Achilles Tendonitis Treatment — Cockburn Central
Achilles tendon pain is one of the most common injuries we see at Cockburn Podiatry — particularly in runners, court sport athletes, and people who have recently increased their activity. Achilles tendonitis (more accurately called Achilles tendinopathy) causes pain, stiffness, and swelling at the back of the heel and lower leg, and it can become chronic and debilitating if left untreated.
Our podiatrists in Cockburn Central provide evidence-based assessment and rehabilitation for Achilles tendinopathy, tailored to your specific injury type, activity level, and goals. With the right treatment, most patients achieve full recovery.
What Is Achilles Tendonitis?
The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It is essential for walking, running, jumping, and pushing off the ground.
Achilles tendonitis refers to pain and dysfunction in the Achilles tendon caused by overloading the tendon beyond its capacity to recover. In acute cases there is true inflammation; in chronic cases the tendon undergoes degenerative changes (tendinosis) where collagen fibres become disorganised and the tendon loses its normal structure. Both forms are collectively termed Achilles tendinopathy.
There are two main types:
- Mid-portion Achilles tendinopathy — affects the mid-section of the tendon, 2–6 cm above the heel. The most common type, particularly in runners.
- Insertional Achilles tendinopathy — affects the point where the tendon attaches to the heel bone. Often accompanied by a bony prominence (Haglund’s deformity or heel spur). More common in older patients and those who wear rigid-backed shoes.
Symptoms of Achilles Tendonitis
- Pain and stiffness along the back of the heel and lower leg, especially first thing in the morning
- A dull aching or burning sensation that worsens with activity and improves with rest
- Pain at the start of a run that often eases mid-run but returns worse afterwards
- Swelling or thickening of the tendon, which may feel nodular
- Tenderness when pressing on the tendon
- Pain when standing on tiptoes or pushing off during walking or running
- Creaking or crepitus felt in the tendon during movement
Common Causes & Risk Factors
- Sudden increases in training — too much, too soon (new running program, start of sport season)
- Tight or weak calf muscles — reduced ability to absorb and distribute load through the tendon
- Flat feet or overpronation — increases rotational stress on the tendon
- Poor footwear — worn-out running shoes or a sudden change to minimalist footwear
- Hard or sloped training surfaces
- Age — tendon quality declines from the mid-30s onwards
- Fluoroquinolone antibiotics — a known risk factor for tendon damage
- Systemic conditions — diabetes, rheumatoid arthritis, and high cholesterol increase tendon vulnerability
Achilles Tendonitis Treatment at Cockburn Podiatry
Our podiatrists begin with a thorough clinical assessment to determine the type and severity of your Achilles tendinopathy, identify contributing biomechanical factors, and exclude more serious conditions such as partial or complete tendon rupture. Where needed, we can refer for ultrasound imaging. Treatment options include:
Load Management & Activity Modification
The foundation of Achilles tendinopathy treatment is modifying — not eliminating — load. Continuing to train through pain worsens tendon degeneration; complete rest leads to tendon weakening. Our podiatrists provide clear, specific guidance on how to adjust your training volume and intensity so healing can occur while fitness is maintained.
Eccentric Heel Raise Program
The Alfredson eccentric heel drop protocol is the most evidence-based exercise for Achilles tendinopathy. Eccentric loading — lowering the heel slowly under resistance — stimulates collagen remodelling in the degenerated tendon and progressively rebuilds its load capacity. The protocol is different for mid-portion versus insertional tendinopathy. Our podiatrists prescribe and supervise the correct version for your injury.
Shockwave Therapy
Shockwave therapy is a highly effective treatment for chronic Achilles tendinopathy that has not responded to exercise rehabilitation alone. High-energy acoustic waves stimulate tendon healing, break down calcific deposits, and promote neovascularisation (new blood vessel growth). Most patients require 3–5 sessions. It is non-invasive with minimal downtime. Learn more about shockwave therapy →
Low Level Laser Therapy (LLLT)
Laser therapy reduces pain and inflammation at a cellular level and accelerates tissue healing. It is particularly useful in the acute phase of Achilles tendinopathy and can be used alongside eccentric exercise and shockwave therapy to enhance recovery.
Strapping & Bracing
Supportive strapping can offload the Achilles tendon in the acute phase, reducing pain and allowing the initial rehabilitation program to begin. Heel raise wedges inserted into footwear reduce the stretch on the tendon and can provide immediate symptom relief, particularly for insertional tendinopathy.
Custom Orthotics
Where overpronation or biomechanical factors are contributing to Achilles tendinopathy, custom orthotics address the underlying load distribution problem. They can incorporate a heel raise to reduce tendon tension and correct abnormal foot mechanics that increase the rotational stress through the tendon. Learn more about custom orthotics →
Footwear Assessment & Advice
Worn-out running shoes or inappropriate footwear are common contributors. We assess your current footwear and recommend specific shoes with appropriate heel drop, cushioning, and support for your foot type and the stage of your rehabilitation.
Imaging & Specialist Referral
Where we suspect a partial or complete tendon rupture, calcific tendinopathy, or where symptoms are not progressing as expected, we refer for ultrasound or MRI imaging. In cases requiring surgical review, we refer to an appropriate specialist.
Why Choose Cockburn Podiatry for Achilles Tendonitis?
- Experienced podiatrists with expertise in tendinopathy rehabilitation and running injuries
- Shockwave therapy and laser therapy available in-clinic — no referral elsewhere
- BUPA and Medibank preferred providers — maximum health fund rebates
- Medicare CDM and DVA card holders welcome
- Conveniently located at Cockburn Central, serving South Lake, Yangebup, Atwell, Success, Hammond Park and surrounds
Frequently Asked Questions
Should I rest completely with Achilles tendonitis?
Complete rest is generally not recommended. The tendon needs controlled loading to heal — rest leads to tendon weakening. The key is reducing the provocative load while introducing a structured eccentric strengthening program. Your podiatrist will determine the right balance for your stage of injury.
How long does Achilles tendonitis take to heal?
Acute cases treated early typically improve significantly within 6–12 weeks. Chronic tendinopathy that has been present for months may take 3–6 months of consistent rehabilitation. Shockwave therapy significantly accelerates recovery in stubborn cases. Early intervention always produces faster results.
What is the difference between insertional and mid-portion Achilles tendonitis?
Insertional tendinopathy affects the heel bone attachment and often involves a bony spur. Mid-portion affects the middle section of the tendon 2–6 cm above the heel. They require different treatment approaches — particularly the exercise program and footwear modifications differ between the two types.
Do I need a referral?
No referral is needed to see us at Cockburn Podiatry. Simply book online or call (08) 9417 3737. Medicare CDM rebates are available with a GP referral, and all major health funds are accepted via on-the-spot HICAPS.
Serving south Perth: We treat patients from Atwell, Success, South Lake, Yangebup, Hammond Park, Aubin Grove, Jandakot, Beeliar, Coogee, Baldivis and the wider Cockburn area.
Ready to treat your Achilles pain? Call us on (08) 9417 3737 or book online. No referral needed. Serving Cockburn Central, South Lake, Yangebup, Atwell, Success, Aubin Grove, Hammond Park, Jandakot and surrounds.
Related services: Shockwave Therapy | Custom Orthotics | Sports Podiatry