Achilles Tendinopathy
Dry Needling for Achilles Tendinopathy | Sunbury & Melton
Achilles tendinopathy is an overuse tendon condition that causes pain and stiffness at the back of the heel. Dry needling may help reduce calf muscle tightness, improve movement and decrease pain, allowing patients to better participate in evidence-based rehabilitation exercises. At Health Wise Chiropractic in Sunbury and Melton, treatment focuses on identifying the underlying causes of tendon overload and developing an individual rehabilitation plan. Every patient responds differently, and management is tailored following a comprehensive assessment.
Achilles tendinopathy is one of the most common causes of pain at the back of the heel, particularly in runners, active individuals and people whose work involves prolonged standing or walking. It develops when the Achilles tendon becomes overloaded over time, leading to pain, stiffness and reduced function. While rest may temporarily reduce symptoms, most cases improve best with a structured rehabilitation program that addresses the underlying causes of tendon overload.
Dry needling may help some people with Achilles tendinopathy by reducing muscle tension in the calf muscles, improving movement, decreasing pain sensitivity and making it easier to perform rehabilitation exercises. It does not directly repair the tendon itself, but when combined with progressive strengthening exercises, activity modification and evidence-informed management, it may assist recovery for appropriate patients.
Early assessment is important because tendon pain often becomes more persistent if loading continues without appropriate treatment. At Health Wise Chiropractic, our practitioners assess the entire lower limb, including the foot, ankle, calf, knee and hip, to identify contributing factors. Patients visiting our Sunbury and Melton clinics receive an individualised treatment plan based on their symptoms, goals and current clinical evidence to help them return safely to work, sport and everyday activities.
What Is This Condition?
What Is Achilles Tendinopathy?
Achilles tendinopathy is a painful condition affecting the Achilles tendon—the thick, strong tendon connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It is the largest tendon in the human body and plays a critical role in walking, running, jumping and climbing stairs by transmitting force from the calf muscles to the foot.
Although it was once commonly referred to as "Achilles tendonitis," research has shown that many long-standing cases involve relatively little inflammation. Instead, the tendon undergoes changes to its collagen structure, increased water content, altered tendon cells and the growth of small blood vessels and nerves. For this reason, the preferred medical term is Achilles tendinopathy, reflecting the broader spectrum of tendon changes rather than inflammation alone.
Achilles tendinopathy generally develops because the tendon is exposed to more load than it can tolerate over time. Rather than resulting from a single injury, it usually occurs after repeated stress that exceeds the tendon's ability to recover. This explains why symptoms often develop gradually over weeks or months.
The condition commonly affects:
Recreational and competitive runners
Football, basketball and netball players
Tennis players
People beginning a new exercise program
Individuals returning to sport after a break
Workers who stand or walk for long periods
Adults between 30 and 60 years of age
There are two main types of Achilles tendinopathy.
Mid-portion Achilles Tendinopathy
This is the most common form and affects the tendon approximately 2–7 centimetres above its attachment to the heel bone. This region has relatively lower blood supply and experiences substantial loading during running and jumping.
Insertional Achilles Tendinopathy
Insertional tendinopathy occurs where the tendon attaches to the heel bone. It may occur alongside irritation of the surrounding bursa or the development of small bony spurs. Certain exercises require modification in these cases to avoid excessive compression of the tendon.
Acute versus Chronic Achilles Tendinopathy
Early (acute) Achilles tendinopathy may develop after a sudden increase in training volume, hill running, sprinting or repetitive loading. Symptoms often include pain during or after activity and mild morning stiffness.
Persistent (chronic) Achilles tendinopathy develops when tendon overload continues without adequate recovery. Over time, pain may occur with everyday walking, prolonged standing and even at rest in more severe cases. Chronic symptoms often require a longer rehabilitation program.
Common symptoms include:
Pain at the back of the heel
Morning stiffness
Pain during running or jumping
Tenderness when squeezing the tendon
Thickening of the tendon
Reduced calf strength
Difficulty pushing off while walking
Pain after prolonged activity
One hallmark feature is that the tendon often feels stiff first thing in the morning or after periods of sitting, before gradually loosening as movement continues.
Achilles tendinopathy differs from other causes of heel pain. For example, plantar fasciitis typically causes pain under the heel rather than behind it, while calf muscle strains usually present with sudden pain higher in the lower leg. Irritation of nearby nerves may also produce burning, tingling or numbness, which is not typical of Achilles tendinopathy.
