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The Achilles tendon connects the calf muscles to the heel bone. Most symptoms that develop gradually result from a tendon that temporarily cannot cope with the load placed on it. A sudden tear is a different condition and needs prompt assessment.
- Pain and stiffness a few centimetres above the heel or right at the attachment point are consistent with Achilles tendinopathy.
- The first steps after sleeping or sitting may hurt. Pain may ease briefly during movement and increase again later.
- Complete rest usually does not restore the ability to tolerate load. Temporarily adjusting the load and gradually strengthening the calf and tendon are the core of treatment.
- A snap or feeling of being kicked, sudden loss of strength, a gap in the tendon or inability to stand on tiptoe may indicate a rupture.
- An ultrasound or MRI is usually unnecessary for a typical overload problem, but may help if there is uncertainty, trauma or inadequate recovery.
- Recovery often takes months. Pain does not always have to disappear completely before the load can safely be increased.
- Smoking, certain diseases and some medicines can make the tendon more vulnerable or slow recovery.
- Have persistent, worsening or bilateral symptoms assessed, and do not wait if you suspect a tear.
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