Achilles tendinopathy is a painful and persistent condition affecting the Achilles tendon — connecting the calf muscles to the heel bone. It is the most common tendon injury in runners and also affects middle-aged recreational athletes. At Burwood Physio, we use evidence-based loading programmes and shockwave therapy to resolve Achilles pain and restore full function.
Types of Achilles Tendinopathy
Mid-Portion Achilles Tendinopathy
The most common type — affects the middle of the tendon, 2-6cm above the heel bone. Pain and stiffness are worst in the morning or at the start of exercise, often easing as the tendon warms up.
Insertional Achilles Tendinopathy
Affects the tendon-to-bone attachment at the calcaneus. Often associated with a Haglund deformity. Requires a different rehabilitation approach — eccentric heel drops below a step are contraindicated.
Symptoms
- Pain and stiffness at the Achilles, worst on first morning steps
- A warm-up phenomenon where pain eases during activity then returns after rest
- Tenderness and thickening of the tendon on palpation
- Pain with hopping, running, and calf raises
Physiotherapy Treatment at Burwood Physio
Heavy Slow Resistance Loading
Progressive calf loading — gastrocnemius (straight leg) and soleus (bent knee) — is the cornerstone of Achilles rehabilitation. A 12-week HSR programme drives tendon remodelling and builds load tolerance. Your physiotherapist will prescribe a programme matched to your activity level and goals.
Shockwave Therapy
Shockwave therapy significantly accelerates recovery for chronic Achilles tendinopathy. Multiple high-quality RCTs support its use, particularly for cases unresponsive to exercise alone. At Burwood Physio we typically see significant improvement within 3-5 sessions.
Load Management and Return to Running
Staying active at a manageable load during rehabilitation — rather than complete rest — produces better outcomes. We use the 24-hour pain rule to guide running progression safely.
Footwear Advice
A small heel raise reduces Achilles tensile load and provides immediate symptom relief during early rehabilitation. We advise on appropriate footwear and heel raise use.
How Long Does Recovery Take?
Most runners see significant improvement within 8-12 weeks. Chronic presentations may need 16-24 weeks for full return to sport. Shockwave therapy accelerates recovery significantly.
Book an Achilles Assessment at Burwood Physio
Located at Shop 2, 36-38 Victoria St E, Burwood NSW 2134. HICAPS on-site, all health funds. Call 02 8322 9022 or book online.
Read more: Shockwave Therapy in Burwood: What It Is, What to Expect & Who It Helps