The prognosis is generally favourable with appropriate management, but recovery requires patience. Tendons adapt more slowly than muscles, and meaningful improvements often occur over several months rather than weeks. Most people improve with conservative treatment that combines education, progressive loading exercises, activity modification and management of contributing factors.
A thorough assessment is important because other conditions—including partial tendon tears, inflammatory arthritis, bursitis or referred pain from the lumbar spine—can produce similar symptoms. Sudden severe pain accompanied by a "pop," marked weakness or an inability to stand on tiptoes may indicate an Achilles tendon rupture, which requires urgent medical assessment.
Understanding the nature of Achilles tendinopathy helps guide effective treatment. Rather than complete rest, modern evidence supports carefully controlled loading to encourage tendon adaptation while avoiding excessive strain. When combined with appropriate therapies such as dry needling where indicated, rehabilitation aims to reduce pain, improve function and gradually restore confidence in everyday activities and sport.
Symptoms
Symptoms of Achilles tendinopathy often develop gradually rather than after a single injury. They may fluctuate depending on activity levels, with pain commonly easing during movement before returning afterwards.
Common symptoms include:
Pain at the back of the heel or lower calf, particularly during or after activity
Morning stiffness in the Achilles tendon that improves with gentle movement
Tenderness when pressing or squeezing the tendon
Pain when walking uphill, climbing stairs or pushing off the toes
Thickening or swelling of the Achilles tendon
Reduced calf strength, particularly during single-leg calf raises
Stiffness after prolonged sitting or inactivity
Pain during running, jumping or sporting activities
Discomfort that worsens after increasing training intensity or duration
Reduced ankle flexibility or difficulty fully bending the ankle upward (dorsiflexion)
A feeling that the tendon is "tight" or "restricted"
Persistent symptoms lasting weeks or months if left untreated
Seek urgent medical attention if you experience a sudden "pop" in the back of the ankle, immediate severe pain, rapid swelling or difficulty walking or standing on your toes, as these may indicate an Achilles tendon rupture.
Who May Benefit from Dry Needling?
Dry needling may be appropriate for people with:
Persistent Achilles tendon pain
Tight calf muscles
Myofascial trigger points
Reduced ankle mobility
Difficulty progressing rehabilitation because of pain
Recurrent Achilles symptoms
Sports-related tendon pain
Occupational tendon overload
Patients who respond best often have muscular tightness contributing to their symptoms rather than tendon pathology alone.
Who May Not Be Suitable?
Dry needling is not appropriate for everyone.
It may not be recommended for patients with:
Needle phobia
Active skin infections
Certain bleeding disorders
Significant anticoagulant use (depending on individual circumstances)
Localised swelling suggestive of infection
Certain stages of pregnancy in specific anatomical regions
Medical conditions where needling is contraindicated
Your chiropractor will discuss your medical history before recommending treatment.
What Happens During Your Appointment?
At Health Wise Chiropractic, your first appointment is designed to identify the underlying causes of your Achilles pain rather than simply treating the symptoms. Every treatment plan is tailored to your individual needs, goals and activity levels.
Comprehensive History
Your chiropractor will begin by asking questions about:
When your symptoms started
How the pain developed
Activities that aggravate or relieve your symptoms
Your work and sporting activities
Previous injuries or surgeries
Current exercise routine
Footwear and training habits
General medical history and medications
This information helps determine whether your symptoms are consistent with Achilles tendinopathy or another condition requiring different management.
Physical Examination
A detailed examination may include:
Observing your standing posture and walking pattern
Assessing calf muscle strength and endurance
Measuring ankle range of motion
Palpating the Achilles tendon to identify tenderness or thickening
Performing functional tests such as single-leg calf raises
Assessing balance and lower limb control
Evaluating foot posture and biomechanics
Examining the knees, hips and lower back where appropriate
If your symptoms suggest another condition, referral for further medical assessment or imaging may be recommended.
Individualised Assessment
Following the examination, your chiropractor will explain:
The likely diagnosis
Factors contributing to your symptoms
Whether dry needling is appropriate
Expected recovery time
Recommended treatment options
Rehabilitation goals
You'll have the opportunity to ask questions and discuss the most suitable management plan.
