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Wade Folske

Understanding and Managing Achilles Tendon Pain

The Achilles tendon is a powerful cord connecting the calf muscles to the heel bone, and is critical for walking, running, and jumping. Its vulnerability to injury, however, is often underestimated. Ignoring the initial twinges and persistent aches can lead to significant problems, ranging from minor discomfort to debilitating ruptures. Understanding the subtle signals your body sends and taking proactive steps to address Achilles tendon pain is paramount to maintaining healthy mobility and preventing long-term complications.

Pay attention to the Early Warning Signs:

The onset of Achilles tendon pain is rarely sudden and dramatic. Instead, it often presents as a gradual increase in discomfort, beginning as a mild ache after exercise or prolonged standing. This early-stage pain is frequently localized to the back of the heel, just above the heel bone. It might feel like stiffness, tightness, or a dull, throbbing sensation. You might notice it more in the morning or after periods of inactivity. These initial symptoms often subside with rest, leading many to dismiss them. However, this is a critical mistake. These subtle cues are your body's way of alerting you to potential problems within the tendon. Ignoring them allows the underlying issue to worsen, potentially resulting in more significant and persistent pain.


Treatment for Achilles pain

Causes of Achilles Tendon Pain:

Several factors contribute to Achilles tendon pain. Overuse is a common culprit, particularly in athletes involved in activities that repeatedly stress the tendon, such as running, jumping, and dancing. Improper training techniques, such as sudden increases in intensity or duration of exercise without adequate conditioning, significantly increase the risk. Inadequate warm-up before activity and insufficient cool-down afterward further compromise the tendon's resilience. Inappropriate footwear, with insufficient arch support or cushioning, can also contribute to the development of pain. Other contributing factors include pre-existing conditions such as plantar fasciitis, flat feet, or leg-length discrepancies. Furthermore, underlying medical conditions, such as arthritis or certain autoimmune disorders, can exacerbate tendon inflammation.

Assessing the Situation: When to Seek Professional Help:

While mild Achilles tendon pain often responds to conservative management, certain signs warrant immediate attention from a healthcare professional:

  • Severe pain: A sudden, sharp, intense pain, particularly if accompanied by a popping or snapping sound, suggests a possible tendon rupture. This requires immediate medical evaluation and intervention.

  • Swelling: Significant swelling around the Achilles tendon indicates inflammation and potential damage that might require more aggressive treatment.

  • Inability to bear weight: If you struggle to put weight on your affected leg, it’s crucial to seek medical advice promptly.

  • Persistent pain: Pain that persists for several weeks despite rest and conservative measures indicates a more serious underlying issue.

  • Limited range of motion: Stiffness and difficulty flexing your ankle or foot are additional warning signs.

  • Numbness or tingling: Any numbness or tingling in the foot or lower leg alongside Achilles tendon pain necessitates immediate medical attention.

Managing Achilles Tendon Pain: Conservative Treatments:

For early-stage Achilles tendon pain, a conservative approach often proves effective. This typically involves the following strategies:

  • Rest: Avoid activities that aggravate the pain. This might include modifying your exercise routine or taking time off from strenuous activities.  Rest doesn’t mean 100% rest, but instead means a change in activity to incorporate active recovery.

  • Ice/heat: Applying ice packs for 15-20 minutes several times a day can help reduce inflammation and alleviate pain during the first 24-72 hours of initial pain.  Heat should be used after the acute inflammatory phase in order to bring nutrition and promote proper healing of damaged tissue.

  • Night Splint:  Wearing a boot at night that keeps the achilles in a more neutral position prevents unwanted scar tissue and shortening of the achilles tendon.

  • Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain but do not accelerate the recovery process.  In some cases, blocking the body’s pain signal can delay the recovery.  The trauma to the muscle is there regardless.  Interfering with the processing of pain by the brain only brings a false sense of security and may lead to a premature return to activity. 

  • Stretching and strengthening exercises: Specific exercises, under the guidance of a professional, can improve flexibility and strengthen the calf muscles, ultimately supporting the Achilles tendon. These exercises should be performed gradually and cautiously, avoiding any movements that increase pain.  When stretching an injured muscle it is crucial to only perform 2 second stretching while incorporating reciprocal inhibition to avoid further irritation to the tendon.

  • Shoes/Inserts: Custom-made or over-the-counter orthotics can provide support and cushioning, reducing strain on the Achilles tendon.  Temporary heel lifts during the acute pain phase should be worn and can be gradually reduced by removing about 3mm of the lift at a time.  Training shoes with a higher heel to toe ratio should be worn.

Prevention is Key:

The best approach to Achilles tendon pain is prevention. This involves adopting a holistic approach that encompasses:

  • Proper warm-up and cool-down: Always warm up before any exercise and cool down afterward to prepare and recover your muscles and tendons.

  • Gradual increase in activity: Avoid sudden increases in training intensity or duration. Gradually increase your activity level to allow your body to adapt.

  • Appropriate footwear: Wearing a shoe with proper support or heel to toe drop ratio is important.  

  • Stretching and strengthening exercises: Regularly engage in stretches and strengthening exercises targeting the calf muscles and Achilles tendon to enhance their resilience.  Slow eccentric exercises are the key to training a muscle to open efficiently and absorb the repetitive shock that causes achilles tendon breakdown.

  • Maintaining a healthy weight: Excess weight puts additional strain on the Achilles tendon. Maintaining a healthy weight through diet and exercise reduces this strain.


Ignoring the early warning signs of Achilles tendon pain is a significant mistake. By paying attention to the subtle cues your body provides, seeking timely professional help when necessary, and adopting proactive prevention strategies, you can significantly reduce your risk of developing a serious injury and maintain healthy, pain-free mobility. Remember, prompt intervention is crucial to avoiding prolonged discomfort and potential long-term complications. 

If you are experiencing any discomfort or have any questions regarding Achilles tendon pain or related conditions, don't hesitate to contact Performance Care Stretch Clinic for expert guidance and support. 

You can reach us through our contact page at https://www.pcstretchclinic.com/contact.

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