Achilles tendonitis

ACHILLES TENDONITIS

Achilles tendonitis is a common problem at the back of the ankle that can develop when the tendon becomes irritated due to repeated stress or a sudden increase in activity. The Achilles tendon connects your calf muscles to your heel and is essential for walking, running, stair climbing and rising onto your toes. When the tendon is asked to do more than it can tolerate at that time, pain, tenderness and stiffness may appear, often worse in the morning or during the first steps. A proper assessment and a gradual rehabilitation plan help reduce symptoms and support a safe return to activity.

When symptoms tend to appear

Achilles tendonitis is often linked to repeated stress on the tendon, especially when walking or running volume increases quickly or when activities require frequent push-off on the toes. In many cases symptoms build up gradually and feel worse during the first movements of the day, may ease with gentle activity and can return after higher demand days. Pain may be located closer to the heel or higher along the tendon and the presentation can vary from person to person.

In physiotherapy we focus on adjusting activity and rebuilding calf and tendon capacity in a progressive way with fewer flare-ups. Rehabilitation is planned around your real-life needs such as stairs, hills, longer walks or a return to training. The aim is to improve ankle movement, gradually restore calf strength and help you return to daily and sport demands with better tolerance and confidence.

Steady progress without sudden changes

With Achilles tendonitis many people get stuck in a cycle: pain appears, they rest completely, symptoms feel better, then they jump back to the same level as before. This often brings symptoms back, not because recovery is impossible but because the return happens without a steady transition. In physiotherapy we help you find a practical activity level you can tolerate as a baseline, then we plan small weekly adjustments so the tendon can adapt. We also look at everyday details such as footwear, walking surfaces and habits that repeatedly stress the calf during the day. This reduces sharp ups and downs and makes a more consistent return to walking, running or training easier.

Where exactly should I feel pain if I have Achilles tendonitis?
Pain is usually at the back of the ankle, either closer to the heel or a bit higher along the tendon. Location helps guide assessment and rehabilitation.
Why is it worse in the morning?
Morning stiffness and tenderness are common and often improve as you start moving gently during the day.
Why does it ease as I warm up then hurt again later?
Gentle movement may reduce stiffness, but if demands become too high for your current stage symptoms can return.
Can I keep walking or do I need complete rest?
Complete rest is usually not necessary. Adjusting activity to avoid strong flare-ups and progressing gradually is often recommended.
Can it lead to a rupture if I ignore it?
If high stress continues without adjustment, the risk of a more serious injury can increase. Early management and gradual return are advised.
Why is it worse on hills?
Hills increase push-off demands and calf work, so symptoms can show up more when the tendon is irritated.
Can I run with Achilles tendonitis?
It depends on symptoms and your current stage. Return to running is usually planned gradually once tolerance improves and symptoms are controlled.