The majority of Achilles’ tendon problems occur as a result of medium-to-long-term repetitive overstrain of the tendon. This typically occurs due to an increase or change in activity – or even a recent change of footwear. It is often predisposed by weakness further up the leg in the knees or hips, causing instability at the ankle joint.

Achilles problems are far less commonly caused by a one-off trauma or injury – generally as a result of the Achilles being put through excessive forces when running, jumping or landing – which can lead to an acute strain or even rupture of the tendon.