Why Achilles pain can drag on
Achilles tendinopathy — pain and stiffness affecting the tendon at the back of the ankle — is particularly common among runners, but it also affects people who’ve suddenly increased their walking, hiking or standing activity. Unlike an acute injury, tendinopathy tends to build up gradually, and it can become a stubborn, ongoing issue if the underlying load isn’t managed properly.
Where shockwave therapy fits in
For Achilles tendinopathy that hasn’t responded to initial conservative treatment, our AHPRA-registered physiotherapists may recommend a course of shockwave therapy alongside an exercise program. The aim is to support the tendon’s healing response while you work through a structured loading plan.
- Delivered directly over the affected part of the tendon
- Combined with a progressive calf and Achilles strengthening program
- Often paired with advice on running load, footwear and surface
What to expect
Sessions typically involve a firm tapping sensation over the tendon, and a course is usually spaced across several weekly appointments. Some tenderness afterwards is normal and generally settles within a day or so.
Quick tip
Sudden increases in running distance or intensity are a common trigger for Achilles tendinopathy — building up load gradually is one of the simplest ways to reduce the risk of it recurring.
The role of loading exercise
Tendons generally respond best to a gradual, progressive strengthening program, which helps rebuild their capacity to handle the demands of running or daily activity. Your physiotherapist will guide the pace of this program based on how your tendon responds, rather than a fixed one-size-fits-all timeline.
Getting back to running after Achilles tendinopathy is usually a gradual process, not a single milestone.
Returning to running or activity
Most people can return to their usual activity, though the timeline varies depending on how long symptoms have been present and how consistently the rehab program is followed. Your physiotherapist will help you plan a graded return that reduces the risk of the pain flaring up again.
Why runners are particularly prone
The repetitive loading involved in running places significant demand on the Achilles tendon, and sudden changes — increased mileage, hill training, or a change in running surface — are common triggers for tendinopathy to develop. Understanding your own training patterns can help identify what may have contributed to your symptoms.
Footwear also plays a role for many runners, and your physiotherapist may suggest reviewing your current shoes as part of a broader management plan alongside shockwave therapy and strengthening exercises.
Preventing recurrence
Once your Achilles tendinopathy has settled, maintaining a sensible, gradual approach to increasing running load remains important for reducing the likelihood of the issue returning in the future.
Cross-training during recovery
While your Achilles recovers, low-impact cross-training such as swimming or cycling may help you maintain general fitness without placing the same repetitive load on the tendon. Your physiotherapist can advise on what’s appropriate for your specific stage of recovery.
Learn more from independent sources: healthdirect Australia. Information on this page is general in nature and is not a substitute for individualised advice from a registered health practitioner.
Information on this page is general in nature and is not a substitute for individualised advice from a registered health practitioner. Our practitioners are registered with AHPRA.