Achilles tendinopathy is a common and often frustrating injury, particularly among runners, cyclists, and anyone who has recently increased their activity level. The good news is that with the right physiotherapy approach, most people make a full recovery and return to the activities they love.
What is Achilles Tendinopathy?
The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone. Achilles tendinopathy occurs when this tendon becomes overloaded — either through a sudden increase in activity, a change in training surface, or cumulative stress over time. This leads to degeneration of the tendon fibres rather than straightforward inflammation.
There are two main types:
- Mid-portion tendinopathy — pain in the middle of the tendon, 2–6cm above the heel. The most common type.
- Insertional tendinopathy — pain right at the point where the tendon attaches to the heel bone. Often more stubborn to treat.
Symptoms
- Pain and stiffness in the Achilles tendon, particularly in the morning or after rest
- Pain that warms up during exercise but returns afterwards
- Thickening or nodule formation in the tendon
- Tenderness to touch along the back of the ankle
- Reduced push-off strength when walking or running
Physiotherapy Treatment for Achilles Tendinopathy
The evidence base for Achilles tendinopathy is strong, and structured physiotherapy consistently outperforms other treatments including steroid injections and rest alone.
Alfredson Heavy-Load Eccentric Protocol
The gold-standard exercise treatment for mid-portion Achilles tendinopathy. This involves performing calf raises with a slow lowering phase (eccentric contraction) on a step, twice daily. The research evidence behind this protocol is excellent, and our physiotherapists will guide you through the correct technique and progression.
Heavy Slow Resistance Training
A newer, equally effective alternative to Alfredson's protocol. Heavy slow resistance training uses lower repetitions with heavier loads, making it more practical for many patients. Your physiotherapist will advise which approach suits your situation.
Load Management
One of the most important aspects of treatment is managing the load on the tendon. This means modifying training — not stopping completely. Your physiotherapist will help you maintain your fitness while the tendon recovers.
Running Gait Analysis
For runners, gait analysis can identify biomechanical factors contributing to Achilles tendinopathy — such as overpronation, reduced ankle dorsiflexion, or excessive forward trunk lean. Our gait analysis service in Surbiton can identify and address these factors.
Sports Massage
Releasing the calf muscles and surrounding soft tissue can reduce the load on the Achilles tendon and speed recovery. Book physio-led sports massage from £40.
Recovery Timeline
Achilles tendinopathy responds well to physiotherapy but requires patience. Most patients see significant improvement in 8–12 weeks. Complete resolution may take 3–6 months, particularly for long-standing or insertional cases. Consistency with the exercise programme is the single biggest factor in recovery time.
Can I Run with Achilles Tendinopathy?
The answer is often yes — but it depends on your symptoms and how you manage your load. Completely stopping running is rarely necessary and can actually slow recovery by removing a positive stimulus for the tendon. Your physiotherapist will advise you on how to modify your training appropriately.
Ready to Book?
Same-week appointments available. CQC-registered clinic. No GP referral needed.
Book Physio Online 020 8133 5694Book Achilles Tendinopathy Treatment in Surbiton
Lambert Sports Clinic offers specialist Achilles tendinopathy treatment at our CQC-registered clinic in Surbiton. Our physiotherapists are experienced in managing running injuries and tendinopathies. Same-week appointments available, Mon & Tue 10am–6pm, Wed 8:30am–6pm, Thu 10am–6pm, Fri 9am–6pm, Sat 9am–2pm.
Book online or call 020 8133 5694.