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Seacoast Spine & Sports Injuries Clinic

Achilles Tendinopathy

Foot, heel & ankle · Before your visit

Achilles tendinopathy is load-related pain in the tendon between the calf and heel.

When to seek urgent medical care

Seek prompt medical evaluation after injury if the foot or ankle is deformed, you cannot take steps, numbness is spreading, an open wound is present, or the foot becomes pale, blue, or unusually cold.

This is not an exhaustive emergency list. If something feels severe, rapidly worsening, or unsafe, call 911 or seek urgent medical evaluation.

Start here

What is achilles tendinopathy?

Achilles tendinopathy is load-related pain in the tendon between the calf and heel. Midportion and insertional symptoms respond to different compression and range considerations, so location matters.

The same label can behave differently from one person to the next. The timing, location, type of symptoms, injury mechanism, and response to movement help distinguish a local tissue problem from referred pain, nerve involvement, or a pattern that should be evaluated elsewhere first.

What achilles tendinopathy can feel like

People do not need every sign below to fit this pattern. They are useful clues to discuss during an evaluation, especially when paired with what changes the symptom and what activity has become difficult.

  • morning tendon stiffness
  • pain during running or jumping
  • thickened or tender tendon
  • pain that warms up then returns

Common contributors and aggravators

A contributor is not always a single cause. Tissue capacity, recovery, the size of a recent load change, and the mechanics of the task can overlap. For achilles tendinopathy, the history commonly examines:

  1. 1running or jumping-volume spike
  2. 2change in speed, hills, or footwear
  3. 3reduced calf capacity

What we look at before planning care

An assessment begins with the story, then tests the findings that can change a decision. For this presentation, that usually means looking at the items below and comparing them with the demands of work, daily life, or sport.

Clinical focusmidportion versus insertional location
Clinical focussingle-leg calf strength
Clinical focusrunning and impact load

Imaging can be useful when the history or examination indicates it, but a scan is not a substitute for matching the finding to symptoms, function, and the clinical screen.

Clinically reviewed

Reviewed by Dr. Tamara Lovelace, DC, DACBSP, ICCSP, Chiropractic Sports Doctor and clinic director, on August 25, 2026.

This page explains what we look at and what care can involve. It is not a diagnosis, and it cannot replace an examination. Bring the problem in and a provider will tell you what is going on.

What your provider will discuss with you

Care for achilles tendinopathy is built around the findings, not a preset protocol. The early goal may be symptom control or protection; the later goal is enough motion, strength, and tolerance for the exact activity you need.

01

progress calf loading by location

Progress is checked against symptom response and function so the plan can change when capacity changes.

02

restore tendon energy storage

Progress is checked against symptom response and function so the plan can change when capacity changes.

03

rebuild hills, speed, and jumping

Progress is checked against symptom response and function so the plan can change when capacity changes.

Common questions about achilles tendinopathy

Short answers to the decisions people usually face before an evaluation.

What is achilles tendinopathy?

Achilles tendinopathy is load-related pain in the tendon between the calf and heel. Midportion and insertional symptoms respond to different compression and range considerations, so location matters.

How is achilles tendinopathy assessed?

The examination is shaped by your history and the task that brings symptoms on. For this pattern, useful checkpoints include midportion versus insertional location, single-leg calf strength, running and impact load. The provider also screens for findings that should be evaluated medically before musculoskeletal care continues.

What can care for achilles tendinopathy include?

A plan may draw from Radial Pressure Wave, Graston, and Physical Therapy, but the service is not the diagnosis. Care is selected around the examination and may focus on progress calf loading by location, restore tendon energy storage, rebuild hills, speed, and jumping. The dose and sequence change with irritability, healing stage, and the activity you need to regain.

Can I stay active with achilles tendinopathy?

Often, some activity can continue after the provoking dose is adjusted, but that decision depends on the tissue, severity, and warning signs. The goal is to protect what needs healing while preserving safe strength and conditioning, then rebuild the specific work, daily-life, or sport demand.

When does achilles tendinopathy need urgent medical care?

Seek prompt medical evaluation after injury if the foot or ankle is deformed, you cannot take steps, numbness is spreading, an open wound is present, or the foot becomes pale, blue, or unusually cold.

Related foot & ankle guides

Symptoms often overlap. These pages can help you compare nearby tissues, referred pain, and different loading patterns.

Browse foot, heel & ankle

Get clarity on achilles tendinopathy.

Book at the Portsmouth or Alton clinic. The first step is a focused assessment that separates what hurts from what is driving it.

Portsmouth Clinic

Portsmouth, NH · Seacoast

Mon to Thu: 9:00 AM to 6:00 PMFriday: 9:00 AM to 5:00 PM
(603) 431-4200
Lakes Region Clinic

Alton, NH · Lakes Region

Mon, Wed, Fri: 9:00 AM to 7:00 PMTue & Thu: 9:00 AM to 6:30 PMSaturday: 8:00 AM to 12:00 PM
(603) 875-4000
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