Your usual walk or workout can feel different when each step brings an ache around your Achilles tendon. You may find yourself slowing down, cutting a session short or wondering why a routine activity has started to hurt.
Achilles tendon pain can develop gradually from repeated strain or appear more suddenly following an injury. However, pain at the back of the ankle can also come from nearby structures. Looking at when your symptoms started, what aggravates them and whether they keep returning can help you understand what may be happening and when to seek an assessment.
What Can Cause Achilles Tendon Pain?
The Achilles tendon is a strong band of tissue connecting the calf muscles to the heel bone. It plays an important role in walking, running, jumping and pushing off the ground.
Achilles tendon pain can develop when the tendon is repeatedly exposed to more load than it can comfortably tolerate. Changes in activity levels, a sudden increase in exercise intensity or repetitive strain may contribute to symptoms. Achilles tendinopathy, for example, can develop when repeated stress on the tendon exceeds its ability to adapt and recover.
However, pain around the Achilles tendon does not always mean the tendon itself is the source. Irritation where the tendon attaches to the heel, inflammation of nearby tissues and other foot or ankle conditions can cause discomfort in a similar area.
How Can an Achilles Tendon Problem Affect Walking or Exercise?
The Achilles tendon helps transfer force from the calf muscles to the heel, allowing you to push off the ground when walking, running or jumping. When the tendon becomes painful or irritated, these movements may become uncomfortable.
You may notice pain or stiffness when taking your first few steps after rest, walking uphill, climbing stairs or increasing your exercise intensity. Activities that place greater load on the tendon, such as running and jumping, may increase pain or stiffness during or after activity. As a result, some people may change the way they walk or reduce their usual exercise.
Why Does Achilles Tendon Pain Develop Gradually or Suddenly?
Achilles tendon pain can develop gradually when the tendon is repeatedly exposed to more load than it can tolerate. This may happen after changes in training frequency, exercise intensity or the type of activity you perform. You might initially notice mild stiffness or discomfort after exercise before symptoms begin affecting your activities more consistently.
Pain that starts suddenly may be associated with an acute Achilles tendon injury, particularly if it occurs during running, jumping, dancing or another forceful movement. Activities involving repeated jumps, rapid changes in direction or forceful push-offs, such as certain dance movements, can place considerable strain on the Achilles tendon. In some cases, an Achilles tendon rupture can cause a sudden pop or snapping sensation at the back of the ankle, followed by difficulty pushing off the affected foot.
Sudden severe pain, particularly when accompanied by swelling, bruising or difficulty walking, should be assessed promptly by a healthcare professional.
How Are Achilles Tendon Problems Assessed and Managed?
Not all Achilles tendon problems require the same approach to treatment. Identifying the underlying cause of your pain is an important first step, as management may differ depending on whether the tendon is inflamed, affected by gradual degeneration or injured by a sudden force.
Assessing the Cause of Achilles Tendon Pain
Assessment typically begins with understanding when your symptoms started, which activities aggravate them and whether there was a specific injury. Your doctor may also examine the ankle, Achilles tendon and surrounding structures to assess your movement and strength.
Depending on your symptoms, assessment may include:
- Physical examination: Checking for tenderness, swelling or changes around the Achilles tendon.
- Movement and strength tests: Assessing ankle movement, calf strength and your ability to push off the affected foot.
- Imaging: An ultrasound or MRI may be recommended if a tendon tear or another injury is suspected.
Managing Achilles Tendon Problems
Treatment depends on the type and severity of the Achilles tendon problem, as well as your symptoms, activity level and individual circumstances. Depending on the diagnosis, management may include:
- Activity modification: Temporarily reducing running, jumping or other activities that aggravate the tendon.
- Physiotherapy and rehabilitation: Using appropriate exercises to progressively strengthen the calf muscles and Achilles tendon.
- Supportive measures: Supportive footwear or heel lifts may be considered for some patients.
- Immobilisation: A boot or cast may be used for certain partial or complete Achilles tendon tears.
- Surgery: Surgical treatment may be considered for certain injuries depending on the extent of the tear, activity level and individual circumstances.
Find Support for Achilles Tendon Pain at The Bone & Joint Centre
Persistent Achilles tendon pain should not be ignored, particularly when it starts affecting your ability to walk, exercise or carry out daily activities comfortably. A medical assessment can help determine whether the Achilles tendon or another nearby structure is causing your symptoms and identify suitable management options.
At The Bone & Joint Centre, patients can have foot and ankle concerns assessed by Dr Kevin Koo Oon Thien, a foot and ankle doctor with over 20 years of experience. Dr Koo has expertise in sports-related injuries and the surgical and non-surgical management of musculoskeletal conditions, with an approach focused on managing pain and helping patients return to comfortable movement where possible.
If Achilles tendon pain is interfering with your mobility or quality of life, book an appointment with us.
