Achilles Tendinopathy Treatment in Surrey Hills

Eastside Physio + Co provides Achilles tendinopathy treatment in Surrey Hills for people across Melbourne’s eastern suburbs. Often called Achilles tendonitis, this is something our physios regularly see in runners and people who play sports such as tennis or netball. The pain might settle with a break from activity, only to return when training starts again.

 

Our physios use a progressive loading program to strengthen the calf and Achilles tendon over time. For persistent symptoms, shockwave therapy may also be offered. Appointments can be booked without a referral.

 

Make a Booking | (03) 9836 1333

 

Achilles tendinopathy symptoms

 

Pain from Achilles tendinopathy can be felt just above the heel or further up the Achilles tendon. It's often stiff and sore when getting out of bed, particularly during those first few steps. Running uphill or hopping can also aggravate the pain.

 

Other signs include:

 

• Stiffness in the morning that improves after moving around

• Pain that eases during a run but comes back afterwards

• A tender or thickened area along the tendon

• Pain where the tendon attaches to the heel (insertional) or further up the tendon (mid-portion)

 

Although Achilles tendonitis is a common name for the condition, inflammation isn't usually the main problem. The tendon is generally responding to the amount of load placed on it.

 

A sudden Achilles tendon rupture needs urgent medical attention. The Better Health Channel says it can feel like “a hard whack on the heel”. Anyone experiencing this should see a GP or attend an emergency department promptly.

 

Pain under the heel, rather than behind it, is covered by our separate heel pain service.

 

What causes Achilles tendinopathy?

 

The Achilles tendon connects the calf muscles to the heel bone. Achilles tendinopathy can develop when someone suddenly increases their running or sport before the tendon has adapted to the extra load.

 

Things that can contribute include:

 

• Returning to sport after time off

• Weak or fatigued calf muscles

• Switching shoes or wearing flat shoes with little support

• Flat feet or feet that roll inwards too much (hyperpronation)

• Increasing running distance, speed or hill sessions too quickly

 

Exercise isn't always behind Achilles tendinopathy. The Better Health Channel also links it to inflammatory arthritis and certain antibiotics called quinolones. Anyone with a history of either should tell their physio during the assessment.

 

A tendon that's been troublesome for some time may have degenerative changes, particularly when the pain keeps returning as exercise increases. Our blog on reactive and degenerative tendons explains the difference.

 

How we assess Achilles tendinopathy

 

Our physios can usually identify Achilles tendinopathy by examining the tendon and asking about symptoms. Most people won't need a scan.

 

The assessment includes:

 

• Finding out whether the pain is higher up the tendon (mid-portion) or down near the heel (insertional)

• Checking calf strength and how long each leg can keep working before tiring

• Measuring ankle movement, including ankle dorsiflexion

• Checking the tendon during walking and hopping

• Reviewing training and footwear history

 

If there's a suspected tear, imaging may be arranged where the result could change treatment.

 

The physio also needs to know what the person wants to get back to. This helps set the goals for rehab, whether they're returning to daily walks or a sport that involves running and jumping.

 

Achilles tendinopathy treatment at Eastside Physio + Co

 

Treatment starts by adjusting load to settle the tendon, then rebuilds its capacity with progressive calf and tendon strength work. Hands-on care and shockwave are added where they help. Every plan our physios write for Achilles tendonitis treatment includes an exercise program.

 

Load management, not complete rest

 

Runners with a sore Achilles tendon may need to drop hill runs and speed work from their training for a while. Jumping can also aggravate the tendon, so court sports might need some adjustments. Swimming and cycling are other ways to stay active without putting the same demands on the calf.

 

The tendon still needs some regular activity to maintain its strength. Cutting back too much or taking a long break can make returning to running or sport harder.

 

Progressive calf and tendon loading

 

Calf strengthening is central to Achilles tendinopathy treatment. If the tendon is sore and reactive, the physio may start with isometric calf raises. These involve holding a calf raise position rather than moving up and down.

 

As the tendon improves, the physio increases the weight used during calf raises and slows the movement down. This is called heavy slow resistance and helps develop tendon strength. Hopping and running drills come later in rehab, when the tendon is ready for more load.

 

The physio adjusts the progressive loading program based on the tendon’s response to exercise, while taking any reactive or degenerative changes into account.

 

Hands-on treatment

 

Our physios may use manual therapy to help with discomfort during rehab. This is an addition to the calf strengthening exercises, not a replacement for them.

