Achilles Tendinopathy & Tendonitis


Achilles tendon issues are common conditions that affects the Achilles tendon, the large band of tissue connecting the calf muscles to the heel bone. It is characterized by pain, stiffness, and swelling in the back of the ankle, often seen in athletes and individuals engaged in repetitive physical activities but it can affect people of all ages and activity levels. This article delves into the world of Achilles tendinopathy and explores the role of physiotherapy in assessing, treating, healing, and rehabilitating this condition. Additionally, we will discuss the significance of gait analysis and biomechanical assessment in stopping Achilles tendinopathy: something we pride ourselves in offering at Achieve Health.


The most common symptom of Achilles tendonitis is pain along the back of the leg or just above the heel.

Inflammation of the Achilles tendon can lead to swelling around the affected area. The back of the ankle may appear swollen and feel tender to the touch.

People with Achilles tendonitis may experience stiffness in the ankle joint, especially after periods of rest or in the morning.

The Achilles tendon becomes tender to touch, and pressure on the affected area can exacerbate the pain.

The condition may result in a reduced range of motion in the ankle, making it difficult to flex or point the foot.

In some cases, the skin around the Achilles tendon may feel warm to the touch and appear red due to increased blood flow to the affected area.

Pain often increases during physical activity, particularly activities that involve pushing off the foot, such as running or jumping.

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How Physiotherapy Can Help

Physiotherapy plays a pivotal role in the comprehensive management of Achilles tendinopathy. The physiotherapist’s expertise comes into play at various stages of the treatment process.

1. Assessment of Achilles Tendinopathy

The initial step in managing Achilles tendinopathy/tendonitis is a thorough assessment. The physiotherapist evaluates the patient’s medical history, lifestyle, and activity level to gain insights into the possible causes of the condition. Physical examination of the affected area and surrounding structures helps in diagnosing the severity of the tendinopathy.

2. Treating Achilles Tendinopathy

Once the assessment is complete, the physiotherapist devises an individualized treatment plan. This plan may include exercises to improve flexibility and strength, manual therapy to reduce pain and stiffness, and the use of modalities such shockwave or needling to promote tissue healing.

3. Healing Achilles Tendinopathy

Promoting healing in the affected tendon is crucial to the recovery process. Physiotherapy employs techniques like eccentric exercises, which focus on controlled lengthening of the tendon during specific movements. This stimulates collagen production and enhances tendon repair. Hands on treatment is also vital to aid the healing process – deep friction massage and IASTM ( instrument assisted soft tissue massage) are examples of this.

4. Rehabilitation for Achilles Tendinopathy

Rehabilitation is a crucial phase of the treatment process. The physiotherapist guides the patient through a progressive rehabilitation program, gradually reintroducing functional activities and sports-specific exercises. This phase aims to restore the patient’s strength, flexibility, and agility.

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The Role of Gait Analysis

Gait analysis is an essential aspect of managing Achilles tendinopathy. It involves observing and analysing the way an individual walks or runs. Identifying abnormal gait patterns can provide valuable insights into the root cause of the tendinopathy.

Importance of Biomechanical Assessment

Biomechanical assessment complements gait analysis by evaluating the alignment, posture, and movement patterns of the body. An improper biomechanical alignment can contribute to the development and persistence of Achilles tendinopathy.

How Physiotherapy Incorporates Gait Analysis and Biomechanical Assessment

Physiotherapists use gait analysis and biomechanical assessment to tailor treatment plans according to the individual’s unique needs. By addressing gait abnormalities and biomechanical imbalances, the physiotherapist can enhance the effectiveness of the treatment and reduce the risk of recurrence. It is common in the case of Achilles issues – that an orthotic may be required, often foot pathologies such as pronation can increase the risk of Achilles tendinopathies. A physio will be able to complete an assessment and make recommendation regarding an orthotic device. This is something we, at Achieve Health, always ensure we assess when treating an Achilles issue as preventing another episode of pain is vital.

The recovery time varies depending on the severity of the condition and the individual’s commitment to the treatment plan. In mild cases, recovery can take a few weeks, while more severe cases may require several months.

Yes, Achilles tendinopathy can affect anyone, not just athletes. It is commonly seen in individuals engaged in activities that involve repetitive movements, such as running but can occur due to factors such as footwear and weakness – so can affect anyone. 

Your physiotherapist will guide you on which exercises are safe and suitable during the treatment period. In some cases, certain activities may need to be modified or temporarily avoided.

Taking appropriate measures, such as proper warm-up, gradual progression of physical activities, and addressing biomechanical issues, can help reduce the risk of developing Achilles tendinopathy.


Achilles tendinopathy/tendonitis can be debilitating conditions, but with the expertise of physiotherapy and the integration of gait analysis and biomechanical assessment, individuals can recover effectively. Early intervention, proper assessment, and personalized treatment plans play a crucial role in the journey towards healing and rehabilitation. Contact us now if you are struggling with Achilles pain: we have specialists at our clinics in Solihull and Birmingham.