Understanding Achilles Tendinopathy: Causes, Symptoms & Treatment

Achilles tendinopathy is a common yet often misunderstood condition that affects the Achilles tendon—the largest tendon in the body. This vital structure connects your calf muscles to your heel bone and plays a crucial role in walking, running, and jumping.

Understanding Achilles tendinopathy is important if you want to prevent long-term discomfort and improve mobility. When the tendon becomes irritated, overused, or inflamed, it can lead to ongoing pain and stiffness that impacts your daily activities.

If you’ve been experiencing discomfort at the back of your heel or lower calf, especially during or after physical activity, you may be dealing with Achilles tendinopathy. The good news is that it’s highly treatable—especially when caught early and managed correctly.

Understanding Achilles Tendinopathy

Achilles tendinopathy refers to the non-inflammatory degeneration of the Achilles tendon due to overuse or excessive strain. Unlike Achilles tendonitis, which involves inflammation, tendinopathy is characterised by the gradual breakdown of the tendon’s collagen fibres.

There are two main types:

• Mid-portion Achilles tendinopathy – affects the middle section of the tendon

• Insertional Achilles tendinopathy – occurs where the tendon attaches to the heel bone

Both can lead to discomfort and reduced performance, particularly in runners, athletes, and those with physically active lifestyles.

Common Causes of Achilles Tendinopathy

Several factors can contribute to the development of this condition:

• Overuse or sudden increase in activity – particularly common among runners

• Poor footwear – lack of proper heel support increases tendon strain

• Tight calf muscles – reduced flexibility puts more pressure on the tendon

• Flat feet or high arches – biomechanical imbalances add stress

• Age-related degeneration – tendons lose elasticity over time

At my clinics in Berkhamsted and Bicester, I regularly see patients with one or more of these risk factors. A comprehensive biomechanical assessment often reveals the root cause and guides treatment.

Symptoms to Watch For

Early recognition is key to preventing long-term issues. Common symptoms include:

• Stiffness or pain at the back of the heel, particularly in the morning or after rest

• Swelling or thickening of the tendon

• Tenderness when touched or moved

• Pain during or after exercise (e.g. running, climbing stairs)

• A creaking or gritty sensation with ankle movement

If you’re experiencing persistent Achilles tendon pain, seek professional help promptly to avoid worsening symptoms.

Diagnosis and Assessment

At both my Berkhamsted and Bicester clinics, I carry out in-depth assessments, including:

• Medical and activity history

• Gait and posture analysis

• Palpation and range of motion tests

• Referral for ultrasound imaging (if necessary)

These tools help me to determine the severity and exact location of the issue. Understanding Achilles tendinopathy at this level allows me to create a tailored treatment plan that addresses your specific symptoms and lifestyle.

Treatment Options for Achilles Tendinopathy

Management involves reducing strain, building strength, and correcting foot mechanics. Depending on your condition, I may recommend:

• Activity modification – easing or adjusting your exercise routine

• Exercise therapy – especially eccentric loading exercises

• Footwear guidance – choosing shoes with heel support or temporary lifts

• Custom orthotics – correcting alignment to relieve pressure

• Manual therapy – massage or mobilisation to aid flexibility

• Shockwave therapy – stimulates healing in persistent cases

Your treatment plan will be based on your individual needs, symptoms, and lifestyle.

Preventing Recurrence

Once symptoms improve, ongoing care is key. To prevent recurrence:

• Avoid sudden increases in physical activity

• Incorporate regular stretching and strengthening routines

• Wear supportive footwear

• Address biomechanical concerns early

Proactive care helps ensure long-term tendon health and avoids future downtime.

Book an Appointment

If you suspect you have Achilles tendinopathy, don’t wait for the pain to worsen. Early intervention can lead to faster recovery and better long-term results.

I offer professional, personalised podiatry care at my clinics in Berkhamsted and Bicester, with flexible appointments and evidence-based treatments tailored to you.

Whether you’re an athlete or just starting to notice discomfort, I’m here to help.

Book your consultation today and take the first step towards stronger, healthier feet.