Do you experience pain at the back of your heel when walking, running or climbing stairs? Does your heel feel stiff when you get out of bed in the morning or after sitting for a long time? These symptoms may be associated with Achilles tendonitis, a condition affecting the tendon that connects your calf muscles to your heel bone.
The Achilles tendon plays an important role in everyday movements such as walking, running, jumping and standing on your toes. When it becomes painful, even simple activities can become uncomfortable.
Understanding Achilles tendon problems and following an appropriate rehabilitation programme can help improve strength, movement and activity tolerance. Physiotherapy may also help you manage symptoms and gradually return to your usual activities.
What Is Achilles Tendonitis?
The Achilles tendon is a strong band of connective tissue located at the back of your lower leg. It connects the calf muscles to the heel bone and helps your foot push off the ground when walking or running.
Achilles tendonitis is a commonly used term for pain involving the Achilles tendon. Many longer-lasting cases are more accurately described as Achilles tendinopathy, which involves changes in the tendon associated with loading and its ability to tolerate physical activity.
The problem can affect different parts of the tendon:
- Midportion Achilles tendinopathy: Pain usually develops a few centimetres above the heel bone.
- Insertional Achilles tendinopathy: Pain occurs where the tendon attaches to the heel bone.
Understanding the location of your pain is important because exercise selection and rehabilitation recommendations may differ.
7 Common Symptoms of Achilles Tendonitis
Symptoms can develop gradually or become noticeable after an increase in physical activity. Common signs include:
1. Pain at the Back of the Heel
You may experience discomfort along the Achilles tendon or near its attachment to the heel bone. Pain may become more noticeable during walking, running or jumping.
2. Morning Stiffness
Your Achilles tendon may feel stiff when you first get out of bed. This stiffness may gradually ease as you begin moving.
3. Tenderness Around the Tendon
The affected area may feel sensitive when touched or pressed. Some people notice discomfort when wearing shoes that rub against the back of the heel.
4. Swelling or Thickening
The tendon may appear slightly swollen or thicker than usual. This can occur in some people with longer-lasting tendon problems.
5. Pain During Physical Activity
Running, jumping, walking uphill and climbing stairs may increase symptoms, particularly when the tendon is not accustomed to the activity level.
6. Reduced Calf Strength
You may find it difficult to rise onto your toes or perform activities that require strong push-off movements.
7. Discomfort After Exercise
Pain or stiffness may become more noticeable after physical activity or following a period of rest.
What Causes Achilles Tendonitis?
Achilles tendon problems often develop when the demands placed on the tendon exceed its current ability to manage loading.
Common contributing factors include:
- Sudden increases in exercise: Increasing running distance, speed or training intensity too quickly may overload the tendon.
- Repetitive jumping and running: Activities involving repeated push-off movements place considerable demands on the Achilles tendon.
- Insufficient recovery: Repeated demanding sessions without enough recovery may contribute to persistent symptoms.
- Reduced calf strength: Limited calf muscle capacity may affect how the lower leg manages physical demands.
- Changes in training surfaces: Suddenly changing running surfaces, hills or training conditions may alter the load placed on the tendon.
- Previous Achilles problems: A history of tendon pain may increase the likelihood of recurring symptoms.
- Footwear changes: Changes in footwear or shoe comfort may influence how the foot and ankle tolerate activity.
7 Effective Ways to Manage Achilles Tendonitis
Managing Achilles tendon pain usually involves adjusting activities and gradually rebuilding the tendon’s ability to tolerate load. The right approach depends on the location and severity of your symptoms.
1. Modify Activities That Increase Pain
Continuing high-impact activities when your tendon is significantly irritated may make symptoms harder to manage.
Consider temporarily modifying activities such as:
- Long-distance running.
- Repeated jumping exercises.
- Hill running or uphill walking.
- High-intensity court sports.
- Activities that cause significant pain during or after exercise.
You may be able to maintain fitness through suitable lower-impact activities, such as swimming or cycling, if they do not aggravate your symptoms.
The aim is to manage the load rather than avoid all movement.
2. Start With Appropriate Calf Strengthening
The calf muscles play an important role in supporting the Achilles tendon during walking, running and jumping. Gradually improving calf strength is a key part of many Achilles rehabilitation programmes.
Depending on your symptoms, suitable exercises may include:
- Seated calf raises.
- Standing calf raises with support.
- Controlled calf strengthening with resistance.
- Progressive single-leg calf raises when appropriate.
Begin at a manageable level and increase resistance gradually. If you have insertional Achilles pain, exercises that involve lowering the heel below the level of a step may aggravate symptoms and should not be introduced without appropriate guidance.
3. Manage Morning Stiffness
Morning stiffness is common in people experiencing Achilles tendon problems. Gentle movement before more demanding activities may help you feel more comfortable.
You can consider:
- Walking gently around your home before starting more demanding activities.
- Performing comfortable ankle movements.
- Avoiding sudden bursts of activity immediately after getting out of bed.
- Gradually increasing your activity as the tendon warms up.
If morning stiffness is persistent or worsening, consider seeking professional assessment.
4. Choose Comfortable and Suitable Footwear
Footwear can influence comfort during everyday activities. Shoes that rub against the heel or place excessive pressure on the painful area may aggravate symptoms.
Consider these points:
- Choose comfortable shoes that fit properly.
- Avoid footwear that repeatedly irritates the back of your heel.
- Use suitable footwear for your walking or exercise activities.
- Ask a healthcare professional whether a temporary heel lift may be appropriate.
