What Is Achilles Tendinitis and What Can Physical Therapy Do To Help?

 To understand this more, let's take a look at the anatomy of the ankle, Achilles, and calf musculature.  As seen in the photo to the left you can see the connection between the two calf muscles as they come together to form a portion of the Achilles tendon.  The other portion of the Achilles tendon is the solus muscle (not shown) but is deep to the calf muscles.  The solus muscle is a flat broad muscle which contracts along with the calf muscles to create force.  The Achilles tendon attaches to the back of the heel which can be an area of pain for people who have Achilles tendinitis. 

Achilles tendinitis is an overuse injury that causes pain and inflammation in the Achilles tendon, the strong core of tissue that connects your calf muscles to your heel bone.  It's not a sudden tear but rather a result of tiny, repetitive microtears that build up over time.  Think of it like a fraying rope, each small tear weakens the tendon, leading to pain and difficulty with activities like running or jumping.  In severe cases, even walking can be difficult.

What Causes It?

This condition is an overuse injury, which means it develops from repeated stress on the tendon without enough time for it to heal. Athletes are particularly susceptible because their activities, like running and dancing, constantly engage the Achilles tendon. If the cycle of pain and activity continues, the body may try to heal itself by forming a nodule—a buildup of scar tissue that can be tough to get rid of and can lead to prolonged pain.

Key Risk Factors

Several factors can increase your risk of developing Achilles tendinitis:

Poor Ankle Mobility and Calf Flexibility: When your ankles and calves are stiff, your Achilles tendon takes on extra stress during movement.

Excessive Foot Pronation: This is when your foot rolls inward too much while you're walking or running. This abnormal motion can put uneven stress on the tendon.

Rapid Changes in Training: Suddenly increasing the intensity, duration, or frequency of your workouts without a gradual ramp-up can shock your tendon and lead to injury.

How Physical Therapy Can Help

Physical therapy is a great way to not only treat the symptoms but also address the root cause of your pain. A physical therapist will create a personalized plan to restore normal movement and reduce stress on the tendon.

Manual Therapy: Techniques like Instrument Assisted Soft Tissue Mobilization (IASTM), dry needling, and massage can help reduce pain and improve range of motion in the affected area.

Loaded Exercise: This is a critical part of recovery. A physical therapist will guide you through exercises that safely strengthen the tendon. This often starts with isometric exercises (contractions without movement) and progresses to eccentric loading (controlled lengthening of the muscle under tension), which has been shown to improve tendon health and reduce pain.

As you progress with the plan, varying degrees of ankle range of motion against resistance will be implemented to ensure the tendon is ready for multiple stress points at multiple angles. By addressing the underlying issues and strengthening the tendon, physical therapy at Ignite Physical Therapy can help you get back to the activities you love while preventing future injuries. If you are suffering from Achilles tendinitis or aren't sure what pain you are feeling, don't hesitate to take care of yourself. Find a physical therapist at Ignite Physical Therapy today to help you get back to the activities you love!