The most common causes are sudden increases in activity (new running programme, hill walking, ramping up training), tight calf muscles, poor biomechanics (flat feet, high arches, overpronation), unsupportive footwear, running on hard surfaces and being middle-aged or older. Sometimes a single misstep or unaccustomed sport triggers an acute episode.

Classic symptoms are pain and stiffness in the lower calf or back of the heel, especially first thing in the morning and after sitting still. Pain typically eases with gentle movement but flares with prolonged activity, hills or running. You may feel a thickening of the tendon, tenderness when pressed and reduced calf flexibility. Severe cases have visible swelling.

Diagnosis is usually straightforward at a clinical examination. The podiatrist palpates the tendon to locate the painful area, assesses your calf flexibility, checks how you walk and looks at your footwear. Imaging (ultrasound or MRI) is sometimes useful for severe or non-responding cases to assess tendon damage and rule out a partial tear.

We combine the treatments with the strongest evidence base:

• Focused shockwave therapy to stimulate tendon healing
• Eccentric loading exercises (the gold-standard exercise approach)
• Manual therapy and stretching for tight calves
• Custom orthotics to offload the tendon and correct biomechanics
• Footwear advice and activity modification
• A structured return-to-activity plan

We tailor the mix to your specific case at your first appointment.

Acute cases (less than 6 weeks of symptoms) often resolve in 3 to 6 weeks. Chronic cases (more than 3 months) typically need 8 to 12 weeks of treatment for meaningful improvement. The eccentric loading programme runs for 12 weeks regardless. We see most patients weekly to fortnightly during the active treatment phase.

Usually not for straightforward cases. Imaging is most useful when symptoms are severe, atypical or not responding as expected. Ultrasound is the most useful imaging for Achilles tendinitis as it shows tendon thickness, any tears and inflammation in real time. We'll discuss imaging with you if it's the right next step.

Common aggravating factors: continuing to run or push through the pain, hill walking and stair climbing, hard or unsupportive footwear, skipping the warm-up before activity, sudden increases in training load, tight unstretched calves and standing on hard floors for long periods.

Several things make a real difference:

• Daily calf stretching (both gastrocnemius and soleus)
• The eccentric heel-drop programme we'll teach you
• Use heel inserts to take pressure off the tendon
• Ice the tendon for 10 to 15 minutes after activity
• Reduce hill walking, stairs and running while the tendon is healing
• Keep gently moving (movement helps; total rest doesn't)

Yes, recurrence is common if the underlying causes aren't addressed. Around 30 percent of cases recur if treated symptomatically without addressing biomechanics, footwear, training load and calf flexibility. Once you know what triggered yours and address it, the recurrence rate drops dramatically. We'll cover this at your final review.

Achilles tendinitis is not life-threatening but it can become disabling if left untreated. Severe untreated cases can lead to partial or complete tendon rupture, which requires surgical repair and months of recovery. Early treatment is much easier than late treatment. Don't push through the pain hoping it will resolve on its own.

Most patients notice some improvement within 2 to 3 weeks of starting the right treatment combination. Significant improvement typically by 6 to 8 weeks. Full return to running or sport usually 10 to 12 weeks for chronic cases. Acute cases can be back to normal activity in 4 to 6 weeks. We'll give you a realistic timeline at your first appointment.

For your first appointment, allow up to 60 minutes. This gives us enough time for a thorough history, examination and treatment in the same visit. Follow-up treatments are typically up to 30 minutes for the vast majority of cases. We'll confirm the exact length when you book.

No. You can book a podiatry appointment directly with us with no GP referral needed. We can write to your GP after your appointment if there's anything they should know.

Wear something comfortable that's easy to roll up to the knee. Bring the shoes you wear most often (we'll often look at how they're wearing for biomechanical clues). If you've had any imaging or test results related to your feet, bring those too. Otherwise just bring yourself.

Podiatry & chiropody is available at our Great Dunmow clinic at 12 Stortford Road, CM6 1DA. The clinic has on-site disabled parking available on request. Just give us a call ahead of your appointment.