Achilles Tendon Problems…

Cole Gibbens

Achilles tendinopathy is one of those injuries that creeps in quietly… then suddenly makes itself very known every time your foot hits the ground. It usually starts as a bit of stiffness or tightness - especially first thing in the morning or at the start of a run - and if ignored, it gradually turns into something that just won’t settle.

At its core, it’s a load management issue. The Achilles tendon is incredibly strong and built to handle force, but like anything, it has a limit. Push it beyond what it’s currently conditioned for - whether that’s a jump in training volume, intensity, hills, or even a change in footwear - and it starts to react. Not by “snapping” or failing, but by becoming irritated, stiff, and less tolerant to load.

From an osteopathic perspective, the tendon is only part of the story. I’m looking at the calf complex, ankle mobility, foot mechanics, and how well everything above, especially the hips, is contributing. If your ankle is stiff, your calf has to work harder. If your calf is overloaded, the Achilles takes the hit. It’s a chain, and weak links show up quickly when you’re asking your body to perform.

Treatment-wise, this is where I like a more hands-on, structural approach. Working through the calf to reduce excessive tone, improving ankle movement, and, where appropriate, using joint techniques to get things moving more efficiently. It’s not about “fixing” the tendon with hands alone, it’s about creating the right environment for it to recover.

But the real gold standard here is loading. Tendons respond to the right kind of stress, not complete rest. So a big part of the plan is progressive strengthening - building the tendon’s capacity back up so it can handle running, jumping, or whatever you throw at it. Ignore that part, and it’ll keep coming back.

And speaking as a runner, I get it. You don’t want to stop - you just want it to behave. The aim isn’t to shut everything down, but to adjust things smartly so you can keep moving while actually improving the problem.

Because Achilles tendinopathies aren’t the end of your training - it’s usually just a sign that your tendon needs to catch up with your ambition.