A heel lift may help some people by reducing the amount of ankle movement required during certain activities, but it is not suitable for everyone.
5. Increase Exercise Intensity Gradually
One common challenge during Achilles tendon rehabilitation is returning to normal exercise too quickly.
To manage your activity levels:
- Start with an exercise intensity your tendon can tolerate.
- Avoid suddenly increasing running distance or speed.
- Allow adequate recovery between demanding sessions.
- Monitor symptoms during activity and the following day.
- Increase training demands gradually as strength improves.
Consistent progress is generally more useful than repeatedly pushing through significant pain.
6. Improve Ankle and Lower-Limb Strength
Achilles rehabilitation may also involve strengthening other muscles around the lower leg and foot.
Your physiotherapist may recommend:
- Foot strengthening exercises.
- Balance and stability training.
- Controlled single-leg movements.
- Hip and lower-limb strengthening.
- Functional exercises that prepare you for walking, running or sports.
The exercises should be selected according to your individual movement and strength assessment.
7. Consider Physiotherapy for a Structured Recovery Plan
If Achilles tendon pain continues or affects your daily activities, physiotherapy may help you understand the problem and develop an appropriate rehabilitation programme.
A physiotherapist may assess your walking pattern, calf strength, ankle movement, tendon tenderness and activity levels.
Your treatment plan may include:
- Progressive calf strengthening.
- Individualised ankle mobility exercises.
- Balance and lower-limb strengthening.
- Activity and training modification.
- Guidance on suitable footwear.
- Gradual return-to-running and sport-specific exercises.
The aim is to improve the tendon’s ability to tolerate everyday and sporting activities while helping you return to your preferred level of movement.
How Long Does Achilles Tendonitis Take to Recover?
Achilles tendon recovery varies depending on the severity of symptoms, the location of the problem and how long the tendon has been affected.
Some people notice improvements over several weeks, while persistent Achilles tendinopathy may require several months of progressive rehabilitation.
Recovery can take longer when the tendon has been irritated for an extended period or when activity levels repeatedly exceed its current capacity.
It is important to understand that tendon recovery is not always a quick process. Gradual improvements in strength, walking ability and exercise tolerance are useful indicators of progress.
Can You Continue Walking With Achilles Tendon Pain?
Walking may still be possible with some Achilles tendon problems. However, the amount of walking you can comfortably manage depends on the severity of your symptoms.
Consider reducing walking distance or pace if you notice significant pain, limping or increased discomfort afterwards.
If walking becomes very painful, you experience sudden weakness or you cannot push off your foot normally, seek medical assessment.
When Should You See a Physiotherapist or Doctor?
Consider professional assessment if:
- Heel pain continues despite modifying your activities.
- Morning stiffness is becoming more noticeable.
- You experience ongoing tenderness or swelling around the tendon.
- You have difficulty performing calf raises.
- Pain is affecting your walking, work or exercise routine.
- Your symptoms repeatedly return when you increase activity.
Important: Sudden sharp pain at the back of the ankle, a popping or snapping sensation, significant weakness or an inability to push off the foot may indicate an Achilles tendon rupture. Seek urgent medical assessment rather than attempting exercises or stretching.
Frequently Asked Questions About Achilles Tendonitis
1. Is Achilles tendonitis the same as Achilles tendinopathy?
The terms are often used interchangeably. However, Achilles tendinopathy is generally preferred for longer-lasting tendon problems because the condition involves changes in tendon structure and function rather than inflammation alone.
2. Can I run with Achilles tendonitis?
Some people can continue modified running, while others may need to temporarily reduce or stop running. Your decision should depend on pain, tendon strength and how symptoms respond during and after activity.
3. Are calf raises good for Achilles tendonitis?
Calf raises are commonly included in Achilles rehabilitation because they help improve calf strength and tendon-loading capacity. The exercise variation and progression should suit your symptoms and the location of the tendon problem.
4. Why is my Achilles tendon painful in the morning?
Some people experience increased tendon stiffness and discomfort after periods of rest. This may become more noticeable during the first few steps after waking up.
5. Can Achilles tendonitis heal without surgery?
Many cases of Achilles tendinopathy are managed without surgery through activity modification and progressive rehabilitation. However, a significant tendon rupture requires prompt medical assessment.
6. Should I stretch my Achilles tendon?
Stretching may be suitable for some people, but it is not always necessary and can aggravate certain types of Achilles pain, particularly insertional symptoms. A physiotherapist can help determine whether stretching is appropriate.
7. Can physiotherapy help prevent Achilles tendon pain from returning?
Physiotherapy may help improve calf strength, movement control and exercise tolerance. A gradual return to activity and appropriate training progression can also help manage the risk of recurring symptoms.
Take the First Step Towards Better Achilles Health
Achilles tendon pain can interfere with walking, running, sports and everyday activities. However, an appropriate rehabilitation approach can help improve strength, movement and confidence.
Managing activity levels, gradually strengthening the calf muscles and following a structured recovery programme are important parts of rehabilitation.
If you are experiencing persistent heel or Achilles tendon pain, PAX Physiotherapy in Modbury North, Adelaide, can help assess your symptoms and discuss suitable treatment options.
Contact our team to arrange an appointment.
PAX Physiotherapy
Unit 2, 438 Montague Road, Modbury North SA 5092
Phone: 08 8333 8333
Mobile: 0499 999 636
Email: admin@paxphysiotherapy.com.au
Website: PAX Physiotherapy
Disclaimer: This article provides general health information and is not a substitute for individual medical advice, diagnosis or treatment. Consult an appropriately qualified healthcare professional about your symptoms.
