A stiff, painful Achilles tendon can make the first steps of the morning uncomfortable and turn a familiar run into a struggle. Achilles tendinopathy is a common cause of pain at the back of the ankle. A gradual, individual exercise plan can help you rebuild strength and return to the activities you enjoy.
What is Achilles tendinopathy?
The Achilles tendon connects your calf muscles to your heel bone. Tendinopathy describes a painful tendon problem that can develop when the tendon struggles to cope with the demands placed on it. A sudden increase in running, jumping or other activity can be a contributor.
Symptoms may occur in the middle of the tendon or where it attaches to the heel. This distinction matters because the most suitable exercise range can differ.
Common symptoms
- Pain or tenderness at the back of the ankle or heel.
- Stiffness when you first get up or after resting.
- Discomfort during or after walking, running or jumping.
- Sometimes, thickening or swelling around the tendon.
Not every painful heel is an Achilles problem. Seek an assessment if symptoms persist, worsen or make daily activity difficult.
What helps Achilles tendon pain?
Adjust the load
You may need to temporarily reduce activities that provoke a marked flare, such as hill running, sprinting or jumping. Prolonged complete rest is usually not the answer for tendinopathy: aim to keep a manageable level of activity and build back gradually. A physiotherapist can help you find the right starting point.
Progress calf strengthening
A loading programme may start with seated heel raises or supported standing heel raises on level ground. It can progress towards single-leg work and greater resistance as your capacity improves. The right frequency, repetitions and resistance depend on your symptoms and goals.
If pain is at the tendon’s attachment to the heel, do not automatically copy heel-drop exercises off a step. Dropping below floor level can be unsuitable for insertional Achilles tendinopathy. Get advice about an appropriate range.
Monitor the response
Some manageable discomfort can occur during rehabilitation. If pain or morning stiffness noticeably increases after a session, review the amount of exercise and other activity you have done. Reduce the load and seek advice if symptoms do not settle. Progress should be guided by your response, rather than a fixed calendar.
How long does recovery take?
Improvement often takes several months. Returning to running or sport involves rebuilding tendon and calf capacity as well as settling pain. Regular exercise, sensible progression and follow-up reviews can help you stay on track, but recovery time varies.
When is Achilles pain urgent?
A sudden snap or pop, abrupt pain at the back of the leg, or difficulty walking or rising onto your toes can indicate a tendon rupture. Seek urgent assessment at A&E rather than starting a tendinopathy exercise routine.
Can online physiotherapy help?
YourPhysio can discuss your symptoms, observe movement by video and guide an exercise programme that fits your current ability. Follow-ups allow your physiotherapist to check technique and adjust the plan as you improve. If you need an in-person examination or medical review, they can advise you accordingly.
Want help deciding your next step? Book a free initial consultation to meet the physiotherapist, explain your symptoms and learn how our online service works. This introductory conversation is free; any subsequent treatment sessions are paid and optional.
Sources: Guy’s and St Thomas’ NHS; George Eliot Hospital NHS; Mersey Care NHS. General information, not an individual diagnosis. Images are illustrative stock photographs.