What it is
Achilles tendinopathy is pain and reduced load tolerance in the tendon that connects the calf to the heel. Like most tendinopathies it is an overuse problem: the tendon is loaded faster than it can adapt. It usually appears either in the middle of the tendon (midportion) or where it inserts into the heel.
Why basketball players get it
Explosive push-off, jumping, and hard court surfaces all load the Achilles. Spikes in activity — a new season, more minutes, returning after a layoff — are the classic triggers. Calf weakness and stiffness contribute.
What the evidence supports
A 2026 meta-analysis of 21 randomised trials concluded that eccentric exercise can serve as a first-line treatment within load-based exercise programs: it outperforms passive modalities for pain relief and is roughly equivalent to other exercise therapies, with its distinctive benefit being tendon adaptation. Progressive calf loading (including eccentric heel drops) is therefore the core of most programs.
Typical recovery shape
Tendinopathy typically responds over weeks to months of progressive loading. Morning stiffness usually improves first. A sudden pop or a feeling of being kicked in the back of the ankle during activity is a potential rupture — seek urgent care.