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Achilles Tendonitis

What is Achilles Tendonitis? 

Achilles Tendonitis is often caused as a result of repetitive activity such as running, jogging and jumping, or in people who are constantly straining and heavily using their feet e.g. tradespeople constantly squatting like plumbers, or roofers who constantly stand on an angle. Achilles tendonitis can also be caused by a one off traumatic event.



  • Aching, painful and/or stiff feet when getting out of bed which gradually eases with walking and movement.

  • Sore heel bone at the start of activity which may ease as you continue that activity. 

    • The pain may then increase shortly afterwards, or even a delayed increase in pain the next day.

  • Noticeable aching feet when walking or use of steps/stairs or steep surfaces.

  • Tight calves are a common manifestation as the inflammation causes referred pain. 

  • The sore heel may be red or feel hot, and sensitive to touch.




Repeated stress to the feet and overuse at particular angles (e.g. standing on a slanted surface for extended periods) is the most common underlying trigger to achilles tendonitis. A sudden, single injury can also lead to achilles tendon, or heel, pain and inflammation (e.g. being run into by a trolley). 


We usually require an X-ray of the area prior to treatment to rule out any other bony or soft tissue problems. 




Achilles tendonitis is very successfully treated using focused shockwaves with ultrasound guidance for precision to stimulate a healing response. Shockwave therapy targets the underlying causes of pain and discomfort for achilles tendinopathies and can provide achilles tendon pain relief. 

About 80% of patients improve significantly within 10 weeks of treatment, even when other options such as medications or radial shockwaves have failed. 


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In-depth Information 

Achilles tendonitis (also known as Achilles tendinopathy or tendinosis) is typically a repetitive mechanical stress issue. It is particularly associated with lower body activities with a degree of impact on and around the achilles tendon. 


The heel pain associated with inflammation surrounding the calcaneus bone is also more prevalent in people who are constantly loading the tendon with pressure e.g. tradespeople constantly squatting like plumbers, or roofers who constantly stand on an angle. 


These types of ongoing activities can eventually cause inflammation or tiny tears within the tendon which then causes heel and foot pain. In some cases extensive swelling leading to redness and sensitivity to pressure can occur on the back of the heel.


There can be both soft tissue swelling and calcification causing swelling. Inflammation in the degenerate tendon either stimulates new bone leading to the formation of a spur, or calcium deposition within the body of the tendon itself. Eventually, the calcium depositing can become an issue as it starts to take up space, leading to pressure and friction.


There is also a degenerative factor when tendons are injured, notably aging, where the body’s ability to repair decreases and intervention to assist healing may be necessary. QLS has found the blood circulation and collagen formation effects of lithotripsy to be effective in augmenting the body’s own healing abilities in this situation. 


During screening, the provided X-ray may show a spur on the back of the heel. This usually develops as the end result of the Achilles tendinopathy. 


Anatomically, the Achilles tendon attaches to the posterior of the heel and can be divided into 2 sections:

  1. Insertional – is the part of the tendon that attaches on to the bone.

  2. Non-insertional – is from where the tendon leaves the bone and runs up the back of the leg to become the calf muscle.

See the image below for a diagrammatic representation.

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