Achilles Tendinopathy: Why Your Heel Pain Might Not Be Plantar Fasciitis

Heel pain is one of the most common reasons people come to see us. For many, plantar fasciitis is the first condition that comes to mind. But not all heel pain is the same. If you feel pain at the back of the heel, especially in the morning, the problem may be with your Achilles tendon. Achilles tendinopathy is often overlooked, yet it’s one of the leading causes of heel pain we treat in the clinic.

What Is Achilles Tendinopathy?

The Achilles tendon is the thick cord that attaches your calf muscles to your heel bone. Tendinopathy occurs when this tendon becomes irritated or degenerative from overuse or stress. It’s different from a short bout of inflammation, it often lingers, causing stiffness, swelling, and pain that doesn’t just disappear with rest.

Common Symptoms

Patients with Achilles tendinopathy often describe:

• Pain and stiffness in the back of the heel first thing in the morning.

• Tenderness when squeezing the tendon.

• Pain that increases with activity like running, jumping, or climbing stairs.

• A swollen or thickened tendon.

• Difficulty pushing off during walking or sport.

If your pain is underneath the heel, that’s more consistent with plantar fasciitis. But pain at the back of the heel is usually the Achilles.

Why It Gets Confused With Plantar Fasciitis

Plantar fasciitis and Achilles tendinopathy can look similar to someone experiencing heel pain for the first time. Both cause morning pain, both flare with activity. The key difference is location. Plantar fasciitis hurts under the heel. Achilles tendinopathy hurts at the back. Without a proper assessment it’s easy to misdiagnose, which delays the right treatment.

Risk Factors

• Sudden increases in exercise or training.

• Unsupportive or worn-out footwear.

• Flat feet or very high arches.

• Tight calf muscles.

• Sports that involve repetitive jumping or sprinting.

• Natural age-related changes in tendon elasticity.

How We Assess It

At My Family Podiatry we take a thorough approach:

• Locating the exact site of pain.

• Assessing in clinic with an ultrasound

• Checking calf flexibility and ankle mobility.

• Assessing foot posture and gait.

• Looking at footwear and training history.

This lets us target treatment properly instead of guessing.

Treatment Options

Load Management: Simply resting usually doesn’t fix Achilles tendinopathy. We work with you to adjust training loads and activities so the tendon isn’t constantly overloaded.

Exercise Therapy: Eccentric calf strengthening exercises are one of the most effective ways to stimulate tendon healing. Building calf strength helps the tendon adapt and repair.

Footwear and Orthotics: Supportive shoes and custom orthotics reduce excessive strain and improve alignment.

Shockwave Therapy: For stubborn Achilles tendon pain, EMS Dolorclast shockwave therapy can make a huge difference. It stimulates blood flow, promotes tissue repair, and reduces pain.

Manual Therapy and Stretching: Targeted stretching and soft tissue treatment support the other interventions.

When to Seek Help

If back-of-heel pain has lasted more than a couple of weeks, if swelling is obvious, or if pain is stopping you from walking or running comfortably, it’s time to get checked. The earlier we treat it, the quicker the recovery.

Heel pain isn’t always plantar fasciitis. If you’ve got pain at the back of your heel, especially first thing in the morning, it could be Achilles tendinopathy. The good news is that with the right treatment plan, from load management and exercise through to orthotics and shockwave therapy, you can get back to moving without constant pain.

If Achilles tendon pain is slowing you down, call My Family Podiatry today and let’s start your recovery.

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