Dry Needling Treatment
If clinically appropriate and with your consent, dry needling may be performed during your appointment.
Treatment typically involves:
Cleaning the skin
Inserting sterile, single-use needles into targeted calf muscles or myofascial trigger points
Leaving the needles in place briefly or using gentle manual stimulation, depending on the treatment approach
Monitoring your comfort throughout the procedure
Most patients describe the sensation as a mild ache, muscle twitch or feeling of pressure rather than significant pain.
Additional Treatment
Depending on your assessment findings, your treatment plan may also include:
Exercise rehabilitation
Calf strengthening
Mobility exercises
Soft tissue therapy
Joint mobilisation where appropriate
Activity modification advice
Education about tendon loading
Return-to-running guidance
Aftercare
Following treatment, you may experience:
Mild muscle soreness for 24–48 hours
Temporary bruising at needle sites
A feeling of muscle relaxation
Improved movement
Your chiropractor may recommend:
Staying well hydrated
Gentle walking or light movement
Avoiding strenuous exercise for the remainder of the day if advised
Completing your prescribed rehabilitation exercises
Gradually increasing activity according to your personalised program
Because Achilles tendinopathy responds best to progressive loading, ongoing rehabilitation and regular reassessment are often important components of successful recovery.
Home Care & Exercises
Exercise-based rehabilitation is considered the most effective conservative treatment for Achilles tendinopathy. While dry needling may help reduce pain and muscle tension, long-term improvement depends on gradually improving the tendon's ability to tolerate load.
Your chiropractor will prescribe exercises appropriate for your stage of recovery. The following beginner-friendly exercises are commonly recommended, but they should be modified if they significantly increase your pain.
A mild increase in discomfort during or shortly after exercise is often acceptable, provided symptoms settle within 24 hours. Sharp pain or worsening symptoms should be discussed with your healthcare provider.
1. Double-Leg Calf Raises
Purpose:
Improve Achilles tendon strength and increase the tendon's capacity to tolerate everyday activities.
Instructions:
Stand holding a bench, wall or chair for balance.
Slowly rise onto both toes.
Pause for 2–3 seconds.
Slowly lower back down.
Keep movements controlled.
Repetitions: 10–15 repetitions
Sets: 3
Frequency: Once daily
Progression:
Increase the height of the heel raise.
Slow the lowering phase.
Progress to single-leg calf raises when comfortable.
2. Isometric Calf Holds
Purpose:
Reduce tendon pain while maintaining calf muscle strength.
Instructions:
Rise onto both toes.
Hold the position without bouncing.
Maintain steady breathing.
Slowly lower.
Hold: 30–45 seconds
Repetitions: 4–5 holds
Frequency: Daily or before exercise
Progression:
Increase the hold time or perform on one leg as symptoms improve.
3. Gastrocnemius Stretch
Purpose:
Improve calf flexibility and ankle mobility.
Instructions:
Stand facing a wall.
Place the affected leg behind you.
Keep the back knee straight.
Keep the heel flat on the floor.
Lean forward until a gentle stretch is felt.
Hold: 30 seconds
Repetitions: 3
Frequency: 2–3 times daily
Progression:
Gradually increase the stretch without forcing the movement.
4. Soleus Stretch
Purpose:
Target the deeper calf muscle (soleus), which also loads the Achilles tendon.
Instructions:
Stand facing a wall.
Place the affected leg behind.
Bend both knees.
Keep the back heel on the floor.
Lean forward until a stretch is felt lower in the calf.
Hold: 30 seconds
Repetitions: 3
Frequency: 2–3 times daily
Progression:
Increase the depth of the stretch as flexibility improves.
5. Single-Leg Balance
Purpose:
Improve ankle stability, balance and lower limb control.
Instructions:
Stand on the affected leg.
Keep your hips level.
Maintain a slight bend in the knee.
Balance without holding on if possible.
Hold: 30–60 seconds
Repetitions: 3
Frequency: Daily
Progression:
As balance improves, try:
Closing your eyes
Standing on a cushion
Turning your head
Performing gentle calf raises while balancing
General Home Care Advice
Recovery is usually improved by combining exercise with healthy tendon-loading habits.
Helpful strategies include:
Gradually increase activity rather than making sudden changes.
Warm up before running or sport.
Avoid pushing through severe pain.
Wear supportive footwear appropriate for your activity.
