Achilles Tendinopathy Treatment | Mona Vale Osteopath
Achilles tendinopathy is one of the most common causes of pain at the back of the heel and ankle. Whether symptoms developed gradually from running or gym training, or have persisted for months despite rest, treatment should focus on improving the tendon's ability to tolerate load rather than simply reducing pain.
At Helix Recovery, we combine a thorough assessment with targeted exercise rehabilitation, hands-on treatment and shockwave therapy where appropriate to help restore function and reduce pain.
What is Achilles Tendinopathy?
The Achilles tendon connects your calf muscles to the heel bone and is responsible for transferring force during walking, running and jumping.
Achilles tendinopathy occurs when the tendon becomes overloaded and loses some of its normal structure and capacity. Rather than being an inflammatory condition, it is now understood to involve changes within the tendon that reduce its ability to tolerate load.
Symptoms often develop gradually and can become persistent if the tendon is repeatedly loaded beyond its current capacity.
Common Symptoms
Pain at the back of the heel or lower calf
Morning stiffness that improves after moving around
Pain during or after running, walking or sport
Tenderness when pressing on the tendon
Pain when walking uphill or climbing stairs
Reduced calf strength or endurance
Thickening of the tendon in some cases
How We Assess Achilles Tendinopathy
Not all pain at the back of the heel is caused by Achilles tendinopathy. During your assessment, we'll determine whether your symptoms are coming from the Achilles tendon or another structure, such as the retrocalcaneal bursa or plantar fascia.
We'll also identify factors such as calf strength, ankle mobility and training load that may be contributing to your symptoms.
How We Treat Achilles Tendinopathy
Treatment is tailored to the stage of your symptoms and your goals.
Your management plan may include:
Shockwave Therapy
Osteopathic manual therapy
Progressive calf strengthening
Isometric exercises for pain relief
Plyometric progression where appropriate
Activity modification without unnecessary rest
Education about tendon loading
Shockwave Therapy for Achilles Tendinopathy
Shockwave therapy may be recommended for persistent Achilles tendinopathy, particularly when symptoms have been present for several months or progress has plateaued despite appropriate rehabilitation.
Current evidence suggests shockwave therapy may help reduce pain and improve function when combined with a structured loading program. It is not a standalone treatment but can be a useful addition to a comprehensive rehabilitation plan.
Common Questions
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Complete rest is rarely the best approach. While reducing aggravating activities may help settle symptoms initially, tendons generally respond best to gradually increasing load through an appropriate rehabilitation program.
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Not usually. Although inflammation may be present early after injury, persistent Achilles tendinopathy is generally considered a condition involving changes to the tendon's structure and load tolerance rather than ongoing inflammation.
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Shockwave therapy has been shown to improve pain and function for some people with persistent Achilles tendinopathy, particularly when combined with progressive strengthening exercises.
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Recovery varies depending on symptom duration and severity. Mild cases may improve over several weeks, while longstanding symptoms often require several months of progressive rehabilitation.
Ready to Get Back on Your Feet?
Whether you're training for a marathon, getting back into the gym or simply want to walk without pain, we'll identify the factors contributing to your symptoms and develop a rehabilitation plan tailored to your goals.