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Le Yantra, Spine & Sports Injury Clinic

Sports Injuries

Achilles Tendinopathy

Achilles tendon pain

A tendon problem, which means loading it, not resting it.

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No referral needed · One-to-one throughout · Treated at both clinics

A hand gripping the back of a bare ankle, the area just above the heel highlighted in red.

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The copy on this page is written and is waiting on clinical sign-off. It carries noindex and stays out of the sitemap until a clinician reviews it and a review date is recorded, which is what makes the medical statements on it attributable.

Achilles tendinopathy is pain and dysfunction in the Achilles tendon, the thick tendon connecting the calf muscles to the heel bone. It occurs in two locations that behave differently: mid-portion, a few centimetres above the heel, and insertional, where the tendon meets the bone.

Insertional problems are generally slower to settle and less tolerant of certain stretches and loading positions, so the distinction matters.

The older term “Achilles tendinitis” implies inflammation. The tissue changes are better described as degenerative, which is why rest and anti-inflammatories alone tend not to resolve it.

What it feels like

Pain and stiffness in the tendon, characteristically worst in the morning and after periods of sitting, easing with movement then returning after activity. Often tender to squeeze. Sometimes visible thickening.

Why it happens

Load exceeding what the tendon can currently tolerate. Common triggers: increased running volume or intensity, adding hill work, a change of footwear, or returning after a break.

When to seek medical care

Sudden severe pain in the back of the calf with a sensation of being struck or kicked, along with difficulty pushing off, may indicate an Achilles rupture. That needs urgent medical assessment.

How we treat it

Progressive loading is the core treatment and it is well supported. The specific programme differs between mid-portion and insertional presentations. Alongside that, addressing training load, calf strength and where relevant footwear and mechanics.

What to expect

Assessment will establish which type you have, because it changes the programme. Expect a loading programme that produces some tendon discomfort, that is acceptable and expected within limits your physiotherapist will explain.

How long it takes

Months rather than weeks, and it depends heavily on doing the loading programme consistently. This is a condition where the home programme carries the result.

Treatments we commonly use

Which of these applies to you is decided at your assessment, not before it.

Frequently asked questions

Should I rest it completely?

No. Tendons do not respond well to rest, they need progressive loading. What needs reducing is the aggravating load, not all load.

Should it hurt when I do the exercises?

Some discomfort during loading is acceptable and expected. Your physiotherapist will explain the limits and what to do if it exceeds them.

Why is it worse in the morning?

Morning stiffness is characteristic of tendon problems and is a useful marker, tracking it over weeks is a good way to gauge progress.

Related conditions

  • Heel Pain

    Under the heel, behind it, or around the sides. The location and the timing are what separate the causes.

  • Shin Splints

    Pain along the inner shin in runners. A load problem that can progress toward a stress fracture if it is worked through.

  • Plantar Fasciitis

    The commonest cause of heel pain. A tissue-loading problem, which is why it responds to loading rather than to rest.

Find us

Treated at both clinics

Every service runs at both our clinics, Malleshwaram and MEI Layout, monday – saturday 9 am – 9 pm · sunday & public holidays 10 am – 5 pm.

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Every treatment plan at Le Yantra starts with a full assessment, not a standard protocol.

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Monday – Saturday 9 AM – 9 PM · Sunday & public holidays 10 AM – 5 PM

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