Achilles Tendon Injuries (Tendinopathy)

Achilles tendinopathy is an irritation of the Achilles tendon, a thick band of tissue along the back of the lower leg that connects the calf muscles to the heel. It occurs when the demand placed on the tendon is greater than its ability to function.

Achilles tendinopathy can result in a limited ability to walk, climb stairs, or participate in recreational activities. Injuries can occur after 1 episode (acute injury) or after repetitive irritation or “microtrauma” (chronic injury). The severity of acute injuries is graded based on the amount of damage to the tendon:

  • Grade I: Mild strain. Mild to moderate pain, tenderness, swelling, stiffness. Expected to heal normally with conservative
  • Grade II: Moderate strain. Moderate pain, swelling, difficulty walking normally. Expected to heal normally with conservative
  • Grade III: Complete rupture, often characterized by a “pop,” immediate pain, inability to bear weight. Typically requires surgery to repair.

Most often, Achilles tendon pain is the result of repetitive trauma to the tendon. This repetitive strain can result in chronic Achilles tendinopathy, which is a gradual breakdown of the tissue and is most often treated with physical therapy.


To help you achieve your specific goals, your physical therapist will select treatment strategies including any or all of the following areas:

  • Pain
  • Range of motion
  • Muscular strength
  • Manual therapy
  • Functional training
  • Patient education

Physical therapy will address issues such as pain or swelling of the affected area, and any lack of strength, flexibility, or body control.

If the condition remains untreated, pain will persist and may result in a complete tear of the Achilles tendon, which often requires surgery to repair.   If surgery is needed, your physical therapist will help you regain your ability to walk without assistance—and carefully guide your return over time to your desired recreational activities.

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