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Achilles Tendinopathy

What is Achilles Tendinopathy?

The achilles tendon attaches the muscles of your calf to the foot to help with walking, running and to lift you up into the tip toe position. Tendinopathy can occur when the load we place on the tendon is too much or too frequent and the tendon simply cannot cope.

What are the symptoms?

  • Pain, felt at the back and above the heel. The level of pain can vary greatly. At times the pain can be very severe and impact greatly on your standing and walking. At other times the pain maybe less intense and you may only be aware of it when you first start moving or after periods of activity. 
  • Stiffness felt in the tendon first thing in the morning or after periods of rest.This usually only lasts a few minutes 
  • Swollen /thickened tendon. Sometimes this lump maybe warm, but not always 

What are the causes?

  • Sudden increase in activity levels, running or walking more or over different terrains
  • Age. It is more common from aged 30
  • Being overweight 
  • Having diabetes
  • Having a tight and/or weak muscles in the calf and surrounding areas

What can I don to help myself?

What you can do to help yourself will depend a little on what your symptoms are like. If your symptoms are very irritable you can try 

  • Using pain killers. It is reconmended to try regular paracetamol and anti-inflammatory tablets, such as Ibuprofen, in the first instance. If you are not sure if these are safe for you to use or they are not effective speak to your GP
  • Apply an icepack (covered with a towel) to the affected area for 15-20 minutes
  • Try to reduce the amount of time you are on your feet, or split longer tasks into shorter bouts of activity, rather than one long period
  • Place a small heel raise into a supportive shoe, such as a pair of laced trainers
  • Try some gentle exercises. We have included some for you to try 

If your symptoms are less irritable and tend to only bother you when first move or after prolonged activity then your treatment would focus more on gradual and progressive strengthening of the calf muscles over several months

  • Self-refer to see a physiotherapist or try the exercises suggested in the link below

Easy exercises for Achilles Tendinopathy

Moderate exercises for Achilles Tendinopathy

Advanced exercises for Achilles Tendinopathy

What will physiotherapy do?

A physiotherapist will take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

Your physiotherapist will create an individual and progressive exercise programme to address your individual needs. Treatments will be based on active rehabilitation, focusing on strength and flexibilty of the muscles surrounding the lower leg and foot.

Acupunture, electrotherapy and massage have not been shown to be effective in treating achilles tendinopathy and therefore will not be offered.

The benefits and risks of using steroid injection can be discussed with your physiotherapist or GP.



Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • your ankle is very painful and you cannot put any weight on it
  • you have direct injury to the ankle and it has become very swollen very quickly
  • your ankle is badly swollen or has changed shape
  • you heard a snap, grinding or popping noise at the time of injury
  • you have a very high temperature, feel hot and shivery, and have redness or heat around the ankle – this can be a sign of infection

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

Exercises & Resources

If you already have a diagnosis from a medical professional you may find some of the following links more helpful



Referral Information

If your ankle pain persists, or you are not sure what to do, you can self-refer to see a local physiotherapist who can help you with your problem.