be sharper and you will feel it more often, eventually impeding your ability even to jog lightly.

Virtually all of the force generated when you “toe off” the ground during running is transmitted by the Achilles, and this force can be as much as 3-5 times your body weight. That’s a large force! 


So if overload is one of the causes of you Tendinopathy Achilles pain, what is the solution?

Pretty simple, a gradual increase in loading.

However, this may not seem as simple when taking intensity, distance, frequency and volume into account. All of these factors need to be MANAGED perfectly. Rest will not help get over the problem.

Also, maybe your body needs a rest from one load and needs a different type of load – like strengthening.

Have a look at the exercise below as a great starting point:

Overload is the main cause for Achilles tendinopathy, however there can be a lot of other contributing factors such as inadequate calf strength/endurance, ankle flexibility/mobility, excessive foot pronation, running technique, inappropriate footwear as well strength and flexibility issues in the lower back, hips and legs.

These would all need to be assessed and addressed appropriately. At APC PHYSIO CLINIC, we will assess all of these potential contributing factors and put you on an individualised LOADING program to get over your Achilles pain.

Obviously, having pain in you heel doesn’t necessarily mean it is an Achilles Tendinopathy. This is another reason why it is important to get assessed as there can be a few other possible areas.


If you have any other queries or you are not quite sure where to begin, feel free to contact us via email, or over the phone on 025 35015.

Also feel free to have a read of some more blogs and/or sign up to our newsletter for monthly advice/tips.

Thank you for reading, and remember:

Move Well, Feel Well, Be Well

For Advice on any other pain you may have like Hip or Neck and Shoulder Pain, feel free to contact us today. We also provide specialised treatments like Dry Needling.

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