Condition library
Achilles tendon pain: what is Achilles tendinopathy and how is it treated?
Achilles tendinopathy is pain, stiffness and sometimes swelling in the Achilles tendon at the back of the lower leg, usually worst first thing in the morning and at the start of exercise. It happens when the tendon has been loaded more than it can adapt to — for example after increasing running mileage, hill or speed work, or jumping. Pain can be in the middle of the tendon or where it attaches to the heel bone. The main treatment is a progressive tendon loading programme; radial shockwave therapy may be added for persistent cases. Glasgow Sport & Spine Clinic in Glasgow treats Achilles pain in runners, athletes and non-athletes.
Seek urgent help — go to A&E — if:
- you felt a sudden snap or a sensation like being kicked or hit in the back of the lower leg, especially during sport
- you suddenly can't push off, walk normally or stand on tiptoe on that leg
These can be signs of an Achilles tendon rupture, which needs prompt treatment.
See your GP or call NHS 111 if:
- the tendon area is hot, red and swollen, or you feel unwell
- you've recently started antibiotics such as ciprofloxacin or levofloxacin (fluoroquinolones) and developed tendon pain — contact your prescriber
- you have pain in several joints or tendons at once
Common causes
- sudden increases in running volume, speed, hills or jumping
- changes in footwear, especially to lower-heeled shoes
- reduced calf strength
- previous Achilles problems
- age — it becomes more common from your 30s onward
How it's assessed
Assessment identifies whether the pain is mid-portion or insertional (at the heel), as they are managed differently. Calf strength and endurance are measured, and training history is reviewed to find where the load jumped.
How it's treated at Glasgow Sport & Spine Clinic
- a progressive calf and tendon loading programme — the core of treatment
- modification of running or training, rather than complete rest
- ART and IASTM to the calf
- dry needling (acupuncture)
- radial shockwave therapy for persistent tendon pain, usually alongside loading exercise
Frequently asked questions
- Should I stop running?
- Not always. Many people can keep running at a reduced level if pain stays mild and settles by the next morning.
- Will rest fix it?
- Rest usually eases pain, but symptoms often return when activity resumes because the tendon hasn't been strengthened.
- How long does recovery take?
- Tendons adapt slowly. Meaningful improvement often takes around 12 weeks of consistent loading, and longer for long-standing cases.
About the practitioner
Guy Murray, BA, BOst (Hons), HDip NMT, is the sole practitioner at Glasgow Sport & Spine Clinic, Suite 1.4, Redtree Business Suites, 33 Dalmarnock Rd, Glasgow G40 4LA. He has treated musculoskeletal pain and sports injuries in Glasgow since 2008, for patients ranging from office workers and older adults to professional athletes. He was the first practitioner in Scotland to be certified in full-body Active Release Technique (2011) and the first in the UK to complete the Postural Restoration Institute core courses, and trained directly under Leon Chaitow. Treatment sessions combine assessment, hands-on treatment and a home rehab plan.
Appointments: 07584 284854 · guy@glasgowsportandspine.co.uk · Monday–Friday, 10:00–18:30 · Book an appointment · Treatments and prices
This page is general information, not a diagnosis. If you are worried about your symptoms, see your GP or call NHS 111.