Dr. Abbie Clinics

Achilles Pain

Pain in the tendon at the back of the heel, often stiff in the morning and sore after activity rather than during it.

  • Common in runners
  • Load related
  • About 45 minutes
  • Nine NSW clinics

Trusted by patients from Sydney to Narrabri

Podiatry NSW/ACT American Academy of Podiatric Sports Medicine (AAPSM) Sports Medicine Australia AHPRA — Australian Health Practitioner Regulation Agency
What you notice

Symptomsand causes

If this sounds like your pain, there is a structural reason for it. The assessment is what finds it.

Common symptoms

  • Stiffness in the tendon first thing in the morning
  • Pain that warms up during activity and returns afterwards
  • Tenderness when you squeeze the tendon above the heel
  • Thickening or a tender lump along the tendon

What causes it

The Achilles transmits everything the calf does into the foot. Pain there usually follows a change in load — more running, faster running, different surfaces or shoes — or a mechanical reason the tendon is working harder than it should.

Diagram comparing a normal Achilles tendon with tendonitis, rupture and tendonosis
Diagram comparing a normal Achilles tendon with tendonitis, rupture and tendonosis
In detail

UnderstandingAchilles pain

The Achilles tendon joins the calf to the back of the heel. Our assessment looks at which side of the tendon hurts, because each side points to a different way the foot is moving.

A thickened Achilles tendon at the back of the heel

Which side of the tendon

Foot rolls in

Inner side

Burning pain and inflammation on the inside of the ankle, behind the ankle bone. Rolling in puts extra strain on the inner tendon.

Rolls out, then in

Both sides

Burning, sharp pain and swelling either side of the attachment, sometimes with a hard lump on the tendon.

Foot rolls out

Outer side

Pain and swelling on the outer side. Often a high-arched foot that stays rolled out through the whole step.

Tendonitis or tendonosis?

The main difference is time. Tendonitis is short-term inflammation, often after a direct injury. Tendonosis is long-term, from repeated strain or an injury that has not healed.

The name matters less than the cause

It matters less what the diagnosis is called than finding the biomechanical reason for it. That reason is what the treatment is aimed at.

Why it should not be ignored

Over time, strain can cause small tears, scarring and adhesions in the tendon.

What a plan can include

Orthotics (with forefoot additions where needed), shockwave, dry needling, manipulation and massage, and injection therapy.

How we diagnose it

The cause,not the sore spot

Achilles Pain is diagnosed with the Najjarine Biomechanical Assessment, so treatment is prescribed against a finding rather than a symptom.

Dr Abbie Najjarine assessing a patient’s gait on a treadmill
01

Assess

We assess calf function and how the foot loads through push-off.

02

Diagnose

We work out whether the problem is the load, the mechanics, or both, and show you what we found.

03

Treat

Treatment addresses the mechanics alongside a graded loading plan, rather than rest alone.

Dr Abbie Najjarine demonstrating a lower limb assessment, with alignment marked on the leg and practitioners observing
Start here

Book an assessment

Find out what is actually causing your Achilles pain.

Patient feedback

What patients sayabout Achilles pain

Google 4.9 Based on 286 Google reviews across our clinics
Chris V. Dr. Abbie Clinics · 3 weeks ago Google

Given a loading plan rather than told to rest, which is what finally worked.

Elena G. Dr. Abbie Clinics · 1 month ago Google

They looked at my calf and my running load, not just the tendon.

Nathan J. Dr. Abbie Clinics · 2 months ago Google

Straightforward explanation of what stage it was at and why that mattered.

Questions

Achilles Painquestions

Not always, and not always completely. Load usually needs managing rather than stopping. Your podiatrist will set that out for your case.

They are different stages and are managed differently, which is part of what the assessment establishes.

The tendon stiffens overnight and is loaded suddenly when you stand. That pattern is one of the things we ask about.

Tendons are slow to respond. You will get a realistic timeframe at the assessment.

No. You can book directly.

Treating lower limb pain since 1990

Book yourassessment

Choose your clinic and book straight into its diary, or call and we will point you to the right practitioner.