Achilles Tendoninopathy

Pain at the back of the leg near your heel.

The Achilles tendon is the largest tendon in the body and connects all of the calf muscles to your heel bone (calcaneus). Although the Achilles tendon can withstand huge stresses from running and jumping, too much strain on the structures may result in overuse and degeneration.

There are two types of Achilles tendinopathy

  • Mid portion Achilles Tendinopathy

In mid-portion Achilles tendinopathy, fibres in the lower one third of the tendon have begun to degenerate, swell, and thicken. This is the most common cause of Achilles tendon pain in young, active people.

  • Insertional Achilles Tendinopathy

Insertional Achilles tendinitis occurs where the tendon attaches (inserts) to the back of the heel bone. This may be the result of degeneration or an inflammatory arthritic condition.

In both mid-portion and insertional Achilles tendinopathy, damaged tendon fibres may calcify. Bone spurs may form at the bony attachment point with insertional Achilles tendinopathy.

Causes of Achilles tendinopathy

Achilles tendinopathy may not be caused by a specific injury. It often results from repetitive stress to the tendon when we to do too much, too soon.

Other factors can make it more likely to develop tendinopathy, including:

  • Overuse of the Achilles tendon. This can be a problem for people who run regularly, for dancers and for people who are involved in sports that require jumping.
  • Wearing inappropriate footwear.
  • Poor training or exercising techniques - for example, a poor running technique.
  • Increasing the intensity of your training and how often you train.
  • Training or exercising on hard or sloped surfaces.
  • Having a high-arched foot.
  • Having poor flexibility - having tight or underdeveloped calf or hamstring muscles.

Symptoms of Achilles Tendinopathy

  • Pain and stiffness in the Achilles tendon when rising from bed in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden "pop" in the back of your calf or heel, you may have ruptured your Achilles tendon. See your doctor or health professional immediately!

Management of Achilles tendinopathy may include some of the following:


  • Time off from sporting activities may be necessary if you have Achilles tendinopathy.
  • Immediately stop any high-impact activities or sports (such as running).
  • As pain improves, restart exercise as pain allows.
  • Complete rest, if it is prolonged, can actually be worse for the injury.

Achilles tendon rehabilitation exercises

Your medical professional will be able to provide an exercise programme suitable for your symptoms.

Specific exercises to help strengthen the Achilles tendon can be extremely helpful and must be done every day. These exercises are shown help with pain and stiffness.

Other treatments such as ultrasound and massage may help relieve symptoms and encourage healing of the Achilles tendon.

Foot orthoses and footwear advice will change the loading and function of your foot which alter the forces sustained by the tendon to reduce tissue stress.

Formthotics™ can help relieve symptoms of Achilles tendinopathy

Formthotics support the structures of the foot to encourage optimal function and even pressure distribution.

Formthotics can provide the ideal base to support, distribute and alter loading forces in people with achilles pain. A variety of Formthotics options allow your medical professional to select Formthotics best for your feet, biomechanics and activity. Your Formthotics are then able to be customised specifically for your needs.

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