Achilles Tendinopathy

What is Achilles Tendinopathy? Also called Achilles tendonitis.

Physiothearpists at our Whistler location have taken a keen interest lately in the management of tendon problems. New research has changed the management of tendon pain. The Achilles tendon is the largest and strongest tendon in the body. It is located in the back of the lower leg and connects the large calf muscles (gastrocnemius & soleus) to the heel bone (calcaneus). Achilles Tendinopathy is a degeneration of the Achilles tendon. It can be acute (due to one-time trauma) or chronic. Often the structures around the tendon become inflamed and the entire tendon becomes less flexible than healthy tendon and a small tear may occur. If left untreated, Achilles Tendinopathy can progress into a chronic condition. In some situations it may progress into a full rupture (tear) and surgery may be required.


Activity-related factors:

  • Activities that involve sudden starts and stops and repetitive jumping,
  • Sudden increases in activity level, and
  • Decreased recovery time between exercise bouts.
  • Equipment and surface issues:
  • Training on poor surfaces or up hills,
  • Changes in surface, i.e. running on trails vs. concrete sidewalks,
  • Switching from high heel to athletic shoes, and
  • Poor footwear, i.e. high heels, soft rearfoot.

Biomechanical and anatomical factors:

  • Abnormal pronation of the foot,
  • Limited ankle range of motion, and
  • Calf muscle weakness and inflexibility.

Signs & Symptoms

The symptoms of Achilles Tendinopathy usually develop gradually though in some cases it can be caused by trauma to the Achilles tendon. Repetitive stress on an already torn Achilles tendon may lead to complete rupture.

Signs of Achilles Tendinopathy include:

  • Presence of an Achilles nodule (Figure 1),
  • Pain in the back of the lower leg and ankle during exercise,
  • Swelling and redness over the Achilles Tendon, and
  • Decreased strength and movement in the lower leg.

Treatment of Achilles Tendionopathy:

At back in action Whistler Physiotherapy we have studied the latest research in this interesting area. We use Paris Orthotic laboritory for custom orthotics and Vasyli off the shelf orthotics when needed.

Treatment protocol may involve:

  • Dscontinuation of the activity that causes the pain.
  • Eccentric graded strengthening program,
  • Identification & correction of predisposing factors,
  • Modalities to increase healing such as Ultrasound
  • Stretching program,
  • Manual mobilization
  • Footwear and custom foot orthotic prescription.