Achilles Tendon Pathology

The legendary warrior of Homer’s Iliad may have died from an arrow piercing his Achilles tendon, but Achilles injuries today have a good prognosis. Achilles tendinopathy is a common injury affecting athletes, particularly males between the ages of 30-50.


The Achilles tendon is formed by the convergence of three structures which are all muscles of the calf: medial gastrocnemuis, lateral gastrocnemius and soleus. They form a thick tendon, which insets into the calcaneus (heel bone).

What usually happens

  • Mild pain after exercise or running that gradually worsens
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
  • A feeling of weakness in the leg
  • Swelling
  • Pain improves with a heat or exercise but recurs after running

Common causes

  • Change in distance speed and training gradient
  • Change of running surface
  • Change in footwear
  • Excessive pronation (flat foot)
  • Poor range of motion
  • Poor muscle flexibility

Most orthopaedic surgeons would agree to a conservative approach to treating Achilles Tendinopathy before considering any invasive treatments (injections or even surgery).

Your Physiotherapist will analyse the factors causing your tendinopathy and design you a structured recovery programme adapted to your needs.