Achilles tendonitis is an incredibly common repetitive strain injury which occurs in up to a quarter of all athletes, professional or otherwise. There are a number of factors that can contribute to achilles tendonitis, however the most common cause is training overload.

With most of us having a hiatus from organised sport in 2020, it’s increasingly likely that more and more of us will experience some sort of achilles pain when returning to activity. But how do we know if what we have is achilles tendonitis?

Common signs you might be experiencing achilles tendonitis are:

Pain just above your heel when putting your foot on the ground first thing in the morning

Pain that improves a bit throughout the day but worsens after periods of inactivity
Pain that gets better when you have an anti-inflammatory
A lump in the tendon above your heel (which is often painful to touch)
Really tight calves!
Heat in your heel
Feeling like you have to walk around on your tippy-toes

“Okay, so maybe I have achilles tendonitis, now what?”

Unfortunately a fully blown achilles tendonitis can last for well over 12 weeks in some cases, but if you can get on top of it early then you greatly reduce that time. The most important aspect to this is going to be the dreaded “load management”.

Rest it! There’s no point asking an unhappy tendon to do something it doesn’t want to - that is just going to make it angrier.

Avoid any activity that’s going to cause more than a 3/10 pain.

Resting might even mean none of your usual activity for a couple of weeks...
Manage your pain symptoms with some soft tissue treatment, ice or heat and whatever medication your doctor prescribes.

Test it. Once your pain levels are regularly within tolerable levels we’ve got to start testing it.

First start with pain free motion. Once you’ve got that you can add a bit of load.

Maybe you can manage 10 heel drops before your pain levels get above a 3/10, that’s okay, tomorrow you might be able to do 12!
A run might still be out of the question, but maybe a ride or a walk is a better option for now.
Set the bar low, going too hard too early can cause setbacks and time away from doing what we love.

Stress it. Now that we can go for a light jog it’s time to get sport specific! Choose your sport and the activity that’s going to stress it most!

Have a go at 50% effort 5 times, if that’s okay try 75% 5 times, if that’s too much, try something in between.

Once you can do something 5 times at 100%, try 10 times.
Do this until you feel confident enough to compete at your best in your sport!

Medina Pabón MA, Naqvi U. Achilles Tendonitis. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538149/