Conditions we treat
Achilles Tendonitis
Reviewed by Andrew Macdonald, Senior Physiotherapist — AHPRA registered, APA member
What is Achilles Tendonitis?
Achilles tendonitis (or tendinopathy) is irritation or degeneration of the Achilles tendon, which connects the calf muscles to the heel bone. It’s especially common in runners and people who’ve recently increased their training load, but can also develop from tight calves, poor footwear or simply age-related changes in the tendon.
Symptoms
Typical symptoms include pain and stiffness at the back of the heel, particularly first thing in the morning or after periods of rest, tenderness along the tendon, and pain that may ease during activity before returning afterward.
Treatment
Andrew’s treatment combines manual therapy and soft tissue work to manage pain and tension in the calf, with a structured, progressive loading exercise programme — the best-evidenced approach for tendon conditions. Shockwave therapy is often used alongside this for tendons that haven’t responded to loading exercises alone. Managing training load and addressing contributing factors like footwear or calf tightness is just as important as the hands-on treatment for a lasting result.
Achilles tendonitis is one of Andrew’s particular clinical interests, and it’s a condition he sees often through his running assessments — if training load is part of what’s driving your symptoms, a full assessment of your running gait and load can help prevent it recurring once you’re back to full training.
How we treat it
Treatments used for achilles tendonitis
Manual TherapyManual therapy uses hands-on techniques — soft tissue work, trigger point therapy, joint mobilisation and fascia distortion release — to ease pain, restore movement and speed recovery.
Shockwave TherapyShockwave therapy uses focused acoustic pulses to stimulate healing in chronic tendon conditions that haven't responded to other treatment, such as Achilles tendinopathy, tennis elbow and plantar fasciitis.
Exercise RehabilitationA structured, progressive exercise programme — tailored to your condition and stage of recovery — to rebuild strength, restore movement and prevent injuries recurring.Frequently asked questions
What's the difference between Achilles tendonitis and a torn Achilles?
Achilles tendonitis (tendinopathy) is irritation or gradual degeneration of the tendon, causing pain and stiffness that builds over time. A tendon tear or rupture is a sudden, often traumatic injury, typically causing sharp pain and an inability to push off on the foot — this needs urgent medical assessment, unlike the gradual onset of tendonitis.
Can you keep running with Achilles tendonitis?
Often yes, in a modified way, since complete rest isn't usually the best approach for tendon conditions. Andrew's structured, progressive loading programme is the best-evidenced approach for tendinopathy, and training load is managed carefully alongside it rather than stopped completely.
What is the best treatment for Achilles tendonitis?
A structured, progressive loading exercise programme is the best-evidenced treatment for Achilles tendinopathy, combined with manual therapy to manage calf tension. Shockwave therapy is often added for tendons that haven't responded to loading exercises alone.
How long does Achilles tendonitis take to heal?
Tendon conditions typically take longer than muscle injuries to resolve — often 6 to 12 weeks for a good response to treatment, and longer for more chronic cases, since tendons adapt gradually to loading. Addressing contributing factors like footwear and calf tightness alongside treatment is what makes the improvement last.
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