By Andrew Siyabalawatte, Oct 2022.
Achilles tendonitis is a common injury that affects runners, walkers, and athletes alike. This painful condition occurs when the Achilles tendonitis-the thick band connecting your calf muscles to your heel-becomes inflamed or irritated from repetitive stress or trauma. Whether it’s caused by overuse, sudden increases in training, or previous injuries, understanding how to manage Achilles tendonitis is key to faster recovery.
What Causes Achilles Tendonitis?
Several factors can lead to Achilles tendonitis, including–
Training errors: too much mileage or intensity increase too quickly
Footwear: worn-out shoes or shoes lacking proper support in Tendonitis
Biomechanics: flat feet (overpronation), misalignment, or calf muscle weakness
Intrinsic factors: age, genetics, tendon vascularity, and prior injuries
A specific type called insertional Achilles tendonitis occurs at the tendonitis attachment point on the heel. This version can be more sensitive to pressure and sometimes requires tailored exercises and footwear modifications.
Achilles Tendonitis, is acommon lower extremity injury in everyday walkers, casual runners and athletes, especially distance runners. This lower leg condition, is usually due to accumulative stress through the tendon over time. It can also originate from sustained trauma like a muscle tear to the gastrocnemius (calf muscle). Achilles Tendonitis is the second most common running-related musculoskeletal injury, following medial tibial stress syndrome, with an incidence of 9.1% to 10.9%.
A List of Causative Factors Leading to Achilles tendonitis Injury
The most common factors include training errors, running technique, previous injury, footwear and running surfaces. Intrinsic factors related to the injury include tendonitis vascularity, gastrocnemius–soleus dysfunction, age, gender, body weight, genetic factors, muscle weakness and lower limb misalignment and flat footedness (pronated feet).
A Real Pain in the Achilles Tendonitis and it’s Associated Symptoms
- Heel Pain – this may be an ache or a sharp pain, which feels worse when you’ve been active or put pressure on it.
- Stiffness in the Achilles Tendonitis – like Plantar Fasciitis also known as Policeman’s heel, the stiffness is often worse first thing in the morning or if you’ve been resting for a while
- Swelling at the back of your ankle – due to the repetitive stress on the Achilles tendonitis insertion site of the heel.
- Tenderness when touching the tendonitis often indicates inflammation following activity, as it tries to heal and return to its normal state.
When To Rest the Achilles tendonitis
There is never really a specific amount of time to rest the Achilles tendonitis. It just is not the real solution. The real focus should be, how to stop overloading it.
If you rest it, it will start to lose some of its strength and fitness over time. This means that you can actually weaken your tendon further if you rest your Achilles tendonitis completely and try to avoid using it most of the time.
Short periods of Achilles tendonitis complete rest may be appropriate if the Achilles tendonitis is extremely sore or painful, but this should not last more than a couple of days.
When To Strengthen the Achilles Tendonitis
When it comes to strengthening the lower limb, people often overlook the calf muscles with tendonitis. Over time, strengthening these muscles will also make the Achilles tendon stronger.
After a successful stretching regime, strengthening should often be introduced.
Stretching the Achilles tendonitis has been shown to increase collagen production and muscle fiber composition.
Stretching should be avoided during early stages of Achilles tendonitis rupture, however in the case of Achilles tendinopathy, stretching is encouraged. The goal of stretching is to prevent problems due to adhesions, shortening, or improper healing in the tendon.
The best type of strengthening in the initial stages of Achilles tendinopathy in my opinion, is isometric strengthening. Isometric strengthening involves holding the muscle under a sustained tension with minimal movement. An example of this type of strengthening exercise is the calf raise hold.
Exercises for Achilles Tendonitis
Proper exercise is vital to healing-
1. Stretching – Gentle calf and Achilles stretches improve flexibility and prevent shortening or adhesions. Stretching is safe for tendonitis but should be avoided in the case of a rupture.
2. Strengthening – Start with isometric exercises like calf raise holds, which strengthen the tendon without excessive movement.
Seated calf raises are excellent for insertional Achilles tendonitis, reducing heel stress while still building strength.
Aim for 1-minute holds initially and gradually increase to 5 minutes, focusing on controlled movements.
Stronger calf muscles mean the tendon experiences less stress during walking or running, reducing the risk of further irritation.
You can also perform this calf raise hold exercise while seated. Holding a light weight to begin with, aim for a 1 min hold, slowly returning in a controlled manner to the start position. Aim to gradually increase the hold time to 5 mins if possible.
How our Insoles Can Help in Achilles Tendonitis?
The right insoles for footwear can make a huge difference when dealing with Achilles tendonitis. Our arch support insoles help stabilize your feet, reduce strain on the Achilles Tendonitis, and improve your overall posture. Unlike standard store-bought insoles inserts, our custom insoles are designed to fit your unique foot shape insoles, helping to increase stability with insoles.
Reduce pain in the heel, knees, and lower back with insoles.
Support insoles help in better posture and balance
Prevent further stress on the tendon with our insoles.
Stronger calf muscles also play a key role. The more you strengthen them, the less strain your Achilles experiences during walking or running with insoles. But the real key to recovery is balance-knowing when to rest with insoles, when to stretch with insoles, and when to strengthen with the insoles. Overloading the tendon too soon can slow healing with insoles, while the right exercises paired with proper insoles can make a huge difference.
For persistent Achilles tendonitis, especially insertional cases, professional guidance is important. At our Guildford clinic, we provide tailored programs that combine:
Targeted exercises for tendon and calf strength
Custom arch support insoles for proper alignment
Advice on avoiding activities that overload the tendon
By following this insoles approach-strengthening, supporting insoles help in, and managing activity-you give your tendon the best chance to heal safely and efficiently.
At Back to Health Wellness, we design our Spine Align insoles using advanced 3D scanning and printing technology. These insoles help redistribute pressure, correct overpronation, and protect your Achilles during daily movement. Even simple cushioned insoles can make a noticeable difference, whether you’re walking with the insoles, running with the insoles, or standing with insoles for long periods.
With the right insoles and a smart exercise plan, your Achilles tendon can recover faster with the insoles, and your feet with insoles get better, knees with insoles feel different, and back will feel more comfortable along the way with insoles.