Achilles Tendinopathy
Achilles tendon pain can make walking, running, stairs and other everyday movement feel more difficult than usual.
The Achilles tendon sits at the back of the ankle and connects the calf muscles to the heel bone. When this area becomes irritated or overloaded, it can lead to pain, stiffness, swelling or reduced function.
An assessment can help identify what may be placing strain on the tendon, whether your symptoms fit with Achilles tendonitis or tendinopathy and what the most suitable next step may be.
What is Achilles tendonitis or Achilles tendinopathy?
Achilles tendonitis, Achilles tendinitis and Achilles tendinopathy are terms often used to describe pain or irritation in the Achilles tendon.
“Tendonitis” or “tendinitis” usually suggests inflammation of a tendon. “Tendinopathy” is often used more broadly for tendon pain, irritation or changes in tendon function, especially when symptoms have been present for longer.
The Achilles tendon helps you push off when walking, running, jumping or climbing stairs. If the tendon is asked to do more than it can currently tolerate, symptoms may develop.
Pain may be felt where the tendon joins the heel bone, slightly higher up the tendon or through the lower calf. The exact location, pattern and behaviour of your symptoms can help guide assessment.
Common symptoms of Achilles tendonitis or tendinopathy
Achilles symptoms can vary depending on how irritated the tendon is and where the discomfort is located.
You may notice:
- Pain at the back of the heel
- Pain in the Achilles tendon
- Stiffness first thing in the morning
- Tenderness when squeezing the tendon
- Swelling or thickening around the tendon
- Pain when walking uphill
- Pain when running
- Discomfort when climbing stairs
- Symptoms that ease during activity, then ache afterwards
- Reduced confidence pushing off through the foot
You do not need to be certain whether you have Achilles tendonitis, Achilles tendinopathy or another cause of heel pain before booking. Assessment helps to clarify what may be happening.
What can contribute to Achilles tendon pain?
Achilles tendon pain is often linked to load.
This means the amount of force the tendon is being asked to manage during walking, running, jumping or sport. Symptoms may start after a clear change, but they can also build gradually.
Possible contributing factors include:
- A sudden increase in running, walking or jumping
- Returning to sport after a break
- Hill running or speed work
- Calf tightness or weakness
- Foot posture
- Biomechanics
- Footwear changes
- Training surface changes
- Reduced recovery
- Previous foot, ankle or lower-limb injury
- Age, weight or some health factors
The painful area is important, but it is not always the full story. How your foot, ankle, calf and lower limb work together can influence how the Achilles tendon is loaded.
Achilles tendonitis, tendinitis and tendinopathy: what is the difference?
The names can be confusing.
Achilles tendonitis and Achilles tendinitis are often used by patients to describe pain, soreness or inflammation around the Achilles tendon. Tendinopathy is a broader clinical term that can describe tendon pain, irritation or impaired tendon function.
The exact label matters less than understanding what is contributing to your symptoms. Your assessment will look at how the tendon is behaving, what loads it is coping with and whether anything else may need to be ruled out.
When should you get Achilles tendon pain assessed?
It is sensible to arrange an assessment if Achilles tendon pain is affecting walking, running, sport or daily activity.
Assessment may be helpful if:
- Pain keeps returning
- Morning stiffness is persistent
- Symptoms are affecting walking or stairs
- Running brings the pain on
- The tendon feels swollen, thickened or tender
- Pain has not improved with sensible self-care
- You are unsure whether it is Achilles tendinopathy or another heel problem
- You are considering insoles or orthoses
- You have changed footwear but symptoms continue
- You have diabetes and foot pain
- You have tingling, numbness or altered sensation
Please seek urgent medical help if you feel a sudden pop or snap in the Achilles, cannot push off the foot, cannot walk normally after an injury, notice sudden swelling or deformity, or have signs of infection such as spreading redness, fever, pus or a deep wound.
How Stuart assesses Achilles tendonitis and tendinopathy
Your appointment is designed to understand your symptoms and the demands being placed on the Achilles tendon.
Stuart may assess:
- Where your Achilles pain is located
- When your symptoms started
- What makes the pain better or worse
- Achilles tendon tenderness, swelling or thickening
- Calf strength and flexibility
- Foot and ankle movement
- Foot posture
- Walking or running gait where appropriate
- Footwear and work shoes
- Training load and activity changes
- Previous injuries or treatment
- Whether rupture, tear or another concern needs referral
Gait analysis may be useful if your Achilles pain appears linked to walking, running or recurring loading patterns. A biomechanical assessment may also help if foot posture, calf function or lower-limb mechanics seem relevant.
Stuart will explain the findings clearly, so you understand what may be contributing to your Achilles tendon pain and which options may be suitable.
Achilles tendonitis treatment options
Achilles tendonitis treatment depends on your symptoms, assessment findings, tendon irritability, activity level and goals.
A plan may include:
- Load management
- Activity modification
- Footwear advice
- Strengthening guidance
- Mobility or flexibility work
- Gait or movement advice
- Biomechanical assessment
- Foot orthoses if suitable
- Referral for imaging or onward care
Treatment is not about simply pushing through pain or stopping activity indefinitely. The aim is to understand what the tendon can currently tolerate and build a practical plan from there.
Orthoses are not needed for everyone. If Stuart thinks they may help support foot function, reduce strain or manage loading, he will explain why and talk through the options.
