Achilles Tendinopathy

01 Overview

The Achilles tendon is an amazing structure, it is the largest tendon within the body. It is an energy-absorbing and energy-releasing structure. Absorbing up to 3 times your body weight and forces up to 7 times your body weight during the push-off phase of gait.

02 Details

About the Achilles Tendon

The Achilles tendon is the largest tendon within the body, it attaches the calf muscles to the heel bone. It is a very powerful structure that load up to 12-13 times the bodies weight during running.

It is crucial for walking and running as during the propulsive (toe off) phase of gait (walking) as the calf muscles contract (tighten) to drive the body forward the Achilles tendons pulls on its attachment site, the heel bone, to create heel lift and ankle joint movement.

Achilles Tendon Issues

The Achilles tendon and calf muscles are essential for walking and running and can high loads.

Problems with the Achilles tend to be oveload or overuse.  Pain occurs due to weakness or dysfunction.

Problems can present in various ways with the most common site being the middle section (mid-portion) of the tendon, 2-6cm up from the heel bone.

Other types of Achilles tendon problems include Insertional Achilles tendinopathy whereby the attachment of the Achilles becomes painful and swollen.

compressed achilles


Pain which is often felt as sharp and stabbing with swelling, this can affect walking especially during the push-off phase and climbing stairs. The Achilles may feel stiff first thing in the morning and after periods of rest.

Pinching the area and it is sore is an indication

In longer-term cases thickening of the Achilles tendon might be noted when compared to the opposite leg.



A diagnosis is made generally from symptoms and clinical assessment, there is commonly localised swelling within the tendon, Imaging such as an Ultrasound is commonly used to aid diagnosis and assess the structures integrity for tears or splits or even rupture so appropriate treatment planning can be commenced.

Common Causes of Achilles Tendinopathy

Age and Sex

Age and Sex
Achilles Tendinopathy is more prevalent in middle age runners especially in men

Increased Body Mass Index

Increased Body Mass Index
An increased body mass places more stress through the tendon during walking & running.  It is an energy-absorbing and energy-releasing structure. Absorbing up to 3 times your body weight and forces up to 7 times your body wright during the push-off phase of gait. Which has been estimated up to 7 times the body during running.

Tight Muscles

Tight Muscles
Tight calf muscles will create an increased pull & stress through the Achilles tendon.

Flat or Pronated Foot Type

Flat or Pronated Foot Type
A rolled in or overly pronated foot type can place more stress on the tendon.

Training Issues

Training Issues
A sudden increase in intensity, distance & poor footwear cam place more stress through the tendon, very common in marathon runners when training.

Training or exercising on hard or sloped surfaces.

Making a change to your training programme – for example, rapidly increasing the intensity of your training and how often you train.

Systemic Causes

Achilles tendinopathy is also more common in people who have certain types of arthritis, such as ankylosing spondylitis or psoriatic arthritis. It is also thought that your genetic ‘makeup’ (the material inherited from your parents which controls various aspects of your body) may play a part for some people who develop Achilles tendinopathy. It is also more common in people who have high blood pressure, high cholesterol or diabetes

People who are taking medicines from a group called fluoroquinolones (such as antibiotics: Ciprofloxacin)

What’s the Fix?

Rest and Ice can help in the early stages.  Reducing activity and even complete rest may be required, depending on the severity.

Stretching and strengthening is key component

Advice and assessment on your training, footwear and running style.

Prevention is key!

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