Achilles Tendon Pain

Injuries to the achilles tendon are incredibly common in long distance runners.

In recent years, pain and tightness in the achilles tendon have been “sub categorised” as there is a huge amount of debate in the world of sports medicine about the causes and pathology of achilles tendon injuries.

In short, what used to be automatically diagnosed as “achilles tendonitis” could be diagnosed or described as:

  • Achilles tendonopathy
  • Achilles tendonosis
  • Achilles tendonitis

Is there is difference between them?

Yes but leave that to a physiotherapist to make the diagnosis. It’s beyond the scope of this injury hub to bore you with the details.

What is the Achilles Tendon?

The Achilles tendon is a very thick and incredibly tendon that connects the calf muscle to the heel.

Throughout your training it is worked incredibly hard and injuries to it are not uncommon.

Many runners make the unforgivable mistake of ignoring initial symptoms and soldiering on with their training programme, hoping that the pain will pass.

The use of anti-inflammatory medication may well help to mask the discomfort, but by continuing to run with an Achilles injury, you might as well end any ideas you have of competing in an event.


  • Muscular imbalances in the lower leg - such as the calf muscles - are often precursors to achilles tendon injuries. To find out if you have tight calf muscles, head back to the Injury Hub and perform the “overhead squat assessment.” When viewing your squat from behind, if you notice your heels being to rise off the floor at the bottom of the squat, then this is a sign that you need to foam roll and stretch the calves.

  • A sudden increase in running distance or intensity can place the Achilles tendon under a level of stress that it is simply not used to, initiating an inflammatory response.

Incorrect footwear with poor shock absorption, and excessive pronation, can also be contributory factors, so once again you should try to prevent the condition rather than having it treated once contracted.


  • Stiffness in the Achilles tendon, especially in the morning
  • Pain when trying to stand on tip-toe;
  • Gradual onset of discomfort during and after exercise;
  • Significant tenderness to touch.


This injury, once contracted, can stay with you for a long period of time, so prevention is your priority.

The key steps you can take to protect your Achilles tendon from injury are:

  • Make sure you have the correct trainers for your running gait.
  • Warm up well before a run with a brisk walk.
  • Stretch out the calf muscles well before and after a run.
  • Do not increase your running intensity and/or speed too quickly.
  • Avoid over-training.


  • If you begin to feel a niggle in your Achilles tendon, the first thing you must do is apply ice to the area and keep icing it for 48–72 hours.

  • Even if you feel it is over the top, keep icing. You must reduce any inflammation as soon as possible.

  • Once you have iced the area for a few days, try some of the foam rolling, stretching and strengthening (in that order) exercises by clicking on the blue button above. Be VERY careful foam rolling the achilles area. If in doubt, STOP.

  • If you have achilles pain that will not go, it’s strongly suggested that you seek professional advice from a physiotherapist. They will then prescribe you a very specific series of stretches and exercises to help repair the tendon and get you back on the road.

  • Be patient - achilles tendon rehab can take weeks, so listen to the advice and DO THE EXERCISES you are prescribed.