Achilles Tendon Pain: Causes, Symptoms, Diagnosis & Treatment Guide

The Achilles tendon is one of the strongest tendons in the human body, yet it is also among the most commonly injured—especially in active adults. Whether you’re a runner, athlete, or someone experiencing heel pain for the first time, understanding Achilles tendon problems is essential for early treatment and faster recovery.

This complete guide covers what the Achilles tendon is, why it gets injured, how to recognize symptoms, and the best treatment options, including when surgery might be needed.

What Is the Achilles Tendon?

The Achilles tendon (also called the heel cord) connects the calf muscles—the gastrocnemius and soleus—to the heel bone. Made of tough collagen fibres, it helps you:

  • Walk
  • Run
  • Jump
  • Stand on your toes

When this tendon weakens or tears, even normal walking becomes challenging, and the ankle may feel unstable or painful.

Common Causes of Achilles Tendon Injuries

Achilles tendon issues are most often seen in:

  • Middle-aged athletes
  • Weekend runners
  • Individuals with high or low foot arches

Why the tendon gets damaged:

  • Age reduces tendon flexibility
  • Repetitive stress from running or jumping
  • Poor blood supply in the lower tendon
  • Degenerative changes causing tiny tears
  • Overuse without proper warm-up or stretching

These small tears may fail to heal completely, leading to conditions like tendonosis (degeneration) or tenosynovitis (inflammation of the tendon lining). In severe cases, the tendon may tear completely.

Signs & Symptoms of Achilles Tendon Problems

1. Complete Tear (Rupture)

A rupture usually presents with:

  • Sudden sharp pain in the heel or calf
  • A popping or snapping sensation
  • Difficulty walking
  • Swelling and bruising

Patients often describe it as “feeling like someone kicked them in the calf.”

2. Tendonosis or Tenosynovitis

These conditions develop gradually:

  • Pain along the back of the ankle
  • Swelling around the tendon
  • Stiffness, especially in the morning
  • Pain during running
  • Discomfort progressing to difficulty walking

Can You Treat Achilles Pain at Home?

Yes—most mild to moderate Achilles tendon problems can be managed with simple steps.

Self-care tips for Achilles pain:

  • Reduce running or high-impact sports temporarily
  • Warm up properly and stretch the Achilles tendon
  • Use cushioned shoes or softer running surfaces
  • Add a ¼-inch heel raise to reduce strain (in both shoes)
  • Apply ice packs to reduce pain and swelling
  • Use paracetamol for pain relief
  • Ask your doctor before using anti-inflammatory medications

A complete tear, however, requires medical attention.

When to See a Doctor

Visit a Foot and Ankle Orthopaedic Surgeon if:

  • You think the tendon has ruptured
  • Pain does not improve despite rest and home treatment
  • Swelling increases or walking becomes difficult

Early diagnosis improves outcomes.

How Doctors Diagnose Achilles Tendon Problems

Your doctor may perform:

  • Clinical examination
  • Blood tests for diabetes or arthritis
  • Ultrasound to check tendon structure
  • MRI scan for detailed imaging
  • X-ray to assess heel bone abnormalities

These tools help determine whether the tendon is inflamed, degenerated, or torn.

Treatment Options for Achilles Tendon Pain

1. Physiotherapy

Most patients respond well to:

  • Guided stretching programs
  • Inflammation reduction techniques
  • Strength-building exercises
  • Correction of gait or foot alignment

2. Orthotics

If your foot shape puts extra stress on the tendon, custom insoles can help distribute pressure and support healing.

3. Surgery

Surgery may be considered when:

  • Conservative treatments fail
  • There is calcification involving the tendon
  • There is chronic inflammation that does not improve
  • A severe Achilles tendon rupture requires repair

Procedures may include removing inflamed tissue, smoothing bony spurs, or repairing damaged tendon fibres.

4. Functional Bracing

Most acute ruptures without internal tendon disease can heal with a structured, supervised bracing protocol.

Can You Return to Running After an Achilles Injury?

In most cases—yes.

You may need to reduce mileage during recovery, but many people return to their usual activities with proper treatment and rehabilitation.
Some surgical cases may face limitations, but this is uncommon with modern techniques and guided physiotherapy.