Achilles Tendinopathy and Its Best Physiotherapy Managements

Achilles Tendinopathy and Its Best Physiotherapy Managements

What Is Achilles Tendinopathy?

An inflammation of the Achilles tendon, a substantial band of tissue that runs down the back of the lower leg and joins the calf muscles to the heel, is known as Achilles tendinopathy. Any issue, either short- or long-term, with a tendon is referred to as “tendinopathy.” While someone is running or jumping, the Achilles tendon transfers the force from the calf muscles down to the foot and aids in controlling the ankle’s position while landing. When the Achilles tendon is put under more strain than it can handle, Achilles tendinopathy develops.

A single occurrence or repeated irritation, or “microtrauma,” can cause this condition. Achilles tendon pain, which is typically brought on by repetitive stress to the tendon and can lead to chronic Achilles tendinopathy,  Physiotherapy is frequently used to treat this condition.

There are numerous factors associated with Achilles tendinopathy, including:

  • Calf muscle tightness.
  • Calf muscle weakness.
  • Abnormal foot structure.
  • Abnormal foot mechanics.
  • Improper footwear.
  • Obesity.

Anywhere along the tendon, pain may be felt; the most typical location to do so is just above the heel, however, it may also be felt where the tendon connects to the heel.

Symptoms of Achilles tendinopathy:

Tenderness to applied pressure in the heel or further up in the Achilles tendon.
Walking causes pain and stiffness, and it will worsen with every step.
ankle swelling.

What Help Can a Physiotherapist Provide?

By addressing difficulties like pain or swelling in the affected area, as well as any lack of strength, flexibility, or body control, physiotherapy helps in the rehabilitation from Achilles tendinopathy. Physiotherapist will create a customized treatment plan that will enable you to accomplish your objectives in the safest and most efficient manner possible. Your treatment can consist of:

Pain management:

Applying ice to the area, bracing the injured leg, using heel lifts, or using therapies like iontophoresis or therapeutic ultrasound are just a few of the pain-relieving techniques that can be used.


The Achilles tendon is less stressed when the heel is raised with the aid of a heel pad. For chronic conditions, additional gait analysis and custom orthotics would be helpful.

Manual therapy:

Your physical therapist may use manual techniques to improve the motion and functionality of your muscles and joints. These methods frequently deal with problems that are challenging to manage on your own. this may include:

  • Soft Tissue techniques.
  • Joint mobilizations.
  • Taping.
  • Dry needling/acupuncture.
Gentle exercise:

Exercise that loads the tendon by adding weight or resistance is helpful for healing from Achilles tendinopathy. You could start by doing light strengthening exercises while seated (eg, pushing and pulling on a resistive band with your foot). After that, you can go on to workouts that require standing (eg, standing heel raises).

Muscle-strengthening exercises:

The Achilles tendon may be put under too much tension if there is muscle weakness or imbalance. Your physiotherapist will create a customized, progressive lower-extremity resistance program for you based on your unique situation to help you correct any weakness-related movement mistakes that might be causing you pain. this treatment program may include:

  1. Concentric strengthen training. and
  2. Eccentric strength training.
Some Examples of Strength training are:
Gastrocnemius heel raise:

This heel raise will eccentrically target the gastrocnemius muscle. Your hands should be on a counter as you stand with your feet shoulder-width apart.  Lift both heels off the ground while maintaining a straight line of motion from your first to second toes.  Lift your unaffected foot off the ground and over the period of 2 to 3 seconds, gradually bring your other heel back down. Two times every day, perform three sets of 10 to 15 repetitions.

Soleus Heel Raise:

The soleus is another vital structure to focus on with eccentric strengthening. To target this muscle, try making this minor adjustment to the prior workout.  Standing with your feet shoulder-width apart and your knees slightly bent.   As you rise onto both heels, maintain a slight bend in your legs   Lift the pain-free leg into the air, then slowly reposition your other heel on the floor. Try performing this twice daily in three sets of 10 to 15 eccentric exercises.

Heavy Resistance Exercises:

Leg Press Heel Raise: This exercise, performed on a leg press machine, strengthening the gastrocnemius and soleus muscles will reduce Achilles tendon pain. Put your feet on the footplate of the leg and press shoulder width apart. Straight knees are what you want. Pick a weight that is heavier. The weight should ideally allow you to perform up to 15 consecutive reps before you are unable to perform any more. Slowly raise onto both toes while using this resistance, then bring the heels back down on the plate. Each stage of the workout should be completed in roughly 3 seconds. Three times, please. 3-4 sets. Try to progressively increase the amount of weight you use every one to two weeks while performing this exercise three times per week.

Seated Calf Raise

This variation of the calf raises targets the deeper soleus muscle using a different piece of exercise equipment. Put both of your feet on the plate of a seated calf raise machine, and place the resistance pad over both of your knees. Choose a resistance that enables you to perform a maximum of 15 consecutive repetitions. Over the course of around 3 seconds, lift yourself up onto your toes with both feet. Take three more seconds to gradually lower your heels back to the footplate. Run through three or four sets of three reps. With heavier weights each week, this technique can be used three times per week.

Stretching exercises:

During daily motions and vigorous physical exercise, the Achilles tendon is subjected to additional stress due to tight calf muscles. For this reason, physiotherapists advise performing workouts to increase or improve calf muscle flexibility. Stretching consists of:

Gastrocnemius Stretch:

Stand with your back to the wall and your feet hip-width apart, staggered, with the foot that is hurting in the back.  Bend the front knee while keeping the back foot’s heel on the ground and the knee straight.  Lean against the wall until you feel light to moderate calf stretch in the back leg. Hold the position for one minute. Repeat between three and five times. Each day, this can be done multiple times.

Soleus Stretch:

Stagger your feet while facing a wall and keep the affected leg to your back. Bend the knee on the affected leg while keeping the heel of the rear foot on the ground.  Without removing your injured heel from the ground, shift your weight in the direction of the wall. When the lower portion of your calf stretches, stop.  Before relaxing, maintain the hold for 30 seconds. Try performing three to five repetitions at a time, twice daily.


  • ESWT.
  • SIS.
  • TECAR Therapy.
  • High-intensity Laser.
  • TENS.
  • Ultrasound.
  • IFT. etc.

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