What is Achilles tendinopathy?
The anatomy of the Achilles tendon
The Achilles tendon is the strongest tendon in the human body. It connects the calf muscles (gastrocnemius and soleus) to the heel (calcaneus) and drives propulsion with every step, stride and jump. Mid-portion tendinopathy is distinguished from insertional tendinopathy, closer to the heel, which is managed slightly differently.
Why does this tendon become painful?
Pain appears when the Achilles tendon is repeatedly loaded beyond its capacity to adapt, particularly during running and jumping activities. A training volume increased too quickly, a stiff calf, or a change of terrain or shoes are the most common causes of tendon overload.
Which sports contribute to Achilles tendinopathy?
All sports involving repeated impact and propulsion place particular strain on this tendon:
- Running, especially on hard surfaces or uphill
- Football and basketball (jumping, sprinting)
- Tennis and racquet sports
- Hiking and trail running
- Dance
- Volleyball
Treating Achilles tendinopathy in rehab with a sports physio
The goal of treatment is to progressively strengthen the Achilles tendon to restore its capacity to absorb load, particularly through eccentric training, which is well documented scientifically for this condition.
- 1Reducing pain and managing load
- 2Ankle mobility
- 3Isometric strengthening
- 4Progressive concentric strengthening
- 5Eccentric strengthening
- 6Ankle proprioceptive work
- 7Correcting movement and footing
- 8Strengthening under sport-specific load
- 9Progressive return to running
- 10Return to competition
Why the physio’s initial assessment matters
During the initial assessment, the physiotherapist aims to precisely locate the pain (mid-tendon or heel insertion), identify the movements that reproduce it, and assess any recent change in training volume or terrain.
“It’s not that the tendon is fragile — it’s the load that needs to be better dosed and distributed.”
Eccentric strengthening, the cornerstone of treatment
Eccentric calf strengthening, particularly slow single-leg heel drops, is the most scientifically documented protocol for Achilles tendinopathy. It’s complemented by broader work on the posterior chain and ankle stability.
In brief
- Eccentric calf strengthening
- Broader work on the posterior chain
- Progressive correction of running load
- Gradual return: mobility, then load, then sport
Ready to take your Achilles tendinopathy seriously?
Start the HOPP programme designed by sports physios.
Should you rest or keep playing sport?
Complete rest generally isn’t necessary and isn’t the most effective solution. It’s better to temporarily adjust the running or jumping volume that clearly reproduces the pain, while starting eccentric strengthening as soon as possible.
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When should you see a specialist for Achilles tendinopathy?
If the pain persists for more than four to six weeks despite adjusting your activities and following a well-run strengthening programme, or if you feel a “snap” suggestive of a rupture, a medical opinion is recommended.
The HOPP care programmes to treat your Achilles tendinopathy and get back to sport
This tendinopathy requires rigorous, progressive eccentric strengthening. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.
The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.
Essential
FROM INJURY TO
BACK TO YOUR ACTIVITIES
59€
One-time payment
“AT YOUR OWN PACE WITH
DAILY ADAPTATION”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
Performance
TO GET BACK TO SPORT
IN THE BEST CONDITIONS
79€
One-time payment
“GET BACK TO YOUR LEVEL
WITHOUT RISK OF RELAPSE”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
Expert
PERSONALISED VIDEO-CALL
SUPPORT, ANY TIME
149€
One-time payment
“A PHYSIO
WHENEVER YOU NEED”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility, Strengthening, Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
- + 2 video calls with an expert sports physio / return check-up
A programme that adapts to you every day
Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your ankle is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.
Ready to start your programme?
Join the HOPP support programme designed by sports physios.
F.A.Q
Does the HOPP programme replace a medical consultation?
No. HOPP is a support and rehab tool designed by sports physiotherapists, but it doesn’t replace a doctor’s opinion. If in doubt, or if the pain persists, see a health professional.
Is the programme suited to all sporting levels?
Yes. Every programme is personalised to your sport, your level and how you feel each day, whether you’re a recreational athlete or preparing for competition.
Can I keep running with Achilles tendinopathy?
In most cases, yes, by temporarily adjusting your volume and terrain, while starting eccentric strengthening alongside it.
How long does it take to heal?
This tendinopathy can take longer to heal than others, with gradual improvement over several weeks to a few months depending on how long the symptoms have been present.
Is there a risk of rupture?
The risk mainly exists with a long-standing, neglected tendinopathy combined with a sudden intense effort. That’s why it’s important to address the pain as soon as it appears rather than letting it settle in.
