Achilles tendinitis: causes, symptoms and treatment
A clinically reviewed guide to Achilles tendon pain — causes and evidence-based loading treatment.
Medically reviewed by D.C Matt
Lead DirectorLast reviewed 1 July 2026
- t affects the Achilles tendon at the back of the ankle and heel.
- It is usually an overload (tendinopathy) problem, not simple inflammation.
- Progressive loading exercise is the most evidence-based treatment.
What is Achilles tendinitis?
Achilles tendinitis is pain and stiffness in the Achilles tendon due to overload, more accurately described as tendinopathy.
It typically develops when tendon load increases faster than the tendon can adapt — for example, a jump in running volume. It reflects a change in the tendon's structure rather than simple short-term inflammation.
What are the symptoms of Achilles tendinitis?
Typical symptoms are pain and stiffness at the back of the heel, worse in the morning and with activity.
- Pain and stiffness in the Achilles, often worst on first steps in the morning
- Pain that warms up then returns after activity
- Tenderness or thickening of the tendon
- Pain with jumping, running or calf raises
How is Achilles tendinitis treated?
The most evidence-based treatment is a progressive tendon-loading (strengthening) programme, alongside load management.
Gradually loading the tendon with calf-strengthening exercises is central to recovery. Shockwave therapy may be considered as an adjunct for stubborn cases. Complete rest is generally not recommended, as tendons need appropriate load to adapt.
The Postura approach
At Postura Wellness, care for Achilles tendinopathy is built around OrthoRestore™ — our signature method that combines chiropractic and physiotherapy into one coordinated plan. Depending on your assessment, it can bring together chiropractic adjustments, dry needling, muscle manipulation, Active Release Technique, and targeted exercises, supported where helpful by technology such as shockwave therapy and bioelectric therapy. The aim is to relieve symptoms while addressing the underlying causes, with a plan tailored to you.
When to seek urgent care
A sudden, sharp pain with a snapping sensation and difficulty walking or pushing off may indicate an Achilles rupture and needs prompt medical assessment.
Sciatica FAQs
Should I rest my Achilles completely?
Usually not. Tendons respond to gradual loading. A progressive strengthening programme is more effective than complete rest.
How long does Achilles tendinitis take to heal?
It often takes a few months of consistent loading. Patience with the programme gives the best long-term outcome.
Does shockwave therapy help Achilles tendinitis?
Evidence is mixed for the Achilles specifically; it may be used as an adjunct to exercise in stubborn cases rather than a first-line, stand-alone treatment.
Can physiotherapy help Achilles tendinitis?
Yes. A guided, progressive tendon-loading programme is the mainstay of treatment.
This guide is informed by patient information from accredited medical institutions:
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