Achilles Tendinitis

Achilles tendinitis is irritation and structural change in the tendon connecting the calf muscles to the heel.

It may be called Achilles tendinopathy or Achilles tendonitis. Symptoms can build gradually or follow a change in running, jumping, footwear or training load. The tendon may feel stiff after rest and become painful when it is loaded.

Common presentations include pain at the back of the ankle or above the heel, tenderness when the tendon is pressed, and stiffness with the first steps after sleep or sitting. Calf discomfort can accompany the tendon problem. Pain may increase during running, stair climbing or repeated heel raises.

A sudden snap, marked weakness when pushing off, or difficulty walking needs prompt assessment because these features can occur with an Achilles tendon rupture. See the related symptom pages for [Ankle Pain](/symptoms/ankle-pain/) and [Heel Pain](/symptoms/heel-pain/).

The tendon can become overloaded when its daily demands rise faster than its capacity to adapt. Common triggers include adding hills or speed work, returning to sport after a break, repeated jumping, or changing shoes. Tight calf muscles and reduced ankle movement may increase the strain passed through the tendon.

Early symptoms may settle during activity and return afterwards. Without a sensible load adjustment, pain can become more persistent and ordinary walking may feel uncomfortable. Recovery usually involves gradual strengthening and carefully increasing tendon demand; improvement is not always linear.

Risk is higher with a sudden training increase, frequent high-impact activity, limited calf strength, reduced ankle flexibility, or footwear that changes how the foot loads. Previous tendon pain and conditions that affect movement can also influence symptoms.

A clinician asks when pain began, what activities provoke it, and whether there was a sudden injury. They examine tenderness, calf strength, ankle movement, walking pattern and the ability to rise onto the toes. Ultrasound or magnetic resonance imaging may be considered when the diagnosis is uncertain or a tear is suspected.

Treatment is matched to the tendon findings and your goals. Relative rest means reducing painful loading while keeping comfortable movement. A physiotherapist may prescribe progressive calf strengthening, balance work and a staged return to activity. [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) and [Strength Training Rehabilitation](/treatments/physiotherapy-and-rehabilitation/strength-training-rehabilitation/) can support this process.

Some people are advised to use temporary heel support or [Custom Orthotics](/treatments/non-surgical-orthopedics/custom-orthotics/). [Shockwave Therapy](/treatments/physiotherapy-and-rehabilitation/shockwave-therapy/) may be discussed when symptoms persist despite an appropriate rehabilitation plan. Surgery is uncommon and considered only in selected cases.

Choose activity that keeps discomfort manageable and avoid repeatedly testing the tendon with painful sprints or jumps. Track how it responds later that day and the following morning. Supportive shoes, a gradual warm-up and scheduled recovery can make daily loading easier.

Persistent pain can reduce fitness and alter walking, which may place extra demand on the knee or other leg. A sudden forceful injury can damage the tendon more severely. Seek urgent care after a snap with weakness or loss of push-off; these signs can indicate [Achilles Tendon Rupture](/conditions/achilles-tendon-rupture/).

Increase running, jumping and hill work in small stages. Maintain calf strength, vary intense sessions with easier activity, replace worn footwear and address recurring stiffness early. A structured warm-up prepares the calf and ankle for higher loads.

An orthopaedic clinician or physiotherapist can assess tendon loading, calf function and your activity demands. Bring details of recent training changes, footwear changes, previous injuries and the movements that reproduce pain.