Achilles Tendon Pain

The Achilles tendon connects your calf to your heel. Repeated strain can irritate or damage it.

Why it happens
A sudden increase in exercise or repeated stress at work can overload the tendon. Ongoing strain may cause small tears and thickening.

What you may notice
Pain, stiffness or swelling behind the heel or lower calf, often worse after rest or with activity.

The location changes treatment
Pain may be in the middle of the tendon or where it joins the heel bone. The latter is called insertional pain. Your clinician checks the location, strength and movement. Imaging may help assess bone spurs or tendon damage when needed.

Treatment and what to expect
Treatment may include a boot, shoe inserts or physical therapy. The exercise plan depends on where the tendon is injured and how severe the problem is. Some persistent cases need surgery. Pain may settle with gentle movement and return with more activity. This does not mean the tendon is fully healed. Ask when to increase walking or exercise, and follow the plan for your specific injury. 

When to call
Seek prompt care for a sudden pop, sharp pain or trouble pushing off or rising onto your toes. Stay off the injured foot until assessed; the tendon may be torn.

Your next steps
● Reduce running, jumping and other activities that trigger pain.
● Wear supportive shoes. Use a boot or inserts if prescribed.
● Follow your clinician's exercise plan. Ask which stretches and strengthening exercises fit your injury. 

Using exercise safely
Learn strengthening exercises from your clinician or physical therapist before doing them alone. Lowering the heel off a step is not suitable for every Achilles problem.

Do not perform step-based heel drops for insertional Achilles pain unless your treating clinician specifically directs a modified plan. Ask whether low-impact activities such as cycling or swimming suit your stage of recovery.

Healing takes time
Symptoms often take several months to improve and may last beyond 3 months even with early care. A boot may help briefly, but using it too long can weaken the calf. Steroid injections into the Achilles tendon are generally avoided because of rupture risk. Do not stretch through a sudden pop or new weakness; seek prompt assessment.