Achilles Tendonitis: What It Is and Why It Happens

Understanding the Pain in Your Heel and Ankle

If you’ve ever felt a sharp or nagging pain at the back of your ankle, especially when walking, running, or even just getting out of bed in the morning, you might be dealing with Achilles tendonitis. It’s frustrating, painful, and can make even the simplest movements feel like a challenge.

But here’s the good news—it’s treatable, and you don’t have to suffer through it forever. Understanding what’s happening and why it started in the first place is the first step to getting back on track.

What Is Achilles Tendonitis?

Let’s start with the basics. Your Achilles tendon is the thick, fibrous band that connects your calf muscles to your heel bone. It plays a massive role in every step you take, whether you’re walking, running, jumping, or even just standing on your toes.

Achilles tendonitis happens when this tendon becomes irritated or inflamed, usually from overuse or strain. It starts with a dull ache or stiffness, often first thing in the morning or after exercise. If left untreated, it can worsen, leading to persistent pain, swelling, and even small tears in the tendon.

This condition is common in runners, athletes, and active individuals, but it can affect anyone—even if you don’t play sports.

What Causes Achilles Tendonitis?

Achilles tendonitis doesn’t just appear out of nowhere. There’s usually a trigger, whether it’s a sudden increase in activity, improper footwear, or a structural issue in the foot or lower leg. Here are some of the most common culprits:

1. A Sudden Increase in Activity

One of the biggest causes of Achilles tendonitis is doing too much, too soon. Maybe you’ve recently started running, added extra kilometres to your routine, or jumped into a high-intensity workout without proper preparation.

The Achilles tendon needs time to adapt to new loads, and when it’s pushed too hard without enough recovery, irritation sets in.

2. Poor Footwear Choices

Believe it or not, your shoes can have a huge impact on your Achilles tendon. Worn-out runners, unsupportive footwear, or even switching to a different shoe style too quickly can put extra strain on the tendon.

A lack of cushioning, poor arch support, or excessive heel height changes the way your foot moves, increasing stress on the Achilles.

3. Tight or Weak Calf Muscles

Your calf muscles work closely with the Achilles tendon, so if they’re tight or weak, they can put extra tension on the tendon, making it more prone to irritation.

This is especially common in people who sit for long periods, those who don’t stretch regularly, or individuals who suddenly ramp up their exercise routine without strengthening the surrounding muscles.

4. Flat Feet or High Arches

Your foot mechanics matter. Flat feet (fallen arches) or high arches can change the way force is distributed through your legs, leading to extra strain on the Achilles.

Without proper support or corrective exercises, these foot structures can increase your risk of developing tendon pain.

5. Age-Related Changes

As we age, our tendons naturally lose some of their elasticity and strength. This doesn’t mean Achilles tendonitis is inevitable, but it does mean that proper warm-ups, strength training, and mobility work become even more important to keep the tendon healthy.

What Are the Symptoms of Achilles Tendonitis?

If you’re wondering whether the discomfort in your ankle or heel is Achilles tendonitis, here are the most common signs to look out for:

✅ Pain or stiffness in the back of the ankle or lower calf (especially in the morning)
✅ Pain that worsens with activity but improves with rest
✅ Tenderness or swelling along the Achilles tendon
✅ A noticeable bump or thickening in the tendon
✅ Difficulty pushing off the foot (e.g., standing on tiptoes, running, or jumping)

The earlier you address these symptoms, the easier it is to prevent long-term damage and get back to moving pain-free.

How Can You Treat Achilles Tendonitis?

The good news? Achilles tendonitis can be managed with the right approach. Here’s what helps:

1. Reducing Strain on the Tendon

If your Achilles is inflamed, the first step is to reduce excessive strain. This doesn’t mean you have to stop all activity, but adjusting workouts, avoiding high-impact movements, and modifying footwear can give the tendon a chance to heal.

2. Gentle Stretching and Mobility Work

Tight calves? Limited ankle mobility? These can make Achilles tendonitis worse. Targeted stretching and mobility exercises can ease tension and restore proper movement patterns.

✅ Calf stretches – Helps lengthen tight calf muscles.
✅ Foam rolling – Releases tension in the lower legs.
✅ Ankle mobility drills – Improves flexibility and reduces stiffness.

3. Strengthening the Tendon

A strong Achilles tendon is a resilient one. Eccentric exercises (where the muscle lengthens under load) are proven to help rebuild the tendon and prevent re-injury.

✅ Heel drop exercises – Controlled lowering of the heel strengthens the tendon gradually.
✅ Single-leg balance drills – Improves stability and foot control.
✅ Resistance band exercises – Strengthens the muscles supporting the Achilles.

4. Hands-On Treatment

Manual therapy techniques such as massage, joint mobilisation, and dry needling can help reduce tightness and improve blood flow to the tendon, speeding up recovery.

5. Choosing the Right Footwear

Supportive, well-cushioned shoes with a slight heel lift can help offload the Achilles tendon and promote healing.

When to Seek Help

If your Achilles pain isn’t improving—or it’s getting worse—it’s time to get professional guidance. Left untreated, Achilles tendonitis can turn into chronic tendinopathy or even lead to a partial tear, which is much harder to recover from.

A physiotherapy-based approach can help by:

✔️ Assessing your movement patterns and foot mechanics
✔️ Providing targeted treatment to reduce pain and inflammation
✔️ Developing a progressive strengthening plan to rebuild tendon health
✔️ Guiding you on safe return-to-activity strategies

Final Thoughts: There’s a Way Forward

Achilles tendonitis is frustrating, but it’s not permanent. With the right treatment, movement strategies, and small daily adjustments, you can get back to the activities you love—without pain holding you back.

If you’re tired of dealing with ankle stiffness, heel pain, or ongoing discomfort, we’re here to help.

📅 Book an appointment with Proactive Physiotherapy today and start your recovery journey!

💡 A stronger, pain-free Achilles starts with the right support.