Achilles Tendonopathy

Where is the pain: At the bottom of the calf muscle, or within the tendon before or at the insertion on the calcaneus bone (heel).

Cause: This is an overuse load injury, sometimes repetition injury. The runner has completed too much volume or intensity too soon. If a runner transitions too quickly from a bulky stability running shoe to a minimalist running shoe.

Aggravating activities: Running, going up or down stairs, heel raises.

Assessment findings: The runner may present with tenderness on palpation, decreased plantar flexion strength, and decreased flexibility of the calf and hamstring muscles.

Common Treatment: In the acute stage (1 – 7 days) the therapist may recommend unloading the tendon with a heel lift, decrease intense workouts like plyometrics (jumping) or hills, ways to protect the area, use of ice, calf and hamstring stretches if needed. In the sub-acute stages or if the condition is chronic the therapist will recommend eccentric strengthening exercises and progress these exercises as appropriate for tissue adaptation and suggestions regarding returning to running safely and with an efficient stride. When returning to running, running on cross country trails or grass would be most favorable.


ReActive Physiotherapy is a physiotherapy, massage therapy, golf and running performance center that is focused on orthopaedic and sports related injures, movement dysfunctions, and injury prevention. The clinic is located in North London at 665 Fanshawe Park Rd W.