What is Achilles Tendinopathy?

Achilles tendinopathy – overuse injury of the Achilles tendon – the thick band of tissue which connects your calf muscles to your heel bone. 

Common injury in runners, field-sport athletes and people who suddenly increase walking intensity or hill work – it can also affect less active individuals. 

What is happening at the tendon:

Despite being called Achilles tendonitis – most cases are not inflammatory. Instead, it’s a degenerative overload condition: 

• The tendon becomes irritated from repeated strain.

• Collagen fibers can then lose their normal structure. 

• The tendon may thicken. 

• Pain occurs with load. 

Symptoms:

• Pain and stiffness in the back of the heel or lower calf. 

• Morning stiffness (often worst after first few steps out of bed). 

• Pain at the start of activity which may ease as you warm-up. 

• Pain that worsens after exercise. 

• Local tenderness when squeezing the tendon. 

• Thickened or slightly swollen tendon. 

Risk Factors:

• Sudden increase in training load. 

• Hill running or speed work.

• Tight calves. 

• Reduced ankle mobility. 

• Poor load recovery.

• Foot biomechanics. 

• Inadequate footwear. 

How Chiropractic Care Can Help:

Chiropractic management focuses on load management, mobility, and biomechanics rather than just symptom relief. 

Joint Mobility. 

• Ankle joint restrictions can increase strain on Achilles. 

• Adjustments or mobilizations of the ankle, foot, and sometimes hip can improve mechanics. 

Soft Tissue Therapy.

• Instrument-assisted soft tissue work. 

• Myofascial release. 

• Trigger point therapy to calf muscles.

These can help improve tissue quality and reduce muscle tension contributing to tendon load. 

Movement and Biomechanical Assessment.

• Advice on footwear. 

• Activity modification strategies. 

How Sports Therapy Helps: 

• Progressive strength programming. 

• Load management planning. 

• Return-to-sport protocols. 

• Plyometric reintroduction. 

• Taping or temporary heel lifts if indicated. 

3 Simple Exercises to help with Achilles Tendinopathy: 

Exercise 1, Eccentric Heel Drops

Stand on a step with heels hanging off. 

1. Rise up on both feet. 

2. Lift the unaffected foot. 

3. Slowly lower down on the affected side (3-5 seconds). 

4. Use both feet to return to the top.

Repeat 3 sets of 10-15 reps.

Mild discomfort is acceptable. Sharp pain is not. 

Exercise 2, Isometric Calf Holds (For Pain Relief). 

1. Rise onto toes. 

2. Hold at the top for 30-45 seconds.

3. Repeat 4-5 times,  

Aim to do this 1-2 times daily.

Exercise 3, Slow Heavy Calf Raises. 

Stand on a flat, stable surface. 

1. Rise up slowly (3 seconds to the top). 

2. Pause for 1-2 seconds at the top.

3. Lower slowly (3 seconds down). 

4. Perform 3-4 sets of 8-12 reps. 

Frequency – 3-4 times. 

Key Principles for Rehabilitation:

• Tendons need progressive loading, not complete rest. 

• Mild discomfort during exercise is normal. 

• Improvement can take 8-12 weeks. 

• Consistency matters more than intensity.