Achilles pain is one of the most common lower limb conditions we see in clinic. It often affects people who are active, on their feet for work, or have recently increased walking, running, or exercise.
It usually starts gradually with stiffness or discomfort at the back of the heel or lower calf and can begin to interfere with daily activities like walking, stairs, exercise, or even getting moving in the morning.
The good news is that Achilles tendinopathy is very treatable once we understand what is driving the problem.
What is Achilles tendinopathy
Your Achilles tendon connects your calf muscles to your heel bone and is essential for walking, running, and pushing off through your foot.
Achilles tendinopathy is not simply wear and tear. It is best understood as a load related condition. This means the tendon has been exposed to more stress than it can currently tolerate, leading to irritation and pain.
Common symptoms include:
- Morning stiffness in the heel or calf
- Pain during or after walking, running, or stairs
- Tenderness or thickening along the tendon
- Reduced calf strength or tightness
Why it happens
There is usually more than one contributing factor.
Common causes include:
- Sudden increase in walking or running
- Changes in footwear or working on harder surfaces
- Calf muscle tightness or weakness
- Reduced ankle mobility
- Foot posture and biomechanics that increase tendon load
This is why a thorough assessment is so important.
Biomechanical assessment
At Custom Podiatry Services we complete a full biomechanical assessment to understand how your feet and lower limb are functioning.
We look at:
- How you walk and move
- Foot posture and arch control
- Ankle range of motion
- Calf strength and loading ability
- Pressure distribution through the foot
This helps us identify exactly what is contributing to the overload on your Achilles tendon so we can treat the cause, not just the symptoms.
Orthotic therapy
In some cases orthotic therapy can be an important part of treatment.
Custom orthotics are designed to sit inside your shoes and help improve how your feet function during movement.
They may help by:
- Reducing excessive strain through the Achilles tendon
- Improving foot and ankle alignment
- Supporting better load distribution through the foot
- Helping control excessive foot motion during walking or running
Orthotics are most effective when combined with strengthening and rehabilitation rather than used on their own.
How we treat Achilles tendinopathy
Treatment is always tailored to your presentation and goals.
Common treatment options include:
- Shockwave therapy using both radial and focused technology with EMS Swiss Doloclast to stimulate healing in persistent tendon pain
- Dry needling to reduce calf muscle tightness and improve movement
- Strength and rehabilitation programs to gradually rebuild tendon capacity and resilience
- Orthotic therapy where biomechanics are contributing to overload
- Manual therapy and taping to reduce pain and support activity during recovery
Achilles tendinopathy is not a condition that improves with rest alone. In many cases, complete rest can actually slow recovery.
The focus of treatment is to:
- Reduce irritation
- Gradually rebuild strength
- Improve how the foot and leg work together
- Restore tolerance to load over time
When to seek help?
You should have your Achilles pain assessed if it:
- Has been present for more than a few weeks
- Keeps returning when you increase activity
- Is affecting walking, exercise, or work
- Is gradually worsening
