Achilles' Tendinosis


Achilles' Tendinosis is a common condition where the calcaneal tendon becomes degenerated due to wear, tear, and a lack of repair. This differs from tendonitis in its chronicity. An Achilles' tendonitis, by definition, is an acute inflammation. This only lasts 4-6 weeks. Tendinosis is chronic and more dangerous. Unresolved Achilles' tendinosis may result in an Achilles' rupture.


You will feel Achilles' tendinosis in the back of your calf, down towards your feet. It's most commonly felt near the heel. Movements with heavy load on the foot and ankle complex will make it feel worse. Your first step out of bed in the morning will be the most painful. As your calf begins to warm-up, your Achilles' tendon may feel better, only for the pain to return after you've cooled down.


Achilles' tendinosis is a classic wear, tear, and lack of repair disease. Achilles' tendons that experience constant load without recovery will eventually degenerate. Most commonly, Achilles' tendinosis features a lack of ankle dorsiflexion. This lack of dorsiflexion puts extra load on your tendon, causing it to break down. This is common in runners, tennis players, and other field athletes.

It must also be noted that metabolism plays a huge role in the recover of tendons. Research is suggesting that tendon injuries are akin to atherosclerosis. This means that the same risk factors for heart disease are the same risk factors for tendon injuries. While you don't need to have a metabolic condition to have tendon disease, it does increase your risk.

What to expect

Home treatment

Home treatment should be focused on improving flexibility, improving strength, and improving your metabolic health.

It's best practice to measure your ankle range of motion using this test.

Then, utilize this movement with this movement. Do these consistently for 4-6 weeks and see if your range improves.

While this isn't a nutrition blog, I can give you a target to hit and a mechanism to get there. You will need a tape measure for this. Measure your waist circumference and your hip circumference. Divide your waist measurement by your hip measurement.

If you are a female, this number should be less than 0.80.

If you are a male, this number should be less than 0.95.

Until you can get under these ratios, you will be at risk for tendon pain. I know it seems ridiculous, but that's what the research suggests. Watch this video if you're interested in the research.

The aforementioned video will also feature a strength test. If you fail the strength test, simply utilize the eccentric ankle dorsiflexions until you pass.

Our intervention

At Wildcard, we focus on improving the range of motion of your ankle and regenerating your tendon with Shockwave Therapy. Here is an example of treatment to the Achilles' tendon.

Patients can expect to see a tangible improvement within a few treatments. While it is always tempting to try and grind out at-home interventions to improve your joint health, Achilles' Tendinosis, if unresolved, can cause catastrophic injury. If the at-home treatments do not work, please find professional help!

Schedule an appointment

At Wildcard Spine and Sport, we specialize in fixing pain that’s lasted longer than six months, even if you’ve seen two or more providers. We are the only practitioners in the five boroughs certified to diagnose and remove adhesion. Click the button below or call the office today at 917-908-0055.

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