Shockwave Therapy for Achilles Tendon Pain
Updated: Nov 2
Achilles tendon pain is one of those injuries that seems to linger. It nags in the morning, slows you down in training, and makes even everyday activities uncomfortable. You may have tried rest, stretching, massage, or new shoes, only to find the pain keeps coming back.
At My Family Podiatry we see this often. One treatment we use for stubborn Achilles pain is shockwave therapy. We use both radial and focused shockwave therapy, choosing based on where along the tendon your pain is. Before we begin, we can use in-clinic diagnostic ultrasound to assess the tendon and guide treatment.
Understanding Achilles Tendon Pain
The Achilles tendon connects your calf muscles to your heel bone. It is the largest tendon in the body, but it is also one of the most prone to overuse injuries.
Symptoms of Achilles tendinopathy include:
Pain or stiffness in the back of the heel, especially in the morning.
Tenderness when squeezing the tendon.
Pain during or after running, jumping, or climbing stairs.
Swelling or thickening of the tendon.
Pain when pushing off during walking or sport.
Some people feel pain right at the heel bone (the tendon insertion), while others feel pain higher up through the middle of the tendon. Treatment needs to account for where the pain is coming from.
The Role of Diagnostic Ultrasound
We can use diagnostic ultrasound in the clinic to examine your Achilles tendon.
Ultrasound allows us to:
Confirm whether the tendon has degeneration or small tears.
See if there is swelling, thickening, or nodule formation.
Identify whether the problem is in the middle of the tendon or at the insertion where it attaches to the bone.
Monitor progress over time as treatment continues.
This information helps us decide whether radial or focused shockwave suits you, and allows us to target treatment precisely where it is needed.
Why Standard Treatments Sometimes Aren’t Enough For Achilles Tendon Pain
Conservative care is always the first step:
Load management (adjusting training volumes).
Calf strengthening and eccentric exercises.
Supportive footwear and orthotics.
Calf stretching for some people. Deep stretches can aggravate insertional pain, so we guide this.
These approaches often help, but some long-standing cases do not settle with a well-run exercise program alone. That is where shockwave therapy can be added.
How Shockwave Therapy Works
Shockwave therapy delivers energy waves into the tissue. These acoustic waves create a controlled microtrauma that stimulates healing. The treatment helps to:
Increase blood flow.
Stimulate tendon remodelling.
Encourage new collagen formation.
Reduce pain signals.
Patients usually describe the feeling as a strong pulsing or tapping sensation. Sessions are short and most people go straight back to normal activities.
Radial Shockwave Therapy
Radial shockwave spreads energy outward in a wider, less focused pattern. It is commonly used for:
The calf muscles.
The mid-portion of the Achilles tendon.
General stiffness and tightness higher up the leg that may be feeding into Achilles pain.
We often use radial shockwave as part of treatment when there is significant calf tightness or when pain is located in the thick middle section of the tendon.
Focused Shockwave Therapy
Focused shockwave delivers energy with precision to a specific point. It penetrates deeper and is especially useful for:
Insertional Achilles tendinopathy (where the tendon attaches to the heel bone).
Chronic, localised pain that hasn’t improved with other care.
Targeting areas of nodule formation or calcification.
Insertional pain can be particularly stubborn because of the stress placed on the tendon attachment during walking and running. Focused shockwave allows us to deliver treatment directly to the problem area while limiting the effect on surrounding tissue.
Combining Radial and Focused Shockwave
Having both available means we can use radial shockwave for calf tightness and diffuse tendon pain, and focused shockwave for insertional or persistent problem spots, often in the same session.
Using ultrasound to guide decisions helps us match the treatment to your tendon.
What to Expect During Treatment
Each session lasts around 5–10 minutes for shockwave before moving into strapping, exercise prescription or any other therapy needed.
Most patients require 3–6 sessions, spaced weekly.
The intensity is adjusted to your tolerance.
Some discomfort during treatment is normal, but it settles quickly.
You can walk immediately afterwards and continue normal daily activity.
We’ll often combine shockwave with strengthening programs and load management to build tendon capacity, which is the main driver of long-term improvement.
Benefits of Shockwave Therapy for Achilles Tendinopathy
Non-invasive and needle-free.
Can be used for both mid-portion and insertional pain.
Guided by diagnostic ultrasound for precision.
An option when progress with exercise has plateaued.
Researched for both mid-portion and insertional Achilles tendinopathy.
Used alongside, not instead of, a strengthening program.
When to Seek Help For Achilles Pain
If your Achilles pain has lasted more than two weeks, is worse in the morning, or has not improved with basic care, it’s time to get assessed. Early treatment is easier, but even long-standing Achilles problems can improve with the right combination of care, ultrasound-guided diagnosis, and shockwave therapy.
Achilles tendon pain can be stubborn, but it doesn’t have to keep you sidelined. At My Family Podiatry we use diagnostic ultrasound to assess the tendon and guide treatment. We then use both radial shockwave therapy and focused shockwave therapy to treat the calf, the mid-portion of the Achilles, and the insertion at the heel. This allows us to tailor treatment to your exact condition and help you get back to comfortable activity.
If you are tired of living with Achilles pain, book your consultation with My Family Podiatry using the button below, or call 07 3088 6116.