Ice may help reduce pain after exercise if symptoms flare.
Stay physically active within comfortable limits.
Follow your rehabilitation program consistently.
Prevention Tips
Although Achilles tendinopathy cannot always be prevented, many cases can be avoided by managing training loads, maintaining lower limb strength and addressing contributing factors early.
Increase Activity Gradually
One of the most common causes of Achilles tendinopathy is doing too much too soon.
Aim to:
Increase running distance gradually.
Avoid sudden increases in speed or hill training.
Build up new exercise programs progressively.
Allow adequate recovery between intense sessions.
Maintain Strong Calf Muscles
Strong calf muscles help absorb force and reduce stress on the Achilles tendon.
Include regular:
Heel raises
Heavy calf strengthening
Balance exercises
Functional lower limb strengthening
Strength training should continue even after symptoms improve to reduce the risk of recurrence.
Improve Ankle Mobility
Restricted ankle movement can increase tendon loading.
Maintain mobility through:
Regular calf stretching
Ankle mobility exercises
Foam rolling where appropriate
Addressing joint stiffness if present
Wear Appropriate Footwear
Supportive footwear should suit your activity and individual biomechanics.
Replace running shoes when worn, and consider professional advice if you're unsure whether your footwear is contributing to your symptoms.
Optimise Your Running Technique
For runners, factors such as training volume, cadence and stride length may influence tendon loading.
A gradual return-to-running program and, where appropriate, running technique assessment may help reduce excessive stress on the Achilles tendon.
Manage Workplace Loads
If your job involves prolonged standing or walking:
Wear supportive footwear.
Alternate tasks where possible.
Take regular movement breaks.
Perform calf stretches during the day.
Avoid standing in one position for extended periods.
Maintain Overall Fitness
Cross-training activities such as cycling, swimming or strength training can help maintain fitness while reducing repetitive stress on the Achilles tendon.
Prioritise Recovery
Healthy tendons recover better when supported by:
Adequate sleep
Good nutrition
Proper hydration
Planned recovery days
Gradual return after injury
Listen to Early Warning Signs
Morning stiffness, calf tightness or mild Achilles discomfort should not be ignored.
Seeking early assessment may prevent symptoms progressing into a longer-term condition that requires more extensive rehabilitation.
Individualised Prevention
Every person's biomechanics, activity levels and goals are different. At Health Wise Chiropractic, prevention strategies are tailored following a comprehensive assessment to address the factors most relevant to you, helping reduce the likelihood of future flare-ups while supporting long-term tendon health.
Achilles tendinopathy is one of the most common tendon conditions affecting physically active Australians, although precise national prevalence figures are limited.
Current evidence indicates:
Approximately 6–18% of recreational runners will develop Achilles tendinopathy during their lifetime.
Achilles tendon injuries account for a significant proportion of lower limb overuse injuries seen in running and jumping sports.
Tendinopathies collectively affect millions of Australians each year and are a frequent reason for visits to physiotherapists, chiropractors, sports physicians and GPs.
Running-related injuries account for around 30–75% of all running injuries, with the Achilles tendon among the most commonly affected structures.
Middle-aged adults remain one of the highest-risk groups, particularly those returning to exercise after periods of inactivity.
Men appear to develop Achilles tendinopathy slightly more often than women, although the condition affects both sexes.
Workplace occupations involving prolonged standing and walking may increase tendon loading and contribute to symptoms.
Musculoskeletal conditions remain one of Australia's leading causes of disability and healthcare utilisation, according to the Australian Institute of Health and Welfare (AIHW).
Although Achilles tendinopathy can become persistent if ignored, most people improve with evidence-based conservative management that includes progressive loading exercises and modification of aggravating activities.
What Does the Evidence Say?
Current research suggests dry needling may provide short-term improvements in pain and function for some people with lower limb tendinopathies, particularly when muscular dysfunction is present. However, the quality of evidence specifically for Achilles tendinopathy remains limited, and results vary between individuals.
Clinical guidelines consistently recommend progressive loading exercises as the foundation of treatment, with adjunct therapies such as dry needling considered on a case-by-case basis. Dry needling should therefore be used to complement, rather than replace, an active rehabilitation program.
At Health Wise Chiropractic, treatment plans are based on the best available evidence, clinical experience and your individual assessment. Our goal is not only to reduce pain but also to improve tendon capacity, restore strength and help reduce the risk of future flare-ups through a personalised rehabilitation program.
