Your Achilles hurts.
But why is it doing
so much work?
Achilles tendon pain can make running, walking, climbing stairs and even your first steps in the morning uncomfortable.
At Yokohama Physio, we look beyond the painful tendon. We assess the tendon itself, how your lower limb moves, and the physical demands placed on your body.
Does this sound familiar?
Achilles symptoms often develop gradually, although sudden pain can also occur. The timing and location of pain help guide assessment.
Morning stiffness
Stiffness or discomfort around the Achilles tendon during your first steps after getting out of bed.
Pain when running
Symptoms during running, especially after changes in training intensity, hills or distance.
Recurring calf tightness
Calf tightness that keeps returning despite regular stretching or massage. This may or may not be related to the Achilles tendon.
Pain during heel raises
Discomfort when rising onto your toes, climbing stairs or performing calf-strengthening exercises.
Loading the tendon matters. Understanding the overload matters too.
Progressive tendon loading is an important part of Achilles rehabilitation. But simply adding more exercises does not address every factor contributing to symptoms. We also ask what demands are being placed on the tendon, how those demands are managed, and whether anything needs to change.
Why does Achilles tendon pain keep coming back?
Achilles tendinopathy is commonly associated with changes in tendon loading and the tendon’s response to those demands. Symptoms can develop when activity exceeds current tolerance.
Running volume, speed work, hill training, jumping, recovery and calf strength may all be relevant.
Depending on the person, we may also explore ankle movement, foot function, big toe mobility, hip movement and walking or running mechanics.
These movement findings do not automatically explain the pain. We assess whether they are clinically relevant rather than assuming every Achilles problem has the same cause.
Questions worth asking
- Where exactly is the tendon painful?
- Has your training load recently changed?
- How does the tendon respond during and after activity?
- Is calf strength or endurance relevant?
- Are movement or loading strategies worth modifying?
- What activities do you want to return to?
Midportion Achilles tendinopathy and insertional Achilles tendinopathy can require different exercise modifications. Pain close to the heel bone may be sensitive to compression during deep ankle dorsiflexion. An accurate assessment matters before choosing heel-drop exercises or stretching.
We assess the tendon. And the movement around it.
We start with the painful area, your history and functional demands, then examine other factors when relevant to your presentation.
Understand your symptoms
We discuss your pain, training history, previous treatment, activity goals and how the tendon responds over time.
Examine relevant function
We evaluate the tendon, calf capacity and, where appropriate, ankle and foot mobility, hip movement and functional tasks.
Test meaningful changes
We examine how symptoms respond to appropriate changes in movement, exercise or loading. These findings help guide your rehabilitation.
It's not simply about making the tendon stronger.
Effective rehabilitation often combines progressive exercise, appropriate load management, and changes to activities that aggravate symptoms.
Load management
Adjusting running, jumping and other activities according to symptoms and current tendon tolerance.
Progressive strengthening
Individually prescribed calf and tendon-loading exercises, progressing resistance and activity as appropriate.
Movement assessment
Exploring walking, running and lower-limb movement to identify useful, individual adjustments where relevant.
Return to activity
A gradual plan for returning to running, sport, gym training or everyday activities, guided by capacity and symptom response.
That is a clinical decision, not a universal rule. Some people need temporary activity modification. Others benefit from progressive loading while remaining active. Often, rehabilitation involves both. Completely avoiding tendon loading for long periods is generally not the goal.
From everyday walking to competitive sport.
Our approach is tailored to the person, not simply their activity level.
Runners
Achilles symptoms associated with running, hill sessions, speed work or training progression.
Gym and HYROX athletes
Tendon symptoms during lunges, running, jumping and other high-demand exercises.
Recreational athletes
People returning to tennis, football, hiking or other active pursuits.
Everyday Achilles pain
Pain or stiffness affecting walking, stairs and normal daily movement.
Experienced care. Individual clinical reasoning.
BHSc Physiotherapy / BSc Sports & Recreation
15+ years of clinical experience
I've worked with people experiencing recurring Achilles and calf symptoms, from recreational runners to competitive athletes.
My approach is to understand the demands placed on the painful area, assess relevant movement and physical capacity, and choose rehabilitation strategies based on the individual.
Learn More About Yuji ↗Questions about Achilles tendon pain
Why is my Achilles tendon stiff in the morning?
Morning stiffness is a common feature of Achilles tendinopathy. Symptoms may change with movement and loading. Other conditions can cause similar symptoms, so the pain location and clinical history also matter.
Should I stretch my Achilles tendon?
Stretching is not automatically necessary. Some people tolerate it well, while others, particularly those with insertional Achilles symptoms, may be aggravated by deep dorsiflexion stretching. Exercise should match the condition.
Are eccentric heel drops the best treatment?
Eccentric exercises can be helpful, but they are not the only effective strengthening strategy. Other progressive loading approaches can also be appropriate. Exercise selection depends on the tendon presentation and tolerance.
Can my hip or foot affect Achilles tendon loading?
Hip, ankle and foot function can influence how people move and distribute forces. However, an unusual movement pattern does not automatically cause Achilles pain. We assess whether these factors are relevant for the individual.
Should I stop running with Achilles pain?
Not necessarily. Some people can continue modified running while rehabilitating. Others need a temporary reduction in activity. The decision depends on symptoms, severity, diagnosis and response to loading.
How long does Achilles rehabilitation take?
Recovery varies with symptom duration, tendon presentation, physical demands and individual response. Tendon rehabilitation often takes months rather than days, especially when symptoms have been present for a long time.
What happens at my initial consultation?
We discuss your symptoms and activity history, assess the tendon and relevant movement, and provide treatment or exercise guidance where appropriate.
A sudden pop or snapping sensation at the back of the ankle, particularly with difficulty walking, pushing off or rising onto your toes, may indicate Achilles tendon rupture and requires urgent medical evaluation. A hot, markedly swollen limb, unexplained calf swelling or other concerning symptoms also need prompt assessment. This page is general information, not a diagnosis.
Let's understand why your Achilles keeps hurting.
Whether you're struggling with morning stiffness, running-related pain or recurring Achilles symptoms, start with an individual consultation at Yokohama Physio.
Book Initial Consultation ↗