If you are frustrated with a long term tendon injury that does not seem to be getting better, hang tough, there are things you can do. In this post we will discuss top tips for managing Achilles tendinopathy.


1 = Take away ‘bad’ load

Achilles tendinopathy is often caused by or at least made worse by running, other sport but sometimes simply walking. Many of the people we see with Achilles tendinopathy are not runners (some studies estimate more than half of those affected are not ‘sportpeople’). Too much too soon of these loads can be damaging, so you may need to reduce these in the short term to reduce pain.


2 = Develop the tendons ability to withstand load

It may seem strange given what we have just talked about in point one, but the best and most evidence based treatment for Achilles tendinopathy is actually exercise. It turns out that the Achilles responds very well to slow, heavy loading of the calf – this has a positive influence unlike running, jumping and walking. So the ability to withstand load is developed with slow progressive loading and then people find it much easier (of importantly less painful!) to return to walking, running and sport.

3 = Understand what aside from activity may be causing YOUR tendon pain

There are so many factors that can contribute to your pain. For example foot posture and whether orthotics would help is often a consideration. Developing strength in your hip and back muscles (what is sometimes called core stability) may be important for some. Some people need to change their running style to reduce Achilles load. We also know that lots of other factors for example having elevated cholesterol levels or females in menopause may play a role in Achilles pain. Did you know that even your thoughts and emotions can influence your pain and sometimes be a barrier to you improving. Our physios specialise in tendinopathy and are experts at finding the important factors that will allow you to improve.

4 = Understand that load is the key, other treatments are just helpers

People commonly make the mistake of thinking an injection will cure them, or surgery might, the reality with tendons is that there is no substitute to progressive exercise and load. Anything else that is added and this includes massage, dry needling, orthotics, etc., etc. are helpers or adjuncts and will most likely only work with a good loading program. This definitely injections and surgery!

For more information about tendinopathies and if we can help please feel free to call or email the clinic.

  • Written by Dr Christian Barton

    Dr Christian is an expert in the management of difficult to treat, long-term injuries. He possesses a particular interest in the knee, specialising in conditions such as osteoarthritis, patellofemoral pain, and running-related injuries. Christian’s primary focus is providing individual exercise solutions and holistic patient education for people with persistent pain. Christian is recognised as a world leader of running retraining treatment, which is often a key missing element in the rehabilitation of injured runners.