Achilles Tendinopathy

Key Points



Achilles tendinopathy is an injury to the tendon that connects your calf muscles to your heel bone.


It’s usually caused by overuse or repeated stress on the tendon.


Symptoms include pain, stiffness, swelling, and tenderness around the heel and lower leg.


It’s a common condition, especially in runners, sports players, and people who stand or walk a lot for work.


At Bromley Sports Injury Clinic, we provide expert assessment, ultrasound imaging, and tailored osteopathic care to support recovery.



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What is Achilles Tendinopathy?

The Achilles tendon is the thick band of tissue at the back of your ankle that connects the calf muscles to your heel. It helps you walk, run, climb, and jump.

Achilles tendinopathy happens when the tendon becomes painful and stiff due to tiny tears and structural changes from repeated stress. In the past, it was called “Achilles tendonitis,” but this is less accurate because there isn’t always inflammation present.

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Symptoms of Achilles Tendinopathy

Common symptoms include:



Pain at the back of the heel or lower calf – worse with activity or after rest


Stiffness, especially first thing in the morning


Swelling around the tendon or ankle


Tenderness to touch


A creaking or grating sensation (crepitus) when moving the ankle



⚠️ If you experience a sudden sharp pain in the heel or calf with an audible “snap”, this could indicate a tendon rupture. Seek urgent medical attention.

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Causes & Risk Factors

Achilles tendinopathy is usually caused by repeated stress on the tendon.
You may be more at risk if you:



Run or play sports that involve sprinting or jumping


Suddenly increase training intensity or volume


Train on hard or sloping surfaces


Wear poor-fitting or unsupportive footwear


Have had previous ankle or calf injuries


Are older (the tendon becomes less flexible with age)


Have metabolic conditions such as diabetes, high cholesterol, or thyroid problems


Are overweight, which increases strain on the tendon



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Diagnosis of Achilles Tendinopathy

At Bromley Sports Injury Clinic, diagnosis is based on:



Detailed case history (symptoms, activity, and risk factors)


Osteopathic examination (range of motion, tenderness, strength testing)


Ultrasound imaging where required → this allows us to visualise the tendon structure, detect degeneration, and rule out rupture in real time.



In most cases, MRI isn’t necessary, as ultrasound is more than sufficient for tendon injuries.

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Self-Help for Achilles Tendinopathy

You can try the following at home:



Relative rest – reduce or avoid activities that trigger pain.


Ice packs – 20 minutes every 2–3 hours (wrapped in a towel).


Pain relief – paracetamol can help; NSAIDs (ibuprofen) may be useful short term, but avoid long-term use.


Gentle stretching – calf stretches and light mobility work.


Heel lifts or supportive insoles – reduce strain on the tendon.


Low-impact exercise – such as swimming or cycling.



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Treatment Options at Bromley Sports Injury Clinic

If symptoms persist, our osteopathic approach combines:

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✅ Education & load management – understanding what movements help or aggravate your tendon.

✅ Manual therapy & sports massage – to relieve calf tightness and improve circulation.

✅ Exercise rehabilitation – gradual loading programmes to restore tendon strength (eccentric exercises).

✅ Ultrasound imaging – to track healing progress and guide treatment.

✅ Injection therapy – for persistent cases, we offer ultrasound-guided Ostenil® injections (hyaluronic acid) to reduce pain and improve tendon health.

✅ Referral if needed – for complex or unresponsive cases, we can refer you to trusted foot & ankle consultants.

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Prevention

To reduce the risk of Achilles tendinopathy:



Warm up properly before activity.


Increase training gradually, especially running volume or intensity.


Wear supportive, well-fitted shoes.


Stretch calves and strengthen lower limbs regularly.


Maintain a healthy weight to reduce tendon strain.


Address underlying metabolic health factors (blood sugar, cholesterol).



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FAQs – Achilles Tendinopathy

Q: How long does it take to recover?
Mild cases may improve in weeks; more persistent cases can take 3+ months of structured management.

Q: Do I need a scan?
Often not, but ultrasound is highly effective if symptoms don’t improve or rupture is suspected.

Q: Can osteopathy help?
Yes — hands-on therapy combined with structured exercise rehabilitation helps restore strength and function.

Q: When should I see a professional?
If pain continues beyond a few weeks despite rest, or you’re struggling with daily activities.

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Book Your Appointment

Don’t let tendon pain slow you down. Book your Achilles Tendinopathy assessment in Bromley today and take the first step back to pain-free movement.