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Achilles Tendon Pain Physiotherapy

Achilles tendon pain and injury is very common among recreational and elite sportspeople. That being said, it's not only for sportspeople - it's also common among sedentary individuals.

Our Achilles tendon is the largest tendon in the entire body (yeah!) and it attaches the calf muscle to the heel bone.

It is thought that up to 50% of runners will experience pain in their tendon at some point in their life.

As shared before, our tendons are really tough stuff, made of fibrous connective tissues that can take high repetitive forces.

If we compare running, running is generally a series of hops and with each hop, our Achilles tendon behaves like an organic spring which stores and springs the energy.

The "harder" the muscle-spring, the greater the amount of energy stored.

Self diagnosis Top 5 tips: Is your pain coming from the tendon?

We always advise that you get properly assessed by an experienced sports or running physiotherapist whenever possible. All our physiotherapists have extensive knowledge and experience of treating Achilles tendon problems.

  1. Is your tendon stiff and sore in the morning or after you have been sitting for a while? Is it particularly painful going down stairs in the morning and the seems to warm up? YES/NO
  2. Does it ease up with gentle activity? For example, does it seem to warm up after 5-20 minutes of walking or if you are a runner or play sport is it more painful at the beginning and seems to warm up as you get going? YES/NO
  3. Does it get worse with activities with which place more stress/load onto the tendon? For example running, jumping or playing sports such as football or basketball. YES/NO
  4. Is it tender to touch? The Achilles tendon is located superficially i.e. close to the skin, so is often tender if you touch them, push them or squeeze them!! YES/NO
  5. Is it worse the next day after you have run or played sport ? Normally the day or even a few days after the activity the Achilles is more sore and stiff in the morning, more painful walking around and then seems to settle down. YES/NO

If you have answered YES to 4 or 5 of these questions it is likely you have an Achilles tendon problem.

How do we treat Achilles tendon complaints?

So what we know is that injured tendons loses their capacity to withstand loads and forces.

Our roles as physiotherapist is to rehabilitate your tendon to improve the stiffness of the tendon so it is able to withstand high repetitive loads again, without pain.

Many physiotherapists and self-help guides on the internet often prescribe ice, calf massage, rest and stretches for the tendon - these can be useful with an acute tendon problem e.g. when you have had the pain for a few days but if it's chronic (ie been injured off-on or for a while now) it's a different ball game entirely.

If you just rest an Achilles tendon complaint this will reduce the pain in the short term but as soon as you go back to running, football or whatever the activity was that used to aggravate the pain, the tendon pain  comes back almost immediately.

What happens is that the injured tendon simply does not have the capacity to take the loads and so becomes painful again fairly quickly. Complete rest can often make the problem even worse.

To improve your strength of your tendon and its ability to withstand load here are some exercises you can carry out in the gym. The key is to ensure they feel heavy and that your tendon has time to recover in between.

We advise that you carry these exercises out at least 3x per week, but ensure you have a day off in between because the day after a loading session the tendon is more vulnerable so a schedule of

  • Mondays / Wednesdays / Fridays or
  • Tuesdays, Thursdays / Saturdays

would be good

We would always advise you consult a professional of you have not used these machines before or not used to going into the gym. If you don’t have access to the gym these exercises can be modified but from experience we find they are less effective.

  • It is important with all these exercises to start with weights that you can easily achieve and ensure that you have the correct technique throughout.
  • If you lose your technique then stop, rest and start again.
  • If your technique does not improve then reduce the weight.
  • We would advise that these exercises are carried out slowly to increase the time under tension on the muscle.
  • We would suggest a pace of 2-3 seconds for each phase.
  • If you do not have access to a gym then we have modified the exercise so you can do it at home.
  • From experience we find that people respond better when they are doing their exercises in the gym.

Achilles Tendon Exercises

1. Calf Strengthening Exercises

  • Start with standing flat on both feet, slowly tip toe as high as possible. Do this as slowly as possible. 10 times is 1 set, do 3 sets daily.
  • The second calf strengthening exercises, is done in sitting. Place both feet flat on ground, and slowly push off and resisting the ground. Do this as slowly as possible. 10 times is 1 set, do 3 sets daily

2. Leg press with equipment (no equipment, do chair squats). Start seated on a stable chair, and do a slow motion of sit > stand > sit. The slower the better. 10 times is 1 set, do 3 sets daily

3. Non-gym option

Here is an option if you do not have access to the gym. This program is called the Alfredson regime.

It was one of the first exercise programs to show positive effects on pain and function. However, it doesn’t work for everyone and is just one option. If pain allows we would advise you get onto the progression of this exercise as soon as possible.

The program was originally designed to be done twice a day but we advise you start every other day but you must ensure it feels very hard and you are reaching fatigue when you get close to the last few reps!

How to carry out this exercise:

  • Raise up on the non- painful leg and drop on the painful side – we advise you take 3 seconds to lower down on the painful side.
  • Repeat this for 3 x 15 reps (have a 1-minute break between sets)
  • Add weight to the exercise – either hold a dumbbell in one hand or put a weight in a ruck sack


Progress the exercise by going up and down on the painful side.

If you experience pain with these exercises or a worsening of your symptoms then we would advise you stop the exercises and get assessed and treated by one of our physiotherapists.

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Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.


  • Cupping TCM
  • Auricular Therapy TCM
  • Herbal TCM Medicine & Supplementation


Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.


All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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We appreciate you as our valued clients and want you to know that the # 1 way we grow as a clinic / brand is through word of mouth referrals from valued patients like yourself.

We prefer not to rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.

book an appointment today
(or check your pains / injuries)

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