Achilles Tendinopathy: Causes, Treatments, and What Works

When you feel a sharp or burning pain at the back of your heel—especially when you first stand up or start walking—you’re likely dealing with Achilles tendinopathy, a degenerative condition of the Achilles tendon caused by overuse and poor load management. Also known as Achilles tendonitis, it’s not just inflammation—it’s tendon breakdown from repeated stress without enough time to heal. This isn’t something you can out-wait. Pushing through the pain usually makes it worse, not better.

Physical therapy, a structured approach to restoring tendon strength through controlled loading and movement is the most proven fix. Studies show eccentric heel drops—slowly lowering your heel off a step—work better than rest alone. But it takes weeks, not days. Many people quit too soon because they expect quick relief. The real trick? Consistency over intensity. You don’t need heavy weights. You need slow, controlled movements every day.

Rest and recovery, the intentional reduction of activities that strain the tendon to allow healing isn’t about sitting still. It’s about switching to low-impact moves like swimming or cycling. Too many people think they need to stop everything. That’s not true. You just need to avoid jumping, sprinting, or climbing stairs until the tendon regains strength. And don’t rely on ice or anti-inflammatory meds to mask the pain—those don’t fix the tendon. They just hide the warning sign.

Some people turn to injections or shockwave therapy, but those are last-resort options. Most cases improve with the right rehab plan. Even if you’ve had this for months, your tendon can still heal. The key is stopping the cycle of overload and giving it the right kind of stress to rebuild. It’s not magic. It’s mechanics.

What you’ll find below are real, practical guides from people who’ve been there—how to adjust your walking, what shoes help, when to skip the NSAIDs, and how to tell if your pain is getting better or just hiding. No fluff. No hype. Just what works.