 

Shockwave therapy for stubborn Achilles pain

 

For Achilles tendinopathy that continues to cause problems despite a loading program, our physios may recommend shockwave therapy (ESWT). It's offered at the Surrey Hills clinic and is used alongside the strengthening exercises.

 

Our physios assess the tendon before starting shockwave therapy. If it's suitable, the first treatment can usually happen at that appointment. The shockwave takes about 5 to 10 minutes, and a typical course involves 3 to 6 visits, spaced 3 to 10 days apart. The physio works out how many are needed after the assessment.

 

Shockwave therapy isn't suitable for everyone. The clinic won't use it during pregnancy or for patients with a pacemaker, a bleeding disorder, blood-thinning medication, or a current cancer diagnosis or tumour in the area being treated. Anyone who's had a cortisone injection near the Achilles tendon must also wait at least 12 weeks before having shockwave.

 

Our shockwave therapy page explains how a shockwave course runs.

 

MLS laser therapy

 

Some patients may also be offered MLS laser therapy alongside their exercises. The research into its use for Achilles and ankle tendinopathy is still limited, although early findings are promising. Our MLS laser therapy page has more information.

 

Footwear and orthotics

 

Our physios check the shoes patients wear for sport and everyday activities, as footwear can affect Achilles pain. If flat feet or excessive inward rolling of the foot are contributing to the problem, they may refer the patient to a podiatrist for custom orthotics.

 

Make a Booking | (03) 9836 1333

 

Returning to running with Achilles tendinopathy

 

Running doesn't always have to stop because of Achilles tendinopathy. The amount may need to come down, though. The next morning is a useful guide. If the tendon feels stiffer than usual after a run, it may have been pushed too hard.

 

Running can start on flat ground at a slower pace, with distance added as the tendon improves. Hills, faster running and jumping come later. Our running injuries blog covers how to build running back up.

 

The calf exercises don't stop just because the pain has improved. They remain part of rehab as running increases. Recovery varies depending on how long the tendon has been troublesome and the demands of the sport. Our physios discuss an expected timeframe after the assessment.

 

Book Achilles tendinopathy treatment in Surrey Hills

 

Eastside Physio + Co is at 427 Canterbury Road, Surrey Hills VIC 3127, on (03) 9836 1333. No referral is needed. Private health claims are processed on the spot via HICAPS, and WorkCover and TAC are accepted. Medicare rebates require a GP Chronic Condition Management Plan.

 

There are three parking bays at the front and two at the rear. Street parking is also available on Canterbury Road. The clinic sees people from Camberwell, Box Hill, Canterbury, Blackburn, Hawthorn, Balwyn, Doncaster, Burwood, Ashburton, Ashwood and Auburn.

 

Make a Booking | (03) 9836 1333

 

Achilles tendinopathy FAQs

 

Is walking good for Achilles tendinopathy?

 

People with Achilles tendinopathy can usually continue walking on flat ground. If the tendon flares up, cutting walks shorter and avoiding hills for a while may help. Long days spent standing or walking can also aggravate symptoms.

 

What should be avoided with Achilles tendonitis?

 

Big jumps in running distance, hill work or jumping can aggravate an already sore tendon. Complete rest for long periods isn't helpful either, as the tendon needs exercise to regain strength. Hands-on treatments alone won't rebuild that strength. The Better Health Channel also advises that corticosteroid injections aren't routinely recommended.

 

Should an Achilles tendon be stretched?

 

Stretching can help some people, but it can also irritate the tendon. This is particularly true when the pain is right down at the heel bone, where the tendon attaches. A physio can check whether stretching is appropriate, although calf strengthening remains the main part of treatment.

 

How many shockwave sessions for Achilles tendinopathy?

 

Eastside Physio + Co generally recommends 3 to 6 shockwave therapy sessions, with 3 to 10 days between appointments. The number depends on the physio's assessment. Calf loading exercises continue throughout the course.

 

Does Achilles tendinopathy go away on its own?

 

The soreness might settle after a few days off, only to return on the next run. Rest can help with the pain, but getting the tendon used to exercise again takes gradual strengthening.

 

When is surgery considered for Achilles tendinopathy?

 

Surgery is generally only considered when other treatments haven't worked, according to the Better Health Channel. A GP and surgeon would assess whether it's appropriate. Physiotherapy focuses on non-surgical treatment first.