Achilles Tendinopathy: Achilles Pain, Causes & Treatment

Pain At The Back Of Your Heel Or Ankle?

Achilles Tendinopathy is one of the most common causes of pain at the back of the heel and ankle.

It can affect runners, walkers, golfers, active adults and anyone who spends long periods on their feet.

Many people initially notice stiffness when getting out of bed in the morning, discomfort during walking or tenderness at the back of the heel. Others find they can no longer exercise comfortably or have lost confidence in activities they once enjoyed.

For some people, symptoms develop gradually over time. For others, the pain seems to appear unexpectedly and progressively worsens.

At Callen Olive, we regularly assess and treat Achilles Tendinopathy, helping people understand why their symptoms have developed and creating personalised treatment plans designed around their lifestyle, goals and desire to remain active.

You're Not Alone

Achilles Tendinopathy can affect people of all ages and activity levels.

We regularly assess and treat:

• Walkers

• Runners

• Golfers

• Active retirees

• Gym-goers

• Busy parents

• People whose jobs involve prolonged standing

Many people come to us after struggling with symptoms for weeks, months and sometimes even years.

Some have stopped exercising altogether, whilst others are finding everyday activities increasingly difficult and simply want to walk comfortably again.

You are not alone.

Our experienced clinicians understand how frustrating persistent Achilles pain can be and are here to help you understand your condition and explore the most appropriate treatment options.

What Is The Achilles Tendon?

The Achilles tendon is the largest and strongest tendon in the body.

It connects the calf muscles to the heel bone and plays a vital role in:

• Walking

• Running

• Climbing stairs

• Jumping

• Balance

• Propulsion during movement

Every step you take places force through the Achilles tendon.

When these forces exceed the tendon's ability to recover and adapt, pain and dysfunction may develop.

What Does Achilles Tendinopathy Feel Like?

People commonly describe:

• Pain at the back of the heel

• Morning stiffness

• Tenderness when touched

• Pain during activity

• Swelling or thickening of the tendon

• Pain when walking uphill

• Difficulty running or exercising

• Stiffness after periods of rest

Many people report that symptoms improve slightly once they "warm up" before becoming painful again later in the day.

Symptoms often fluctuate, with good days and bad days, which can make the condition particularly frustrating.

How Can Achilles Tendinopathy Affect Everyday Life?

The Achilles tendon plays an important role in almost every activity that involves movement.

Many people find themselves:

• Avoiding long walks

• Reducing exercise and sporting activities

• Struggling with hills and stairs

• Losing confidence in their mobility

• Becoming less active and less fit

• Worrying that they may never get back to normal activity levels

For some people, the impact on comfort, wellbeing and quality of life can be significant.

Is Achilles Tendinopathy Really Inflammation?

This is one of the biggest misconceptions surrounding Achilles pain.

Whilst inflammation may be present in the early stages, many persistent cases involve changes within the structure of the tendon itself rather than ongoing inflammation.

This helps explain why symptoms sometimes continue despite rest, anti-inflammatory medication or temporary activity modification.

Successful treatment often focuses on improving the tendon's ability to tolerate load rather than simply reducing inflammation.

What Causes Achilles Tendinopathy?

There is rarely one single cause.

Several factors may contribute to excessive strain through the Achilles tendon.

Sudden Changes In Activity

Increasing walking, running, golf, gym training or exercise too quickly can overload the tendon.

Tight Calf Muscles

Reduced flexibility may increase strain through the Achilles tendon.

Foot Biomechanics

The way your feet function during walking and running may influence tendon loading.

Footwear

Worn or inappropriate footwear may contribute to symptoms.

Ageing

As we age, tendons generally become less resilient and recover more slowly.

Previous Injury

A history of Achilles problems may increase the risk of future symptoms.

Often, multiple factors are involved rather than one single cause.

Types Of Achilles Tendinopathy

Mid-Portion Achilles Tendinopathy

Occurs within the main body of the tendon, usually several centimetres above the heel bone.

Insertional Achilles Tendinopathy

Occurs where the tendon attaches directly to the heel bone.

These two conditions often require different management strategies, which is why accurate diagnosis is important.

Why Early Assessment Matters

Many people continue exercising on a painful Achilles tendon for months before seeking advice.

Unfortunately, symptoms can become increasingly persistent when the factors contributing to tendon overload remain unaddressed.

Persistent pain can lead to:

• Reduced activity levels

• Loss of strength and fitness

• Changes in walking patterns

• Compensation injuries elsewhere in the foot and lower limb

• Long-term frustration

• Reduced confidence in movement

Early assessment and treatment can often help reduce pain, improve function and support a quicker return to comfortable activity.

How We Assess Achilles Tendinopathy

Assessment begins by understanding your symptoms and how they are affecting your everyday life.

This may include:

• Clinical examination

• Biomechanical assessment

• OptoGait gait analysis

• Footwear assessment

• Activity review

• Tendon loading assessment

Where appropriate, diagnostic imaging may also be recommended.

By understanding why symptoms have developed, we can create a personalised treatment plan tailored to your individual needs and goals.

Your Personalised Treatment Plan

Treatment depends on symptom severity, tendon location and the factors contributing to excessive tendon loading.

Management may include:

Footwear Advice

Appropriate footwear may help reduce unnecessary stress through the tendon and improve comfort.

Rehabilitation Exercises

Progressive strengthening exercises form one of the most important aspects of treatment and help improve the tendon's ability to tolerate load.

Custom Foot Orthotics

Custom Foot Orthotics may help optimise foot function and reduce excessive strain through the tendon where appropriate.

Activity Modification

Remaining active is often beneficial for both physical and mental wellbeing, although temporary modifications may sometimes be required depending on the severity of symptoms.

