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Why am I getting pain in my heel or achilles tendon?

Updated: Oct 10, 2023

Have you recently started running, or taken up another new sporting or work activity and are now noticing some pain at the back of the heel?

Does it take a few steps for things to ‘get going’ first thing in the morning or after you have sat for a while? Maybe it is a bit stiff and sore when you start running, but actually improves when you get into the run, only to return with a vengeance afterwards? Does stretching your calf, or poking at the back of the heel, aggravate things?

You could be developing an Achillies tendinopathy (the condition formerly known as tendinitis, or tendinosis).

Tendons are strong, collagen fibers that connect muscles to bones, and act like springs to store and transfer energy, allowing movement to occur. Tendons are creatures of habit and require a consistent load to stay happy. When there is a change in load, tendons can become irritated and can often leave us with pain. This commonly occurs with a large or rapid increase in load; however it can also occur with a sharp reduction of load. These overloaded or underloaded states cause the tendon to become disorganised and inefficient at handling the required loads, which can cause pain and dysfunction.

Achillies tendinopathy refers to this condition occurring around the lower end of the calf muscle, where it attaches onto the heel. Commonly, this occurs when someone exhausts their calf muscle by rapidly increasing the load through the area, such as starting a running program when they haven’t ran for a long time. Other risk factors for developing this condition include older age, weaker lower limb muscles, and a history of ankle instability.

Fortunately, this pain does not have to last forever. Tendons like to be loaded consistently, within what they can tolerate at any given time, and the Achillies tendon is the largest and strongest tendon in the human body! Therefore, the mainstay treatment for this is optimal loading. This involves reducing your exercise and daily activity load initially (but not stopping the activity!) to a level that the tendon can tolerate, and gradually building up the tendon’s capacity through targeted exercises and safe activity progression.

Your physiotherapist will work with you to find the best combination of optimal activity loading, with some lower limb strengthening exercises to build the tendon’s resilience. While this injury can take anywhere from one to six months to fully recover, you will be progressively doing more and more of the activities you love. Speak to one of our friendly physiotherapists to assist you in progressing your activities safely and effectively to enable this optimal loading to occur in your tendon.

call us on 9744 5066 for more information :)

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