Achilles Tendinopathy: Causes, Symptoms, and Treatment Options

Achilles tendinopathy is a condition that causes pain, stiffness, and swelling in the Achilles tendon, the strong band of tissue that connects the calf muscles to the heel bone. It most commonly develops due to repeated micro-trauma rather than a single injury.

After each minor injury, the tendon may not fully heal before being stressed again. Over time, this leads to gradual degeneration of the tendon, resulting in ongoing discomfort and reduced function.

Common Causes of Achilles Tendinopathy

Several factors can contribute to repeated strain on the Achilles tendon, including:

• Overuse, especially in runners and individuals who participate in repetitive or high-impact activities
• Inappropriate footwear, such as shoes with poor heel support or worn-out soles
• Training on hard or sloped surfaces, which increases tendon stress
• Poor training or exercise technique
• Sudden changes in training volume or intensity, such as increasing distance or speed too quickly

These risk factors are common among recreational and competitive athletes across Canada, particularly during seasonal training changes.

Signs and Symptoms

The hallmark symptoms of Achilles tendinopathy include:

• Pain and stiffness along the Achilles tendon, especially first thing in the morning
• Discomfort that worsens after activity, even if it eases during exercise
• Tenderness when the tendon is touched
• Mild swelling or thickening of the tendon
• Pain that interferes with daily activities such as walking, climbing stairs, or standing for long periods

Many runners notice pain at the start of a run that improves temporarily, only to return or worsen after stopping.

Management and Treatment Options

Managing Achilles tendinopathy early can help prevent long-term damage or rupture.

Rest and Activity Modification

High-impact activities should be reduced or stopped initially. Low-impact alternatives such as swimming or cycling may be introduced as pain allows.

Pain Relief

Short-term use of pain relievers such as acetaminophen or ibuprofen may help reduce discomfort. These should not be used for more than 7–14 days, as prolonged use may impair tendon healing.

Ice Therapy

Applying an ice pack for 10–30 minutes can help reduce pain and swelling, particularly in the early stages.

Footwear and Orthotics

Supportive shoes or heel-lift inserts may reduce strain on the tendon and improve comfort during walking or standing.

Rehabilitation Exercises

Specific stretching and strengthening exercises for the calf muscles and Achilles tendon are a key part of recovery and long-term prevention.

Important Notice (Educational Disclaimer)

This information is provided for educational purposes only and is not a substitute for medical diagnosis or treatment. Achilles tendon injuries can vary in severity. If pain is persistent, worsening, or limits normal movement, assessment by a qualified healthcare professional is strongly recommended.

Learning how to recognize and respond to musculoskeletal injuries is an important part of injury prevention. Canadians can build these skills through first aid and CPR training with St. Mark James Training, Canada’s largest 100% Canadian-owned and operated first aid training provider.