Achilles tendinopathy: Causes, Treatments, and What Really Works

When you feel a sharp or burning pain right above your heel—especially when you first stand up in the morning or after sitting for a while—you’re not just sore. You might be dealing with Achilles tendinopathy, a degenerative condition of the Achilles tendon caused by overuse and poor recovery. Also known as Achilles tendonitis, it’s not just inflammation—it’s the tendon breaking down from repeated stress without enough time to heal. This isn’t something that goes away with rest alone. If you’re a runner, a dancer, or even someone who walks a lot, your Achilles tendon is working hard every day. And when it’s pushed too far, too fast, it starts to fray, thicken, and hurt.

The real problem? Most people treat it like a simple strain. They ice it, take ibuprofen, and hope it fades. But physical therapy, a targeted, progressive loading program designed to rebuild tendon strength is what actually works. Studies show that eccentric heel drops—lowering your heel slowly off a step—are one of the most effective exercises for this condition. It’s not glamorous, but it rebuilds the tendon’s structure over time. Meanwhile, tendon injury, a broader term that includes tears, ruptures, and chronic degeneration can sometimes be confused with Achilles tendinopathy. The difference matters because a full rupture needs surgery. Tendinopathy doesn’t. But if you ignore the early warning signs—stiffness, swelling, pain during activity—you risk turning a manageable issue into a long-term one.

What you won’t find in most quick-fix guides is how much footwear, training volume, and even your hip strength play a role. Worn-out shoes, sudden spikes in mileage, weak glutes—all of these can overload the Achilles. And no, stretching alone won’t fix it. The tendon needs load, not just flexibility. That’s why so many people get stuck in a cycle of pain and temporary relief. The good news? Most cases improve within 3 to 6 months with the right plan. You don’t need surgery. You don’t need injections. You need consistency, patience, and a clear understanding of what your tendon actually needs to heal.

Below, you’ll find real-world guides on managing pain, avoiding common mistakes, and choosing treatments backed by science—not marketing. Whether you’re trying to get back to running, walking without discomfort, or just figuring out why your heel won’t stop aching, these posts give you the facts you need to move forward.