Achilles Tendinopathy, the Rehab Journey


An insight into ‘Achilles Tendinopathy’ and likely rehab journey


Rehab for an aggravated achilles tendon can be a slow, frustrating process. The medical term for this achilles tendon dysfunction is ‘achilles tendinopathy’ and it tends to be an overuse injury which is brought on by excessive overload of the tendon. 

An aggravated tendon can fall under 3 different stages which describe the state of the tendon and changes that have occurred. The three stages are: reactive tendinopathy, tendon disrepair and degenerative tendinopathy. These stages can be thought of as a continuum and a tendon may slide up and down the continuum throughout the rehab process. Too much load may cause the tendon to slide along the continuum in a negative way; however, if completed properly, should result in progression along the continuum. Finding the right amount of load (or exercise) is often the trickiest part of rehab; however, this will often mean some modifications to your current activities and optimising recovery, whilst beginning some targeted exercises to improve the state of the tendon. 

In most cases, your physio will encourage you to continue moving and provide you with strategies to avoid flare-ups during your recovery. It is important to continue moving because complete rest will often be detrimental to long term outcomes as it will likely promote deconditioning of your calf muscles and achilles tendon; thus meaning that the tendon will be able to tolerate less load. 

The first goal should be to aid in pain reduction which may include exercises, hands-on therapy and activity modification. During this stage, a graded exercise program should be started which aims to load the achilles tendon in a tolerable manner. The exercise program will likely be progressed from strength building exercises towards functional exercises. Once base strength and tendon tolerance has improved, the exercise program will likely progress towards explosive movements and/or sports-specific movements if these types of movements are part of your goals. 

The rehab process can take anywhere from 3-6 months before significant symptom improvement occurs, so being patient, but diligent is very important to achieving great outcomes. At a very simple level, the aim of rehab is to settle the tendon down, then gradually build it back up to improve the amount of load the tendon can tolerate. We would love to help guide you through the process at PhysioWest, so please get in touch or come see us in clinic!


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