Achilles Tendinopathy – Causes & Treatment for Recovery

Characterised by pain in the heel and along the tendon or calf area while walking or running, achilles tendinopathy (or achilles tendinitis) is one of the more common injuries to the lower leg area. Often caused by overuse or repetitive strain of the tendon, this sort of achilles pain is common in runners and gymnasts.

The difference between achilles pain and other overuse injuries is that it if left unmanaged, it can spiral into lasting issues. So, let’s delve into identifying, treating, managing, and preventing achillies tendinopathy.

What is Achilles Tendinopathy?

Achilles tendinopathy is a condition where the achilles tendon becomes damaged from overuse, as the tendon’s fibres have started to breakdown, causing swelling and pain. The achilles tendon itself is located at the back of your calf, connecting your calf muscles from base of your heel to the back of the knee. 

The pain caused by achilles tendinopathy is pretty distinct - you’ll feel it straining the length of the tendon, and it can feel like sharp pressure, particularly around the heel or the lower part of the leg. 

Achilles tendinopathy will usually be worse in the mornings, where it can feel stiff, swollen, and sometimes hot with pain. There are different types and stages of achilles tendinopathy, each relevant to progress of the injury. To put it simply, the early stages of achilles tendinopathy are usually reversible, but become permanent once the injury progresses into the chronic phase.

Stages of Achilles Tendinopathy

Achilles tendinopathy can get progressively worse in different stages -  the three main types or stages of the injury include:

• Reactive Tendinopathy —  Happens when an acute overload is placed on the tendon over a short period of time. Some discomfort and tightness may be experienced until the next morning as a result of the tendon becoming thicker through recovery. 

• Tendon Disrepair — Occurs when the tendon is subject to continuous overload, resulting in a greater level of injury. Blood vessels and nerves may grow into the tendon tissue to aid recovery, leading to some pain and tension in the Achilles tendon during the start of exercise activity. 

• Degenerative Tendinopathy — Prolonged overload to the tendon to the point of severe cell degeneration. As tendon cells die quicker than recovery can occur, pain becomes intense and difficult to exercise with. Tendons at this stage face a high risk of a tear or rupture. 

Beyond these stages, damage to achilles tendons can be long lasting, and chronic - causing significant problems with mobility. The best way avoid turning your minor strain from getting progressively worse is to seek treatment early. 

Achilles Tendinopathy Symptoms

So, what signs should you look out if you think you may have achilles tendinopathy? Symptoms will generally look like:

• Pain at the back of the heel, especially when walking or running

• Swelling in the heel or calf

• Loss of strength in the feet

• Uncomfortable tension or stifness in the tendon at the start of the day

Causes of Achilles Tendinopathy

Walking, running, jumping are all actions that require the use of your achilles tendon. The most common cause of achilles tendinopathy is overuse — you’ve probably exerted too much effort with your feet, causing your tendon to becoming overloaded. 

However, other factors like blunt trauma or muscle fatigue can also cause achilles tendinopathy. Getting hit on the back of the lower leg or heel can certainly injure your tendon, while tired muscles can cause the tendon to overcompensate for the loss of strength and become more stressed.  

Treatment and Recovery for Achilles Tendinopathy

Treatment for achilles tendinopathy is best carried out with a qualified physiotherapist. During treatment, your physio will prescribe a bunch of different methods that aim to rest, heal, and strengthen your achilles tendon. 

These treatment methods include:

• De-loading: Intentional, planned periods of recovery that remove load from the tendon, allowing it to rest and regenerate. Rest is a critical part of speeding up recovery time. 

• Pressure massages: Targeted massages to the calf muscle can help to promote recovery and release tension from the achilles tendon. The release in tension can provide pain relief and restore range of motion. 

• Strengthening exercises: Specific loading exercises aimed at gradually restoring strength to the tendon. This form or treatment is by far the most effective in aiding tendon repair.  

How Long Does It Take to Recover From Achilles Tendinopathy?

It depends on how extensive the damage to your achilles tendon is. At stage 1 (reactive tendinopathy), recovery can take up to a few days. Stage 2 (tendon disrepair) will require several weeks to reduce the tension and pain in the tendon. With stage 3 degenerative tendinopathy, however, recovery will lengthen to a period extending over a few months due to the severity of the condition. 

Tips for Prevention

The good news is that achilles tendinopathy can be prevented altogether with the right techniques and care. Here are some helpful tips you can keep in mind:

Warming up before running or other exercise will be effective in reducing the chances of your injuring your achilles tendon. Straight leg calf stretches and walking on your toes, in particular, should be a focus during your warmups to get blood circulating in your lower leg. 

If you don’t already have a pair of shoes that are offer good support for your heel, consider getting a pair that has shock absorptions padding. This can reduce the amount of load on your tendon during activity as well as provide some cushion when your feet hit the ground. 

When is It Time to See a Specialist?

Any pain and sensitivity that doesn’t fade on its own is a clear sign that you should see a physiotherapist for proper diagnosis and if necessary, treatment. Feeling pain in your heel or achilles tendon while walking or running isn’t normal - you should seek professional help whether you’re an elite athlete, or a weekend ParkRun participant.

Given the fact that cchilles tendinopathy can worsen to the point that your mobility can be impacted, it’s best to not risk it. With experienced sports physiotherapists on our team, Infinite Health can help you get a speedy recovery from achilles tendinopathy. Book a consultation at our clinics across Mosman, Chatswood, North Sydney, and in the Sydney CBD today.