Physiotherapy for Achilles Tendonitis

Achilles tendonitis is an injury to the Achilles tendon causing overstretching or tearing of tissue fibers resulting in symptoms. A tendon is a strong band of tissue connecting your muscle to your bone. The condition is a fairly common sports injury, especially in athletes requiring them to suddenly sprint or jump. Achilles tendonitis is also called Achilles tendinopathy. Complete tearing of the tendon is called ruptured Achilles.

The Achilles Tendon and Calf Muscles

Your Achilles tendon is the largest tendon in your body attaching your calf muscles to your heel bone (calcaneus). Your calf is comprised of 3 muscles: the gastrocnemius, soleus and the plantaris. Your calf attaches to your heel bone through your Achilles tendon.


Achilles tendonitis happen when tendon fibers are stretched beyond what it can take or tear. The condition may occur because of repetitive use or forceful pulling of the tendon. The condition may occur in athletes engaging in sprinting, long distance walking or running, long jumps, football, basketball, soccer, and baseball.

Improper exercise program, having a poorly conditioned calf and Achilles, or having a certain foot abnormality may result in the development of Achilles tendonitis. If you have had a previous injury to your Achilles, you may be at risk of having another.


The most common symptom is pain over the site of stretch or tear. Depending on the severity of your injury, you may also experience
  • Swelling
  • Bruising
  • Calf muscle weakness
  • Symptom of pain worsens with movement
  • Difficulty walking


Minor cases of Achilles tendonitis can be effectively managed with rest, ice, and elevation initially. Taking pain medication may also help relieve your symptoms. More severe cases may require surgery to repair the torn tendon.
  • Rest and avoid certain movements or activities that make your symptoms worst.
  • Wrap an ice pack with towel and apply over your injury for 20 minutes. Continue applying ice every 3 to 4 hours during the first 2 to 3 days following your injury or until swelling subsides.
  • Elevate your limb above the level of your heart to help minimize swelling.
  • Perform gradual stretching and strengthening exercises once your symptoms have improved.

Physiotherapy can help you manage your symptoms and safely return you to your original activity or sport.

Physiotherapy Treatment Options for Achilles Tendonitis

The physiotherapy treatments that you receive will depend on the severity of your injury, symptoms, overall fitness, goals and whether you’ve undergone surgical repair. Treatment options may include
  • Ice or hot pack application
  • Transcutaneous electrical nerve stimulation (TENS)
  • Ultrasound
  • Soft tissue mobilization (massage)
  • Manual stretching
  • Joint mobilization
  • Physiotherapy exercises
    • Gradual stretching or flexibility exercises
    • Gentle range of motion exercises
    • Gradual strengthening exercises
    • Balance exercises
  • Recommend use of heel wedges when necessary
  • Recommend use of walking aid (e.g. walker, crutches)
  • Gait or walking training
  • Patient education
    • About Achilles tendonitis
    • Precautions to observe
    • Activity modification
    • Injury prevention
  • Work or sport-specific rehabilitation program

Your physiotherapist may also provide you with a home management and exercise program, which you can do when you get home. Make sure to follow your physiotherapist’s home instructions.

Return to Work or Activity

Your physiotherapist will help you determine when you can safely return to your work or sports. How soon you can safely return to your activities will depend on how fast your injured tendon heals, your motivation in participating in your rehabilitation program and your specific needs and goals.

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