Completely stopping activity is not always necessary and, in some cases, may delay recovery.

Our goal is to help you remain as active as possible whilst supporting tendon healing through appropriate rehabilitation and load management.

Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy is one of the most evidence-based treatments available for persistent Achilles Tendinopathy.

The treatment uses acoustic pressure waves to stimulate healing responses within the affected tendon and may help reduce pain whilst improving function.

Shockwave Therapy can be particularly beneficial for persistent Achilles pain that has not responded to rest, stretching or other conservative treatments.

At Callen Olive, Shockwave Therapy is combined with a personalised rehabilitation programme designed to address both symptoms and the factors contributing to tendon overload.

Our goal is not simply to reduce pain, but to improve the tendon's ability to tolerate activity and support long-term recovery.

Why Doesn't Rest Alone Always Work?

One of the most common mistakes people make when Achilles pain develops is stopping all activity and waiting for the pain to settle.

Whilst short-term activity modification may sometimes be appropriate, complete rest often fails to address the underlying problem.

The Achilles tendon responds positively to appropriate loading.

In many cases, the goal is not to avoid loading the tendon altogether, but to gradually improve its ability to tolerate load over time.

This is why symptoms often return as soon as walking, exercise or everyday activities are resumed.

Successful treatment often involves identifying and addressing factors contributing to tendon overload, including:

• Foot biomechanics

• Footwear

• Calf flexibility

• Training errors

• Activity levels

• Tendon strength and resilience

Our objective is not simply to reduce pain today, but to help reduce the likelihood of symptoms repeatedly returning in the future.

Can I Continue Walking With Achilles Tendinopathy?

In many cases, yes.

Remaining active is often beneficial for both physical and mental wellbeing.

However, the amount and type of activity that is appropriate will depend on the severity of symptoms and the underlying cause of the problem.

For some people, simple adjustments to footwear, activity levels or treatment may allow them to continue walking comfortably.

For others, a temporary reduction in activity may be necessary whilst symptoms settle.

Our goal is to help you remain as active as possible whilst supporting recovery and preventing further tendon irritation.

Can Achilles Tendinopathy Lead To A Rupture?

This is a common concern for many people.

Whilst most individuals with Achilles Tendinopathy will never experience a tendon rupture, long-standing tendon degeneration can reduce the tendon's ability to tolerate load.

An Achilles tendon rupture is a separate injury involving a partial or complete tear of the tendon.

Symptoms of a rupture may include:

• A sudden sharp pain in the back of the ankle

• A sensation of being kicked or struck from behind

• A popping or snapping sensation

• Difficulty pushing off the foot

• Difficulty standing on tiptoe

If you experience a sudden injury and suspect a rupture, you should seek urgent medical assessment.

Our goal is to identify tendon problems early and provide appropriate treatment to improve tendon health, reduce symptoms and support safe participation in activity.

Why Choose Callen Olive?

We Care.

We understand how frustrating persistent Achilles pain can be.

Many people come to us after weeks, months or even years of ongoing discomfort. Some have stopped exercising, whilst others are struggling with everyday activities and simply want to move comfortably again.

Our experienced clinicians combine expert assessment, biomechanics, rehabilitation and evidence-based treatments to understand the true cause of your symptoms and create treatment plans tailored to your individual needs and goals.

Because caring for your feet isn't simply about reducing pain. It's about helping you move with comfort, confidence and ease.

Healthy Feet. Healthy Body. Healthy Mind.

Treatment Fees

No two patients are the same.

That's why every treatment plan is tailored to your individual needs, lifestyle and goals. Following your assessment, your clinician will explain the treatment options available and help you choose the most appropriate pathway to achieve the best possible outcome.

Our focus is always on helping you achieve the best possible outcome for your comfort, mobility and long-term wellbeing.

New Patient Biomechanics Assessment: £180
New Patient Biomechanics Assessment with Principal Podiatrist: £225

Our team will support you throughout every stage of your recovery to ensure you feel informed, reassured and cared for.

If you are unsure which appointment is most suitable, our Patient Care Team will be happy to help.

Call us on +44 333 305 8347.

Related Conditions

• Heel Pain

• Plantar Fasciitis

• Flat Feet

• Posterior Tibial Tendon Dysfunction

• Arthritis

Related Treatments

• Biomechanical Assessment

• OptoGait Gait Analysis

• Custom Foot Orthotics

• Shockwave Therapy

Learn More

• Running & Foot Health

• Walking For Wellbeing

• Foot Health For Golfers

• Active Ageing & Foot Health

Frequently Asked Questions

Will Achilles Tendinopathy Go Away On Its Own?

Some cases improve with time, but symptoms can persist for months or even years if the underlying causes are not identified and addressed.

Why Is My Achilles More Painful In The Morning?

Tendons often become stiff after periods of rest, which is why many people notice symptoms during their first few steps of the day.

Should I Stop Walking Or Exercising?

Not necessarily. Many people can remain active with appropriate advice and treatment. Your clinician will discuss the most suitable approach for your individual circumstances.

How Long Does Achilles Tendinopathy Take To Improve?

Recovery varies between individuals and depends on factors such as symptom duration, activity levels, tendon health and treatment approach.

Can Orthotics Help Achilles Tendinopathy?

For some people, Custom Foot Orthotics may help improve foot function and reduce excessive strain through the tendon.

Is Shockwave Therapy Painful?

Most people tolerate treatment well. Your clinician will explain the procedure fully and discuss whether it may be appropriate for your condition.

Ready To Move Comfortably Again?

You don't have to simply put up with Achilles pain.

Whether your symptoms have recently developed or have been affecting you for some time, our experienced team is here to help.

Book your assessment today and take the first step towards moving with comfort, confidence and ease.