Achilles tendinopathy and returning to walking or running

A stiff, sore Achilles can make the first steps of the morning uncomfortable and leave you unsure whether to continue exercising. You might notice it after increasing your running, doing more hill walking or spending longer on your feet.

For runners and active adults in Standish and Wigan, a useful first step is understanding the problem before choosing exercises from the internet.

What is Achilles tendinopathy

The Achilles tendon connects your calf muscles to your heel. Tendinopathy describes a condition involving tendon pain and reduced ability to tolerate activity. It can develop when demands on the tendon exceed what it currently copes with, although several factors can contribute.

Symptoms can include tenderness, stiffness and thickening around the tendon. An assessment usually considers your symptoms, activity history and physical examination; scans are not always needed. United Lincolnshire Hospitals guidance.

Why the location of pain matters

Pain where the tendon attaches to the heel is called insertional Achilles tendinopathy. Pain further up the tendon is usually described as midportion tendinopathy.

Exercises may need to differ. With insertional symptoms, lowering your heel deeply off a step can increase compression at the attachment. A clinician may start loading exercises on a flat surface and adjust footwear or uphill activity. Copying a heel-drop routine without checking the location of your problem can therefore be unhelpful. Kent Community Health guidance on insertional Achilles pain.

What rehabilitation usually involves

Treatment commonly combines changes to aggravating activity with a progressive calf strengthening programme. Exercises may begin at a manageable level and become more demanding as your capacity improves. The aim is to build tolerance for what you want to do, including running and jumping when appropriate.

Recovery often takes months. Monitor how the tendon responds during activity and afterwards, including the following morning. Increasing stiffness or a persistent symptom flare is a reason to review the load with your clinician. Oxford University Hospitals Achilles rehabilitation guidance.

Can you keep running

There is no single answer for every runner. Discuss the amount, pace and terrain you currently tolerate, alongside what happens later that day and the next morning. Some people need a temporary reduction or pause; others may be able to continue a modified programme.

Make the discussion specific. Bring your recent weekly mileage, any changes to hills or speed sessions, and your next event date. If you are not a runner, the same conversation can focus on your walking route, work shifts or time spent standing.

A useful question is: “What can I keep doing while we work on this, and what would tell us I am ready to increase it?” That is more practical than repeatedly testing the tendon with the activity that currently hurts most.

When Achilles pain needs urgent assessment

A sudden snap or pop, a feeling of being kicked at the back of the ankle, or a sudden loss of push-off strength could indicate a rupture. Seek urgent assessment through NHS 111 or an urgent treatment service. Being able to walk does not reliably exclude a rupture. Do not start a strengthening routine for a suspected acute tear. AAOS information on Achilles tendon rupture.

Common questions about Achilles tendinopathy

Will stretching alone solve it? Stretching does not replace progressive loading, and deep stretching may irritate insertional symptoms. Get advice on the right approach for your tendon.

Do I need to be a runner to get it? No. It can also affect people whose main activities are walking, work or everyday tasks.

What should I bring to an appointment? Your usual activity or training details, a description of where it hurts, and any previous investigations or treatment information. See our appointment FAQs for clothing and other practical details.

Achilles rehabilitation in Standish and Wigan

If Achilles pain is interrupting your routine, contact 360 Healthcare Hub to discuss an injury rehabilitation appointment. Tell us what you want to return to, whether that is comfortable dog walks or a running event.

You can also book a free 15-minute advice call.

This article is general information and cannot diagnose the cause of your tendon pain.