Current Clinical Concepts: Conservative Management of Achilles Tendinopathy

J Athl Train. 2020 May;55(5):438-447. doi: 10.4085/1062-6050-356-19. Epub 2020 Apr 8.


Achilles tendinopathy is a painful overuse injury that is extremely common in athletes, especially those who participate in running and jumping sports. In addition to pain, Achilles tendinopathy is accompanied by alterations in the tendon's structure and mechanical properties, altered lower extremity function, and fear of movement. Cumulatively, these impairments limit sport participation and performance. A thorough evaluation and comprehensive treatment plan, centered on progressive tendon loading, is required to ensure full recovery of tendon health and to minimize the risk of reinjury. In this review, we will provide an update on the evidence-based evaluation, outcome assessment, treatment, and return-to-sport planning for Achilles tendinopathy. Furthermore, we will provide the strength of evidence for these recommendations using the Strength of Recommendation Taxonomy system.

Keywords: exercise therapy; loading; rehabilitation; tendinitis; tendon.

Publication types

  • Review

MeSH terms

  • Achilles Tendon / injuries*
  • Achilles Tendon / pathology
  • Athletic Injuries / physiopathology
  • Athletic Injuries / therapy*
  • Conservative Treatment*
  • Cumulative Trauma Disorders / physiopathology
  • Cumulative Trauma Disorders / therapy*
  • Exercise Therapy*
  • Humans
  • Pain / etiology
  • Pain / physiopathology
  • Return to Sport
  • Running / injuries
  • Tendinopathy / pathology
  • Tendinopathy / physiopathology
  • Tendinopathy / therapy*