What it is
Achilles tendinopathy is pain, swelling and impaired function of the Achilles tendon, typically resulting from overuse and failed tendon healing responses rather than simple “inflammation.” It can present as mid-portion tendinopathy or insertional tendinopathy near the heel bone.
Common causes / risk factors
- Rapid increases in training load (running, jumping), inappropriate footwear, biomechanical overload, and reduced tendon capacity from poor conditioning or age.
- Systemic factors (certain medications, metabolic conditions) can also predispose.
Symptoms
- Localised pain in the Achilles region that worsens with activity and improves with rest early on, but may become persistent.
- Morning stiffness and tenderness on palpation; thickening of the tendon can occur in chronic cases.
Evidence-based treatments
- Progressive tendon loading / exercise therapy (eccentric and heavy slow resistance programs) is the cornerstone of treatment and has strong supporting evidence.
- Activity modification, footwear advice, and structured rehabilitation supervised by a clinician.
- Adjuncts: shockwave therapy, individualised orthotic or heel raise use, and in select cases imaging-guided injections or referral for advanced treatments. Surgical options considered when conservative care (12+ weeks) fails.
How Clear Step Podiatry can help
- Thorough assessment (biomechanics, tendon load patterns, mobility and strength testing).
- Personalised progressive loading program with technique coaching and regular review.
- Load management plan (return-to-run/treadmill guidance), footwear optimisation and orthotic prescription when required.
Access to adjunct therapies (extracorporeal shockwave therapy) and referrals for imaging or specialist care when needed.
