Achilles tendinopathy is a common overuse injury that affects the Achilles tendon causing pain and discomfort at the back of the heel. It can affect both athletes and non-athletes and is associated with overuse or excessive chronic stress on the tendon.

There are two main types of Achilles tendinopathy. Insertional tendinopathy is located where the tendon inserts onto the calcaneus (heel) and mid portion tendinopathy is located in the middle of the Achilles’ tendon.

People most commonly report that symptoms in the Achilles region gradually increasing over time, leading to an increase in pain and stiffness at the back of the heel. Most commonly, it is worse in the morning when first standing up. It can also be painful after resting, on the initiation of activity. Pain often is increased at the beginning of exercise and then settles down once warmed up.

Increases in symptoms usually coincides with a change in activity, either with increased training loads or loads associated with changes in work posture. For example, someone who is doing more standing than normal. Other factors that can play a role include changes in footwear , walking on different surfaces, poor foot and gait biomechanics such as flat foot, or other injuries to other areas of the body that can put more load and stress on the ankle.