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Achilles Tendon Physiotherapy

Our achilles tendon is the strongest and largest tendon of the entire body. It attaches to three muscles which are:

  • plantaris
  • gastrocnemius
  • soleus

connecting them to our calcaneal bone (commonly known as our heel).

It’s located from the back of our ankle to about one third height of the back of our legs (around 6 inches or 15 cm length) and it’s super strong. Food for thought: the achilles tendon can carry up to 4X of your weight when walking, and 8X when running (imagine that!)


Of course, like any body parts and structures, our achilles tendon too can get damaged and injured. Most of the time, you dont need to operate on it at all unless it’s been fully torn. Other than that, ankle and tendon physiotherapy can help lots, combined with

  • orthotics
  • equipment

Doctors may try to avoid prescribing anti-inflammatory drugs as they may contribute to Achilles tendon tendinopathy.

Achilles pain and physio (non surgical)

As I mentioned earlier, most of the time, patients with achilles pains and injuries do not require surgery, unless it’s fully torn and very unstable. Physiotherapists often treat patients with achilles tendon pains and injuries, and if the injury is mild, most of physiotherapy intervention will revolve around tendon physiotherapy such as

  • manual therapy including soft tissue management and mobilization
  • stretches
  • ultrasound therapy and even shockwave therapy to help with soft tissue healing
  • gradual progressive work on strengthening and endurance

Sometimes the referring doctor may prescribe a custom made ankle-foot-orthosis (AFO) that is specially made to suit your feet and ankle. The goal is to protect it from further injury, correct alignments as well provide a “passive background stretch” at all times.

Depending on severity, it may take 6-12 sessions (and weeks) to recover.

If achilles tendon surgery is required

If the achilles tendon is fully ruptured, then surgery becomes a medical necessity as without an intact achilles tendon, it’d be very hard to walk (very unstable ankle joint, and perhaps much pain with weight bearing and movements).

The operating surgeon will arrange for the surgery to reattach the torn parts together (sometimes they may need to harvest more ligament or tendon depending on the state of the torn tendon). Surgery is pretty straightforward, and you may highly likely be placed in an ankle-foot-orthosis to protect the post surgery site and tendon.

Depending on the amount of injury and damage received to the achilles tendon (and the surrounding structures too of course), full recovery to injury can take 10 – 18 months to recovery, as well as physiotherapy during this time to build and restore

  • range of joints of the knee, foot and toes
  • muscle strength
  • normal walking and running patterns
  • normal balance
  • return to life, work and normal responsibilities

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