Why does my Achilles tendinopathy keep coming back?

Achilles tendinopathies occur due to excessive chronic stress upon the tendon. When the tendon adapts poorly to load, it’s structure begins to change, causing pain and inflammation.

The Achilles tendon is the biggest and strongest tendon in the body. It has the capacity to resist large forces, and takes on 6-8x our bodyweight in forces when jumping and running. How are we meant to heal a structure that naturally takes on so much load?

It almost feels contradictory because you’re dealing with an overload injury, but tendons need adequate loading to heal. Exposing it to reduced load will reduce your pain, but an elimination of pain from easy activities does not mean the problem is fixed. Now you will have to address the load intolerance issue that started the problem in the first place.

For example, running is a big cause for many Achilles tendinopathies. It can be due to a multitude of things, including ~ lacking calf strength, an improper running program or shoes, or an unideal running technique. If these elements are not addressed, we cannot expect that picking up your usual running routine after a period of rest will be pain free.

Re-loading the Achilles should be a gradual process, and should include a mixture of strengthening, plyometrics and exposure to different activities. There’s no one-size fits all program, so a tailored plan for your physiotherapist is key!