Musculoskeletal Condition · Glastonbury, CT

Achilles Tendinopathy

Achilles tendon pain and stiffness: exercise-based care, activity changes and selected injection options with Dr. Paul Tortland, DO in Glastonbury, CT.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What is Achilles tendinopathy?

Achilles tendinopathy is an overuse-related disorder of the tendon connecting the calf muscles to the heel. It often causes pain or stiffness at the back of the heel or lower calf, especially with the first steps or activity. Treatment usually starts with progressive calf-loading exercises and activity adjustments; injections are reserved for selected persistent cases after assessment.

Explore related conditions: Browse the Foot and ankle condition hub for related diagnoses and treatment options.

CARE OPTIONS

How is Achilles tendinopathy treated?

Dr. Tortland’s potential treatment options: For persistent Achilles tendinopathy, Dr. Tortland may discuss PRP treatment only in selected cases after confirming the diagnosis and reviewing other treatment options. Evidence for injections is variable, and treatment must account for tendon location, chronicity, and rupture risk.

Physical therapy and traditional care: Progressive calf-strengthening and tendon-loading physical therapy, temporary reduction of running or jumping volume, footwear review, and heel lifts in selected cases are common approaches. The loading plan should be gradual rather than based on repeated complete rest.

When other care may be needed: A sudden pop, rapid swelling, a palpable gap, or inability to push off may indicate Achilles rupture and needs urgent evaluation. Persistent symptoms may warrant imaging or specialist review.

Common questions

Questions about achilles tendinopathy

What causes Achilles tendinopathy?

Achilles tendinopathy is usually an overuse problem in which the tendon is loaded faster than it can adapt, such as after a sudden increase in running, jumping, or hill work. Tight calves, footwear, and age-related changes may contribute.

What are the symptoms of Achilles tendinopathy?

Typical symptoms are pain and stiffness along the back of the heel or lower calf, often worst in the morning or at the start of activity. A sudden pop with inability to push off may signal a rupture and needs prompt medical evaluation.

What are the non-surgical treatment options for Achilles tendinopathy?

Progressive loading exercise is the foundation of care, along with activity modification, footwear changes, and sometimes shockwave therapy. Surgical referral is considered for tears or when months of conservative care fail.

What regenerative options may help Achilles tendinopathy?

Ultrasound-guided PRP may be discussed for persistent Achilles tendinopathy after a structured loading program, but evidence is mixed and benefit is not guaranteed. Injection candidacy depends on tendon location, severity and examination. Sudden pain with a pop or loss of push-off needs urgent assessment for rupture.