What is Achilles Tendonitis?
Achilles tendonitis is a common term used for pain affecting the Achilles tendon at the back of the ankle. The condition is now often referred to as Achilles tendinopathy, particularly when symptoms have been present for some time.
The Achilles tendon connects the calf muscles to the heel bone and is exposed to high loads during walking, running and jumping. Pain may develop in the middle portion of the tendon or closer to where the tendon attaches to the heel.
Symptoms can include pain and stiffness at the back of the ankle, tenderness, swelling or thickening of the tendon. Pain may be worse when first getting up, during activity, or after an increase in walking, running or sport.
Assessment helps determine which part of the Achilles tendon is involved and whether other factors are contributing to the symptoms.
What Causes Achilles Tendon Pain?
Achilles tendon pain usually develops when the tendon is exposed to more load than it can tolerate. This can happen gradually or after a sudden increase in walking, running, jumping or sport.
Common contributing factors can include:
- a rapid increase in training volume or intensity
- hill running, speed work or repeated jumping
- reduced calf strength or ankle flexibility
- changes in footwear or training surface
- returning to activity too quickly after a break or injury
- changes in lower-limb strength or movement patterns
Achilles tendinopathy is usually influenced by a combination of factors rather than one single cause. Assessment helps identify which factors are most relevant so treatment can be targeted appropriately.
How is Achilles Tendinopathy Treated?
Treatment depends on where the tendon is painful, how long symptoms have been present, activity levels and the factors identified during assessment.
Management may include:
- temporary modification of aggravating activity while keeping the tendon moving where appropriate
- progressive calf and Achilles strengthening exercises
- mobility work when ankle movement is restricted
- footwear advice and temporary heel lifts in selected cases
- taping or other short-term symptom-relief strategies
- orthotic therapy when there is a clear clinical indication
- shockwave therapy for selected persistent cases
- a gradual return to walking, running or sport as tendon capacity improves
Achilles tendinopathy usually responds best to a progressive loading program rather than complete rest. Treatment should be adjusted to the individual, particularly when symptoms are insertional or have been present for a long time.
When Should You See a Podiatrist?
Consider an assessment if Achilles pain keeps returning, is getting worse, or is limiting walking, work, exercise or sport. Assessment is also worthwhile if there is persistent swelling or thickening of the tendon, significant morning stiffness, or symptoms that are not improving despite reducing aggravating activity. A podiatry assessment can help determine which part of the tendon is involved, identify contributing factors and guide an appropriate rehabilitation plan.
