Nearly one in four runners experience Achilles tendonitis, and at North West Physio, we understand exactly how frustrating it can be when something you love becomes painful. Many active individuals spend months trying rest, ice, and stretching routines they found online, only to find themselves still aching when they return to their favourite activities or not performing as well as they were pre-injury.
Achilles tendon pain is absolutely treatable, and with the right Achilles tendonitis treatment approach, you can return to running stronger than before.
Book your comprehensive Achilles assessment to discover how structured, evidence-based Achilles tendonitis treatment can transform your journey back to peak performance.
What is Achilles tendonitis (and tendinopathy)?
Your Achilles tendon is the largest and strongest tendon in your body, connecting your calf muscles to your heel bone. Every time you push off during running, jumping, or even walking up stairs, this remarkable structure handles forces equivalent to several times your body weight.
When we talk about Achilles tendonitis treatment, we’re typically referring to two related but distinct conditions. True tendonitis involves inflammation of the tendon and usually occurs in the acute phases of injury. However, most persistent Achilles tendonitis pain that lasts longer than a few weeks is actually tendinopathy: a degenerative condition where the tendon’s structure becomes disorganised and weakened.
This distinction matters enormously for your Achilles tendonitis treatment. While inflammation responds well to rest and anti-inflammatory approaches, tendinopathy requires progressive loading and strengthening to stimulate healthy tissue remodelling. This is why many people find their symptoms return as soon as they resume activity after a period of rest – the underlying tendon structure hasn’t been properly addressed.
Understanding this difference helps explain why traditional “rest and ice” approaches often fail to provide lasting relief for chronic Achilles tendonitis.
Common causes of Achilles tendon pain
Understanding what triggered your Achilles tendonitis can help prevent future flare-ups and guide your treatment approach. The most common culprits include:
Training load errors
Sudden increases in running volume, intensity, or frequency account for the majority of Achilles injuries. Your tendon adapts to load gradually, so jumping from 20km to 40km per week or adding hill training without proper progression can overwhelm its capacity.
Biomechanical factors
Poor calf strength, reduced ankle mobility, or altered foot mechanics can place excessive stress on your Achilles tendon. Even seemingly minor changes like new running shoes or altered running surfaces can contribute to overload.
Recovery and load management
Insufficient recovery between training sessions, poor sleep, or inadequate nutrition can impair your tendon’s ability to adapt and repair, making it more susceptible to injury.
Age-related changes
As we age, tendons naturally become less elastic and require longer recovery periods. This doesn’t mean you can’t maintain an active lifestyle, but it does highlight the importance of appropriate load management in your Achilles tendonitis treatment plan.
Signs your Achilles pain needs treatment (and not just rest)
While minor pain might resolve with a few days of modified activity, certain signs indicate you need professional Achilles tendonitis treatment:
Morning stiffness that persists
If your Achilles feels stiff and painful for more than 30 minutes after getting out of bed, this suggests tendon changes that won’t resolve with rest alone.
The ‘warm-up phenomenon’
Pain that improves during exercise but returns afterwards is a classic sign of tendinopathy. While this might seem like a good sign, it actually indicates your tendon needs structured treatment.
Visible or physical changes
- Thickening of the tendon
- Nodules or lumps
- Persistent tenderness to touch
- Swelling that doesn’t reduce with rest
Performance impact
Reduced power during push-off, difficulty with calf raises, or compensatory movement patterns indicate your Achilles tendonitis is affecting function and needs professional attention.
Duration
Any Achilles tendonitis pain persisting longer than 2-3 weeks warrants professional assessment, even if it seems mild.
Why ‘rest and stretch’ often isn’t enough
This might surprise you, but complete rest is rarely the answer for effective Achilles tendonitis treatment. Here’s why the traditional approach often falls short
Tendons need load to heal
Your Achilles tendon responds to controlled loading by producing new, healthy collagen fibers. Without appropriate stimulus, the healing process stalls, and the tendon may actually weaken further. This is why structured Achilles tendonitis treatment focuses on progressive loading rather than complete avoidance.