Frequently Asked Questions
1. Can dry needling cure Achilles tendinopathy?
No. Dry needling is not considered a cure. It may help reduce pain and muscle tightness, making it easier to complete the strengthening exercises that are considered the foundation of recovery.
2. Is dry needling painful?
Most people experience a brief ache, muscle twitch or feeling of pressure. Mild soreness for 24–48 hours afterwards is common and usually settles without treatment.
3. How many dry needling sessions will I need?
The number of sessions varies depending on your symptoms, how long you've had the condition and how you respond to treatment. Your chiropractor will review your progress regularly and adjust your treatment plan accordingly.
4. Should I stop exercising if I have Achilles tendinopathy?
Not usually. Complete rest is rarely recommended. Instead, activities are often modified while a progressive strengthening program is introduced to help the tendon adapt safely.
5. Can I keep running?
Some people can continue running with adjustments to training volume or intensity, while others may need a temporary reduction in activity. This decision is based on your symptoms and assessment findings.
6. Is dry needling the same as acupuncture?
No. Dry needling is based on modern anatomy, biomechanics and pain science, whereas acupuncture is based on Traditional Chinese Medicine principles.
7. Do I need an ultrasound or MRI?
Not always. Achilles tendinopathy can often be diagnosed through a detailed history and physical examination. Imaging may be recommended if the diagnosis is unclear or symptoms are not improving as expected.
8. What happens if Achilles tendinopathy is left untreated?
Without appropriate management, symptoms may become more persistent, making everyday activities and sport increasingly difficult. Early assessment often leads to better outcomes.
9. When should I seek urgent medical attention?
Seek immediate medical assessment if you experience a sudden "pop" in the back of your ankle, significant swelling, severe pain or an inability to stand on your toes, as these may indicate an Achilles tendon rupture.
10. Can Achilles tendinopathy come back?
Yes. Recurrence is possible if contributing factors such as training errors, calf weakness or poor load management are not addressed. Ongoing strengthening and gradual progression of activity can help reduce the risk.
Why Choose Health Wise Chiropractic?
At Health Wise Chiropractic, we believe successful management of Achilles tendinopathy involves more than simply treating the painful area. Our experienced practitioners perform a comprehensive assessment to identify the factors contributing to your symptoms, including tendon loading, calf strength, ankle mobility, biomechanics and activity levels.
Our approach is evidence-informed and tailored to your individual needs. Where appropriate, your treatment plan may include dry needling, chiropractic care, soft tissue therapy, rehabilitation exercises and practical advice to help you return safely to work, recreation and sport.
We place a strong emphasis on patient education, progressive rehabilitation and long-term injury prevention, ensuring you understand your condition and how to manage it effectively.
With convenient online bookings and clinics located in Sunbury and Melton, we're committed to providing personalised musculoskeletal care that supports your recovery while helping you achieve your long-term health and activity goals.
Field: Related Services
Patients with Achilles tendinopathy may also benefit from other evidence-informed services available at Health Wise Chiropractic, depending on their assessment findings.
Related services include:
Shockwave Therapy for persistent tendon pain where clinically appropriate
Chiropractic Care to improve lower limb biomechanics and joint mobility
Sports Massage Therapy to address calf muscle tightness and soft tissue restrictions
Exercise Rehabilitation Programs focusing on progressive tendon loading and strength
Custom Rehabilitation Programs for return to running and sport
Laser Therapy where appropriate as part of a multimodal treatment approach
Dry Needling for associated calf muscle trigger points and muscular dysfunction
Injury Prevention Assessments to identify factors contributing to recurrent tendon overload
Take the First Step Towards Recovering from Achilles Tendinopathy
If you're experiencing persistent pain or stiffness at the back of your heel, early assessment can help identify the cause and guide the most appropriate treatment. At Health Wise Chiropractic, our experienced practitioners provide comprehensive assessments and personalised management plans based on the latest evidence and your individual goals. Whether your symptoms developed through running, sport, work or everyday activities, we'll work with you to improve tendon function, reduce pain and support a safe return to the activities you enjoy. With convenient online bookings and clinics in Sunbury and Melton, we're here to help you move with greater confidence. Book your assessment today or contact our friendly team to discuss whether dry needling is appropriate for your Achilles tendinopathy.