Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
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Paratendinopathy of the Achilles Tendon
What is paratendinopathy of the Achilles tendon?
The Achilles tendon is the strong tendon that connects the calf muscles to the heel bone. It is surrounded by a thin layer of connective tissue known as the paratenon. When this tissue becomes inflamed, the condition is called paratendinopathy. Physiotherapy is highly effective in treating paratendinopathy of the Achilles tendon, helping to reduce pain, improve function, and support recovery.
How does paratendinopathy of the Achilles tendon happen?
Paratendinopathy of the Achilles tendon occurs as a result of irritation or repeated trauma to the paratenon — the connective tissue sleeve that surrounds the Achilles tendon. The paratenon’s role is to protect the tendon and reduce friction as it moves against surrounding structures. When this function is disrupted, irritation can develop. For example, ill-fitting shoes that place excessive pressure on the back of the heel can trigger the condition. Similarly, repetitive overuse of the calf muscles and Achilles tendon can cause ongoing trauma to the paratenon as the tendon slides within its sleeve. In response to this damage, the body initiates an inflammatory process, leading to paratendinopathy.
What are the symptoms of paratendinopathy of the Achilles tendon?
Paratendinopathy typically causes pain at the back of the ankle, just above the heel bone. This pain may develop suddenly or build up gradually over time. Swelling around the Achilles tendon is common, and in some cases, a creaking or crunching sensation can be felt at the back of the ankle when the foot is moved. Other symptoms may include:
- Stiffness in the ankle, especially in the morning or after rest
- Tenderness when pressing around the Achilles tendon
- Warmth or redness over the back of the ankle
- Pain that worsens with activity, particularly running or jumping
- Reduced ankle flexibility
- Difficulty pushing off the foot during walking or exercise
What should I do if I have paratendinopathy of the Achilles tendon?
Paratendinopathy will not usually resolve on its own unless the underlying cause is identified and corrected. If you suspect you may have this condition, it is important to book a physiotherapy assessment as soon as possible. While waiting for your appointment, you can help manage symptoms by applying ice to the Achilles tendon — for example, using a bag of frozen peas or crushed ice wrapped in a damp cloth — for 15–20 minutes every couple of hours.
What shouldn’t I do if I have paratendinopathy of the Achilles tendon?
If you are experiencing pain around your Achilles tendon, it is essential to arrange a physiotherapy assessment. Continuing with normal activity despite the pain may worsen the injury and increase the risk of it becoming chronic. Over time, this can lead to scar tissue forming within the paratenon, resulting in a much longer recovery period and extended time away from normal activity.
Physiotherapy for paratendinopathy of the Achilles tendon.
Physiotherapy plays a vital role in the treatment of Achilles tendon paratendinopathy. Your physiotherapist will begin by assessing your condition and designing a tailored treatment programme. Treatment may include:
- Pain relief techniques – including ice therapy, ultrasound, or shockwave therapy
- Manual therapy – soft tissue massage and mobilisation to reduce tension and improve circulation
- Stretching exercises – to maintain or restore calf and Achilles flexibility
- Eccentric strengthening exercises – controlled heel-lowering programmes to strengthen the tendon
- Proprioception and balance training – to improve ankle stability and reduce risk of recurrence
- Activity modification – guidance on reducing or adjusting load while maintaining fitness
- Footwear and orthotic advice – ensuring proper heel support and reducing pressure on the tendon
- Gradual return-to-sport programmes – safe progression back to running, jumping, or high-impact activities
To arrange an appointment, please call +65 81535374 or visit acephysiosports.com.
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