About the condition
Achilles tendinopathy can affect the tendon’s midportion or its attachment to the heel. Location matters when selecting exercises. Sudden loss of push-off after a snap needs assessment for rupture.
Treatment options
Progressive tendon loading is central to midportion care. Adjust aggravating activity and select a starting exercise dose you can tolerate and repeat consistently.
Surgical considerations
Surgery is generally considered only for selected persistent problems after non-surgical treatment. Discuss the diagnosis and the likely benefits and risks before considering a procedure.
Rehabilitation principles
Build calf strength before progressing towards running and jumping demands. Insertional symptoms may require modification of heel-drop depth to avoid excessive compression at the attachment.
Recovery expectations
Improvement often requires sustained progression. Track calf capacity, walking or running tolerance and the response between sessions. Fluctuating pain needs interpretation in context, rather than automatic complete rest.
Evidence context
The 2024 guideline concerns midportion tendinopathy. Insertional disease requires separate considerations; one exercise prescription should not be assumed to fit both.
Research & guidance
Evidence sources checked: 2026-10-11.
Editorial draft — HK+A clinical review pending.