Condition
Achilles Tendinopathy in Currambine
Achilles pain has a very recognisable pattern: stiff and sore for the first few minutes in the morning, better once you are warm, worse again the day after a hard session. It responds well to loading and poorly to rest, which is the opposite of what most people try first.
How do you treat Achilles tendinopathy?
The primary treatment is progressive loading — calf and Achilles strengthening built up gradually over months, alongside a temporary reduction in whatever is aggravating it. Assessment at Northern Beaches Chiropractic in Currambine identifies where in the tendon the problem sits, because mid-portion and insertional Achilles pain are loaded differently.
What commonly contributes to it
People commonly visit us for assessment and management of achilles pain. These are the factors that turn up most often — your own picture is worked out in the assessment.
- A jump in running volume, pace or hill work
- A change of footwear, particularly a drop in heel height
- Starting or returning to running after time off
- Standing occupations on hard floors
- Calf strength that has not kept up with what is being asked of it
Mid-portion and insertional are not the same problem
Pain in the middle of the tendon, a few centimetres above the heel, and pain right where the tendon attaches to the heel bone behave differently and are loaded differently.
Insertional pain is typically aggravated by compression — deep stretching, hills, and shoes with no heel — so the loading programme steers around those positions early on. Mid-portion pain tolerates a broader range from the start.
Getting this wrong is one of the more common reasons an Achilles programme stalls, which is why assessment starts with locating it precisely.
Loading is the treatment, not the reward for getting better
Tendons need mechanical load to remodel. A programme of progressive calf work — usually heavy and slow, around three times a week — is the intervention with the strongest support behind it.
Some discomfort during the exercises is expected and acceptable, provided it settles within about twenty-four hours. That tolerance is what allows the tendon to keep being loaded rather than sitting idle.
It takes longer than you want it to
Meaningful change in Achilles tendinopathy is measured in months rather than weeks, and the strength work needs to continue past the point where it stops hurting.
The practical plan is usually to keep running in some reduced form where symptoms allow, rather than stopping outright and losing the running fitness alongside the tendon capacity.
Frequently asked questions
Is it Achilles tendonitis or Achilles tendinopathy?
Tendinopathy is the more accurate term. “Tendonitis” implies inflammation, and the tissue changes in a long-standing painful Achilles are largely structural rather than inflammatory. The name matters mainly because it points at a different treatment — loading rather than anti-inflammatories.
Should I stretch my Achilles?
For mid-portion pain, gentle calf stretching is usually fine. For insertional pain it often makes things worse, because stretching compresses the tendon against the heel bone. This is one of the main reasons the two are worth telling apart.
Can I keep running?
Often yes, at reduced volume. The usual guide is that pain during the run stays low and the tendon is no worse the following morning. If it is worse, the load was too much.
Do heel raises in my shoes help?
A temporary heel lift reduces load on the tendon and can make walking and running more comfortable, particularly with insertional pain. It is a useful short-term measure rather than a fix.
Will I need a scan?
Rarely. Achilles tendinopathy is diagnosed clinically, and imaging findings correlate poorly with symptoms. A scan is worth arranging if a rupture is suspected or if the presentation does not fit the usual pattern.
Related pages
Last reviewed by Dr Corey Williams, Chiropractor. This page is general information, not individual health advice.
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