Excessive stretching can worsen symptoms
While gentle mobility work has its place in treatment, aggressive stretching can compress an already irritated tendon against the heel bone, potentially worsening your Achilles tendonitis pain
Deconditioning effects
Complete rest leads to rapid loss of strength and endurance in your calf muscles, creating a cycle where you’re more vulnerable to re-injury when you return to activity.
Missing the Root Cause
Rest doesn’t address the underlying factors that contributed to your Achilles tendonitis in the first place, making recurrence highly likely without proper treatment.
How physiotherapy treats Achilles tendonitis
Effective Achilles tendonitis treatment requires a comprehensive approach that addresses both symptoms and underlying causes.
At North West Physio, our structured approach has consistently delivered meaningful results. Our patients typically experience significant improvements in pain levels and functional outcomes within 6-12 weeks, with many achieving complete resolution of symptoms while returning to their pre-injury activity levels.
Together, we’ll assess your tendon’s current capacity, identify contributing factors like calf strength deficits or ankle mobility restrictions, and evaluate your movement patterns during functional activities.
Your treatment plan is tailored to your specific presentation, goals, and lifestyle. Our comprehensive evaluation may include VALD, running analysis, and exercise physiology sessions to identify movement patterns that may contribute to tendon overload, ensuring your treatment addresses all contributing factors.
Our podiatry services work in conjunction with physiotherapy to provide comprehensive foot care and targeted treatment strategies. Patients who undergo our combined assessment and customised orthotic fittings consistently report reduced pain and improved functionality, enabling them to return to sports and daily activities with confidence.
Achilles tendonitis treatment FAQs
Is walking bad for Achilles tendonitis pain?
Walking is usually well-tolerated and can be part of your treatment program. However, if walking significantly increases your Achilles tendonitis pain or causes prolonged morning stiffness, this suggests you may need professional assessment to determine the best approach. We can help you find the right activity level for your current tendon capacity.
How long should I stop running?
Completely stopping running isn’t always necessary with proper Achilles tendonitis treatment. The duration depends on your specific presentation, but many runners can continue with modifications while undergoing treatment. We’ll work together to find the right balance for your recovery, using pain monitoring guidelines to ensure safe progression back to full running.
Will my Achilles tendonitis come back once I return to running?
With proper Achilles tendonitis treatment and gradual return-to-activity planning, recurrence rates are significantly reduced. The key is addressing underlying contributing factors like calf strength deficits or training load errors, not just treating symptoms. Our physiotherapists provide specific strategies for load management and biomechanical optimisation to help prevent future flare-ups and keep you running confidently.
How do I know if my Achilles tendonitis pain is serious enough to need physiotherapy?
If your Achilles tendonitis pain persists beyond 2-3 weeks, affects your daily activities, or keeps returning despite rest periods, it’s time for professional treatment. Morning stiffness lasting over 30 minutes, visible tendon thickening, or reduced push-off strength are clear indicators that structured treatment will be more effective than waiting. Early intervention typically leads to faster, more complete recovery.
Can I continue my gym workouts while receiving Achilles tendonitis treatment?
Many gym activities can continue with appropriate modifications during your treatment. Low-impact exercises like cycling, swimming, or upper body strength training are usually well-tolerated. However, activities involving jumping, calf raises, or explosive movements may need temporary adjustment. We’ll help you maintain your fitness while protecting your healing tendon through smart exercise selection.
Achilles pain treatment with North West Physio
Choose active, evidence-based Achilles tendonitis treatment over hoping the problem will disappear on its own. With the right understanding, appropriate treatment, and professional guidance, you can not only overcome this challenge but return to your activities with greater resilience and confidence.
Ready to take the first step towards lasting recovery? Book your comprehensive Achilles assessment today.
