Formally known as Achilles tendinitis, ‘itis’ meaning inflammation, but in recent years we have realised that tendons aren’t get inflamed, they suffer overuse, and a decreased tolerance to exercise, so we now call it a tendinopathy.

Are there different types of Achilles tendinopathy?

You can experience mid tendon and insertional Achilles tendinopathy (see image). Tendinopathy has three stages, a continuum, if you will.  The stages are.

           Reactive Tendinopathy

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           Tendon disrepair

                          ↓  ↑

           Tendon degeneration.

Because tendinopathy is a continuum, it is possible to improve a tendon with proper care.

What is it and how does it present?

Characterised by pain at the back of the heel particularly in the morning and generally the day after a run/exercise. You may be able to see a thickening of the tendon in comparison to the other Achilles. 

What can happen if left untreated?

An Achilles tendon rupture can occur when the tendon is in the degeneration phase. 

What factors?

  • Achilles tendinopathy is more common age 30+
  • Its more common in men
  • More common if you’re overweight
  • Have tight or weak calf muscles
  • If you have diabetes
  • Poor endurance of calf muscles
  • Poor stability of hips
  • Stiff joints in foot
  • Poorly supporting footwear
  • Increase mileage too fast


What can be done about it?

  • Ice (natural pain killer)
  • Painkillers i.e. paracetamol*
  • Reduce exercise load temporarily
  • Stretching calf muscles
  • Maintaining ankle joint mobility
  • Strengthening hip complex
  • Alfredson Eccentric exercises – specific tendon loading.
  • Consider maintain fitness by changing to cycling swimming or aqua jogging
  • Leave 48 hrs. in between runs

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