Achilles tendon pain: causes and what helps in general
A guide to Achilles tendon pain at the back of the heel, why it develops in runners and active people, and the signs that need urgent attention.
The Achilles tendon connects the calf muscles to the heel bone and handles large loads when you walk, run and jump. Pain in this tendon, called Achilles tendinopathy, often develops when load increases faster than the tendon can adapt.
When to get urgent help
Go to A&E or call 999 if you have any of these. They can be signs of a fracture, infection, blood clot or other emergency.
- A limb that looks deformed, or a joint that you cannot move or put weight on after an injury
- A cold, pale or numb foot or hand after injury
- A hot, red, swollen joint with a high temperature
- A painful, swollen, warm calf, with or without breathlessness or chest pain
What it can feel like
- Pain and stiffness in the tendon, in the back of the ankle or just above the heel
- Stiffness that is worse first thing in the morning or after sitting
- Pain that builds during running or jumping and may ease once warmed up
- Sometimes thickening or tenderness along the tendon
Common contributors
- A rapid increase in running, hill work or speed work
- Changes in footwear or running surface
- Calf tightness or weakness
- Returning to training after a break too quickly
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Avoid complete rest. Tendons generally respond to controlled, gradually increasing load
- Reduce the activities that clearly provoke the pain, then build back in small steps
- Choose supportive footwear and consider a small heel lift temporarily if it makes walking more comfortable
- Avoid sudden jumps in distance or intensity when you return to running
- If you use over-the-counter pain relief, follow the packet instructions or ask a pharmacist
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Pain after a significant injury, fall or twist
- Pain that is constant, severe or getting worse, or wakes you at night
- Unexplained weight loss, fever or feeling generally unwell with limb pain
Consider seeing your GP if:
- A sudden sharp pain or a feeling of being kicked in the back of the ankle, or a popping sound. This can be a tendon rupture and needs urgent assessment
- You cannot rise onto your toes or push off properly
- Pain that is not improving after several weeks
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of Achilles tendon pain, so I do not claim that osteopathy treats it.
What an osteopath can usefully do is assess the tendon, calf and ankle, look at training load and footwear, rule out a tendon tear, and guide a graded loading programme. Progressive calf loading is the best-supported approach for Achilles tendinopathy, and tendons adapt slowly, so progress is measured in weeks to months. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
How long does Achilles tendon pain take to settle?
Tendons adapt slowly to load, so recovery from Achilles tendinopathy is usually measured in weeks to months rather than days. Gradual, controlled loading tends to work better than complete rest.
How do I know if I have ruptured my Achilles?
A sudden sharp pain or a sensation like being kicked in the back of the ankle, sometimes with a pop, and difficulty rising onto your toes, can mean a rupture. This needs urgent assessment, so go to A&E or call NHS 111.
Free 5-minute exercise sheet
A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.