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  • Achilles paratendonitis is characterised by inflammation and thickening of the sheath surrounding the Achilles tendon.

  • On palpation and ultrasound assessment of the paratendon, swelling, crepitus and discomfort can be detected.

Signs & Symptoms Copy

  • Achilles tendinopathy is an overuse condition characterized by gradual onset of pain in the Achilles.

  • This is the largest tendon in the body. It attaches the calf muscles in the lower leg to the back of the heel (Calcaneus). There are two calf muscles, the Gastrocnemius and Soleus. These strong muscles allow us to rise up on our toes making them prime muscles used in walking and running.

  • Pain is usually worse in the morning and eases with heat and exercise.  Pain reappears a few hours after physical activity.

What Causes It?

  • Over pronation of the feet

  • Tight calf muscles

  • Poor tensile strength through the tendon and calf muscles

  • Hypomobile ankle and subtalar joints

  • Overtraining or change in intensity, duration, frequency

  • Incorrect or poor footwear

  • Previous Achilles strain or rupture

How to Self Manage

  • Implement the R.I.C.E. protocol to reduce pain and swelling

  • Modify aggravating activities

  • Stretch calf muscles

  • Review footwear


This condition requires prompt management, as the tendon can remain thick and inflamed.  This then has the potential to progress into a more degenerative condition referred to as Achilles Tendinopathy

How Physio Helps

  • Assess biomechanics

  • Review and modification of training program

  • Soft tissue massage

  • Deep transverse frictions

  • Joint mobilisation

  • Taping to offload the tendon

  • Exercise prescription

  • Electrotherapy

  • Prescription of a heel raise to offload the tendon

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