Achilles pain and running
Running places repeated load through the Achilles tendon.
Symptoms may appear after increasing distance, adding hills, changing pace, switching shoes or returning after time away. Some runners notice stiffness at the start of a run that eases, then discomfort later in the day or the following morning.
Stuart is a runner himself, so he understands how frustrating Achilles pain can be when it interrupts training. Your assessment may look at your running history, footwear, gait, calf strength, recovery and how your training load is being managed.
The goal is to guide practical next steps so you can return to activity where appropriate, without ignoring the factors that may have contributed to the problem.
Achilles heel pain
People often describe pain at the back of the heel as “Achilles heel” pain. This may be linked to the Achilles tendon itself, irritation where the tendon joins the heel bone or another structure around the back of the heel. Pain in this area can feel worse in certain shoes, during hills or stairs, or after activity.
The location of your pain helps guide assessment. Pain at the tendon insertion may need a slightly different approach from pain higher up the tendon, so it is worth having the area assessed properly if symptoms persist.
Other tendon pain around the foot and ankle
Not all tendon pain around the ankle is Achilles tendinopathy. Peroneal tendonitis, posterior tibial tendon irritation and extensor tendon problems can also cause discomfort around the foot or ankle. The location of pain, type of activity that triggers it and the way your foot loads can help separate one issue from another.
If your pain is not clearly at the back of the heel or Achilles tendon, Stuart can assess the wider foot and ankle to help identify what may be involved.
Podiatry clinics in London and Surrey
Evolution Podiatry provides specialist foot, ankle and lower-limb care across London and Surrey. Choose the clinic that is most convenient for you, then book an appointment or speak to the clinic if you are unsure which location or appointment type is most suitable.
Notting Hill, W10
Specialist Podiatry care in Notting Hill for patients across West London.Wimbledon, SW19
Foot and lower-limb assessment in Wimbledon for patients across South West London.Woking, GU21
Podiatry appointments in Woking for patients across Surrey.
Meet Stuart Hodder
Stuart Hodder is a Specialist Podiatrist and the clinical lead at Evolution Podiatry. He works with patients experiencing foot, ankle and lower-limb pain, helping them understand what may be contributing to their symptoms and what the most suitable next step is.
His approach is calm, practical and personal. Patients see Stuart for clear explanations, careful assessment and treatment planning that is shaped around their symptoms, movement, footwear, activity level and goals.
Stuart has a particular interest in lower-limb function, biomechanics, gait analysis, sports and exercise injuries, child development and alignment concerns. This means he often looks beyond the painful area itself. His work involves assessing concerns such as heel pain, Achilles pain, shin splints, flat feet, sports injuries, gait problems, children’s foot concerns and orthotic needs.
- Specialist Podiatrist and a member of the Royal College of Podiatrists
- HCPC registered (CH14453)
- Experienced in NHS and private practice
- Strong interest in biomechanics and gait analysis
- Runner and cyclist with personal experience of injury and rehabilitation
- Registered and works with insurance medical providers
Achilles tendonitis and tendinopathy FAQs
- When should I seek urgent help for Achilles pain?
Seek urgent medical help if you feel a sudden pop or snap, cannot push off through the foot, cannot walk normally after an injury, notice sudden swelling or deformity, or have signs of infection.
- What is Achilles tendonitis?
Achilles tendonitis is a term often used for pain or irritation in the Achilles tendon. It may cause pain, stiffness, swelling or tenderness at the back of the heel or lower calf.
- Is Achilles tendinopathy the same as Achilles tendinitis?
They are closely related terms. Tendinitis often suggests inflammation, while tendinopathy is a broader term for tendon pain or impaired tendon function. Your assessment can help clarify what may be happening.
- What causes Achilles tendon pain?
Achilles tendon pain may be linked to sudden increases in activity, running, jumping, calf tightness or weakness, foot posture, biomechanics, footwear, training surface changes, reduced recovery or previous injury.
- Why is my Achilles stiff in the morning?
Morning stiffness can happen when the tendon is irritated or struggling with load. It is commonly reported with Achilles tendinopathy, but assessment is useful if it persists or affects activity.
- Can I keep running with Achilles tendonitis?
That depends on your symptoms and assessment findings. If running is making pain worse or symptoms are not settling, it may be sensible to reduce or modify activity until you have been assessed.
- Will I need gait analysis?
Not always. Gait analysis may be useful if your Achilles pain is linked to walking, running or recurring loading patterns. Stuart will explain whether it is appropriate for you.
- Will I need orthoses?
Not everyone with Achilles pain needs orthoses. They may be discussed if your assessment suggests they could help support foot function or manage loading.
- How long does Achilles tendonitis take to improve?
Recovery varies. It depends on how long symptoms have been present, how irritable the tendon is, what is contributing to the problem and how your body responds to treatment.
Insights
Helpful, plain English articles about foot pain, sports injuries, gait, children’s foot health and treatment options.
How your footwear can affect foot and lower-limb pain
Why does my foot hurt when I walk?
When should you see a Podiatrist for foot pain?
Book an Achilles tendon assessment
If Achilles pain or stiffness is affecting how you walk, run or move, an assessment can help identify what may be contributing to your symptoms.
Book an assessment with Stuart to understand what may be driving your Achilles tendon pain and what the most suitable next steps may be.