Achilles Tendinopathy
Achilles tendinopathy is pain and load intolerance in the Achilles tendon, common in runners and people who've recently changed their training. Assessment focuses on how the tendon is currently tolerating load.
30-minute appointments as standard · No referral required
What is Achilles Tendinopathy?
Achilles tendinopathy refers to pain and reduced load tolerance in the Achilles tendon, at the back of the ankle and lower calf. It’s common among runners, particularly following changes in training volume, intensity or surface.
This can include pain or stiffness at the back of the ankle, particularly first thing in the morning or after rest, discomfort that builds during running, or tenderness directly over the tendon.
How We Assess Achilles Tendinopathy
Assessment includes your running and training history, footwear, and how your symptoms respond to different loads and activities.
We assess ankle and calf strength and movement, along with how the tendon responds to loaded activities such as calf raises or hopping, to understand its current capacity.
Treatment and Rehabilitation Approach
Treatment centres on progressive tendon loading, guided by what the assessment finds, alongside guidance on managing running load while the tendon adapts.
This sits within our broader foot and ankle pain approach and running-specific load management principles.
Looking for help with Achilles Tendinopathy?
An assessment can help identify the factors contributing to your symptoms and guide the next steps.
Symptoms
Pain at the back of the ankle
Typically felt directly over the Achilles tendon, above the heel.
Morning stiffness
Stiffness or pain that’s often worse with the first steps after rest, easing with movement.
Pain that builds with running
Symptoms commonly increase during or after running, particularly following a change in training.
Causes and Risk Factors
Rapid changes in running load
A sudden increase in running volume, intensity or hill work can outpace tendon capacity.
Calf and ankle strength factors
Reduced calf strength or ankle mobility can influence how load is managed through the tendon.
Footwear and training surfaces
Changes in footwear or running surface can alter the demands placed on the Achilles tendon.
Return-to-Sport Considerations
Progressive tendon loading
Load is increased in structured stages to build tendon capacity without overloading it.
Reintroduce running gradually
Running volume and intensity are reintroduced in stages, guided by how the tendon responds.
Rebuild calf and ankle capacity
Strength and control through the calf and ankle are progressed to support a return to full training.
Frequently Asked Questions
Can I keep running with Achilles tendinopathy?
Often yes, with training load adjusted to a level the tendon can tolerate — an assessment helps determine what’s appropriate.
How long does Achilles tendinopathy take to settle?
Tendon-related injuries can take longer than muscle injuries to resolve, and timeframes vary between individuals.
Should I stretch my Achilles tendon?
This depends on your specific presentation — your physiotherapist can advise on what’s appropriate as part of your program.
Do I need a scan for Achilles pain?
Imaging isn’t always required and doesn’t always change management. It’s considered on a case-by-case basis at assessment.
Clinically reviewed by Ryan Harris on 18/08/2026