Achilles Tendinopathy: Understanding the Pain Behind Your Step

Introduction

Do you feel pain, stiffness, or a burning sensation at the back of your heel — especially during your first steps in the morning or after activity? You may be experiencing Achilles tendinopathy.

This condition is not just for athletes. It can affect walkers, runners, busy professionals, and anyone on their feet all day. The good news? With a guided physiotherapy plan focused on movement and tendon healing, recovery is completely achievable.

What is Achilles Tendinopathy?

The Achilles tendon is the strongest tendon in your body, connecting your calf muscles to your heel bone. It helps you walk, run, jump, and push off.

Achilles tendinopathy refers to overuse or degeneration of this tendon — not a tear. It typically occurs due to repetitive strain without enough time for healing.

Causes

• Sudden increase in activity or intensity (e.g., running or jumping)

• Poor footwear or worn-out soles

• Tight calf muscles or weak foot mechanics

• Flat feet or overpronation

• Sedentary lifestyle followed by sudden activity

• Improper training surfaces (like concrete or slopes)

Symptoms of Achilles Tendinopathy

Pain and stiffness at the back of the heel or lower calf

Pain worse in the morning or after rest

Swelling, thickening, or tenderness over the tendon

Pain during climbing stairs, walking uphill, or standing on tiptoes

Crepitus (a creaky sound/feel) when moving the tendon

Insertional vs. Midportion Tendinopathy

There are two common types:

1️⃣ Midportion Achilles Tendinopathy

• Occurs 2–6 cm above the heel

• Common in active individuals

• Responds well to eccentric loading exercises

2️⃣ Insertional Achilles Tendinopathy

• Pain is right at the tendon’s insertion on the heel bone

• More sensitive to compression and shoes

• Requires gentler, modified loading strategies

How Physiotherapy Helps

At CKS – MedVana, we follow a structured, phase-wise rehab program to:

• Reduce pain

• Rebuild tendon strength and elasticity

• Improve movement mechanics

• Prevent recurrence

Phase-Wise Rehab Strategy

Phase 1: Reduce Load & Calm the Tendon

Phase 2: Controlled Tendon Loading

Phase 3: Restore Function.

Phase 4: Return to Sport or Work

Bone & Movement Therapy Integration

Bone Therapy Focus:

• Joint mobilizations of ankle, subtalar, and midfoot joints

• Correcting foot pronation or alignment issues

• Prescribing orthotic support if needed

Movement Therapy Focus:

• Neuromuscular control of glutes and hamstrings

• Core training for dynamic stability

• Addressing kinetic chain imbalances

Footwear & Lifestyle Tips

• Choose shoes with good heel cushioning and slight elevation

• Avoid flat slippers or hard soles

• Warm up before walks/runs

• Don’t ignore early morning stiffness — it’s often the first sign

Final Thoughts

Achilles tendinopathy is treatable without surgery, especially when diagnosed early. With personalized movement-based rehab and bone therapy, you can return to your favorite activities stronger than before.