Why does Achilles tendinitis cause heel pain?

The Achilles tendon transfers force from the calf to the heel so you can push off while walking. Irritation may occur higher along the tendon or close to its heel attachment. Pain at the back of the heel can be tender to touch and may worsen with stairs, running, jumping or firm-backed shoes.

Some people notice stiffness after sleep or sitting, followed by soreness after activity. Pain under the heel or toward the sole can have a different source, such as the plantar tissues. The exact location, trigger and examination help identify which structure needs attention.

Reduce impact activities and steep inclines for a short period, while keeping comfortable movement. Avoid shoes that rub the back of the heel; cushioned, supportive footwear may feel better. Do not begin forceful calf stretching or intense heel drops without guidance, particularly when pain is close to the tendon attachment. A physiotherapist can plan progressive loading and check walking mechanics. Cold through a cloth may offer temporary relief.

Seek assessment if heel pain interferes with normal walking, lasts despite reducing aggravating activity or repeatedly returns. Obtain urgent care after a snap, sudden loss of push-off, marked swelling, an open wound, or inability to bear weight. A clinician can distinguish tendon irritation from rupture, fracture or another heel problem.

Ask whether the pain is at the tendon attachment or elsewhere in the heel, which footwear and activities are suitable, and how to progress exercises. Ask what changes mean that you should stop loading the tendon and return for review.