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  • Writer's pictureLuke Nelson

"Why is my Achilles tendon so thick?"

Updated: Jul 15, 2021

This is a question often posed to us by those that are either currently experiencing Achilles tendinopathy, or may have in the past. So what does a thick tendon mean?

Our response to this question is: "It's our bodies' amazing ability to adapt!"

You see when a tendon undergoes tendinopathic changes, the core of the tendon may be in disrepair, but the body responds to this by layering new tissue around it, & thereby thickening the tendon. This is what tendon researcher Sean Docking refers to as "the donut & the hole" analogy. Optimal management for tendinopathy then focuses on building up the "donut" & not worrying so much about the "hole".

In the first image above, we see thickening of the right tendon in both patients, the second image shows an ultrasound of a tendinopathic tendon which demonstrates this "donut" appearance.

Interestingly, a recent study by Corrigan et al earlier this year, found that those with thicker Achilles tendons had WORSE symptoms & calf muscle function at 1 year after imaging.

Our take on this? It's important to recognize that tendon thickness is something that is NOT used to determine progress. Your pain & function are more important than what your tendon looks like. So to summarize, don't worry about the thickness of the tendon, but ensure you properly rehab it :)

If you need help with your Achilles issues, please don't hesitate to contact us!

#achilles #tendinopathy #achillestendonitis #achillesrehab #achillestendon #achillesrecovery #achillestendinopathy #calf #strongtendon #running #runninginjury #rehab #chiropractic #sportschiropractic


  • Corrigan, P., et al. (2020). "Tendon Morphology and Mechanical Properties Are Associated With the Recovery of Symptoms and Function in Patients With Achilles Tendinopathy." Orthopaedic Journal of Sports Medicine 8(4): 2325967120917271.

  • Docking, S. I. and J. Cook (2019). "How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development: A narrative review." J Musculoskelet Neuronal Interact 19(3): 300-310.


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