Question 1

What is the Achilles tendon and what does it do?

Accepted Answer

The Achilles tendon is the large tendon at the back of your ankle connecting your calf muscles (gastrocnemius and soleus) to your heel bone (calcaneus). It's the strongest and thickest tendon in the body. Every time you walk, run, or jump, your Achilles tendon is working. It's essential for pushing off when walking, running uphill, jumping, and standing on your toes.

Question 2

What's the difference between tendinopathy and tendinitis?

Accepted Answer

Tendinitis implies inflammation, but research shows Achilles pain is usually due to failed healing and degenerative changes, not inflammation. That's why we use the term 'tendinopathy' (disease of tendon) instead of 'tendinitis' (inflammation of tendon). This is important because anti-inflammatory treatments like ice and NSAIDs may help pain short-term but don't address the underlying problem - that's why eccentric loading exercises are the treatment of choice.

Question 3

Will my Achilles tendinopathy heal on its own with rest?

Accepted Answer

No - rest alone doesn't work for Achilles tendinopathy. While rest may reduce pain temporarily, the underlying tendon weakness and degeneration remain. In fact, complete rest can make the tendon weaker. The tendon needs gradual loading through eccentric exercises to stimulate proper healing and strengthen the collagen structure. This is why eccentric exercises are the gold standard treatment.

Question 4

Why do eccentric exercises work?

Accepted Answer

Eccentric exercises (slowly lowering your heel while on one leg) place a specific type of load on the tendon that stimulates healing. This controlled loading: 1) Promotes collagen remodeling and tendon strengthening, 2) Increases tendon thickness, 3) Reduces abnormal blood vessels and nerve ingrowth (which cause pain), 4) Improves tendon's ability to handle load. Studies show 60-90% of people improve significantly with 12 weeks of daily eccentric exercises.

Question 5

Can I run through Achilles tendinopathy?

Accepted Answer

Generally no - continuing to run at your normal volume usually makes it worse. However, you don't need complete rest. The key is finding your 'pain-provocation threshold' - the amount of activity you can do without pain worsening 24 hours later. This might mean running half your normal distance, or taking 2-3 weeks off running while doing eccentric exercises and cross-training. Some pain during activity (3-5/10) is acceptable, but pain the next day means you overdid it.

Medical Disclaimer

Achilles Tendinopathy (Achilles Tendon Pain)

📖What is Achilles Tendinopathy (Achilles Tendon Pain)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention