Achilles Tendon Pain: Most Common Cause & How To Treat It?

It can be disempowering going throughout the day with pain in the Achilles tendon not knowing what is the cause and you can treat it. I understand that it may even be concerning, as the pain not only affects your physical yet mental state as well. But do now worry, you came to the right place. Today you will find out what is the most common cause of pain in the Achilles tendon and how to treat it.

Most Common Cause of Achilles Tendon Pain

The Achilles tendon is the strongest tendon in your body as it plays an important role in walking, running, or jumping. Your Achilles tendon absorbs a huge amount of force as well it produces the same amount of force output. Different activities require different amounts of force absorption which can be up to several times your body weight such as running and jumping.

Achilles Tendinopathy

The most common cause of pain in the Achilles tendon is a condition called Achilles Tendinopathy. 

Having a strong Achilles tendon is essential but your everyday life and activities can lead it to wear out. You may experience symptoms such as pain, tenderness, swelling, and stiffness around your tendon, heel, and back of the ankle.

The repeated stress of your tendon causes small micro-injuries to take place and never actually heal up properly. As your Achilles tendon has insertions on the heel bone and calf muscles, gastrocnemius, and soleus, the injury can occur in several places. The most common one is where the muscle joins in with the tendon, called the junction. The junction takes a longer time to heal as it has less blood supply than your muscles.

That is why proper rehabilitation and knowledge about this condition are necessary.

It is hard to pinpoint what the exact cause for developing Achilles tendinopathy may be in your case. Usually there are several points that you should look out for:

Repeated stress

When your tendon absorbs the force you place upon it, it can be viewed as a moment of stress for the tendon. For individuals that are often physically active, maybe an athlete, or have a job that is physically demanding or requires plenty of standing and walking hours the risk is higher.

This is due to the excess amount of stress placed upon the Achilles tendon and inadequate rest. The wear and tear in a similar matter is often the most probable cause for developing Achilles tendinopathy.

Bad training technique and intensity

Your running or jumping techniques play a major role in your developing Achilles tendinopathy. Remember that your Achilles tendon works like a rubber. It needs to stretch and contract properly for it to provide adequate force absorption and output.

If your heel is striking the floor first while running or running, it hinders the proper mechanics and causes increased amounts of stress on your tendon. If you train at a much higher intensity than what your body is used to, your Achilles tendon won’t be able to absorb the excess force. 

Improper footwear & Excess Pronation

Using shoes that are unsupportive or provide an unnecessary amount of support. Are you using too big and wide or too small and narrow shoes? It is all about finding footwear that is fit for your needs.

If you find yourself having excess pronation (flat arch or foot rotating inwards) you are at higher risk for developing Achilles tendinopathy. This is due to the fact that improper anatomy in your foot affects the ability of the Achilles tendon to absorb force. 

How to Treat It?

Well, the first step is obvious. Rest! If you are not able to rest because of the work, try changing your work patterns if possible. By that I mean, take more frequent shorter breaks or shift your working responsibilities and tasks.

Do not be afraid to have this discussion with your boss. Your health comes first and your Achilles tendon will thank you in the long run.

This said, do not opt-in on resting without moving around from time to time. A complete immobilization will only lead to muscle atrophy, meaning muscle loss. Muscle loss will cause your rehabilitation time and pain to increase. 

Get yourself proper footwear as discussed earlier in this post. Find shoes with enough support and cushioning, not too little and not too much. We need your feet and surrounding muscles and tendons to move and work adequately. If you do suffer from excess pronation try getting supportive insoles or heel locks. 

Rehabilitation, Strength & Flexibility Training

For some of you changing your shoes and resting a bit more may be the solution but generally for everyone suffering from Achilles tendinopathy, a proper rehabilitation regime is necessary. The rehabilitation regimes usually consist of you performing strength and flexibility training.

For best effect, get in touch with a physical therapist who will organize an optimal personalized program for you. Sometimes physical therapists may even perform manual therapy, meaning they work hands-on directly on your body. 

But, I do understand that for some of you this is not an option because of different personal reasons. That is why I will be providing you with beneficial exercises and techniques for treating your Achilles tendinopathy, Achilles tendon pain.

Calf Raise Isometric Holds

This exercise should be performed at the start of your rehabilitation. Performing isometric hold meaning holding one position for a certain amount of time has shown beneficial effects regarding pain and strength.

Depending on your level of pain or irritability you can choose to perform this exercise with both legs or one leg. Hold the calf raise position at the end or mid-portion for a couple of seconds. Start by performing shorter holds and fewer repetitions. Increase gradually as your pain sensation decreases.

Eccentric & Regular Calf Raises

When your pain and irritability levels decrease then you can start performing eccentric calf raises. It is performed by a regular concentric and one-legged excentric part. That means that you start by performing a regular calf raise meaning up with both legs but on the way down you do it only with one. The way down, excentric, the part should take from 3-6 seconds. 

When further decreases in pain occur that is when you can start performing regular calf raises. Start with both feet on a flat surface before moving to one foot. The level of difficulty can be increased by performing calf raises on some kind of ledge, or stair and adding additional weight.

Plyometric Exercises

After adequate strength and pain decreases occur it is time to start performing plyometric exercises. Plyometric exercises work on the tendons’ energy force absorption and output by utilizing a stretch-shortening cycle. Those exercises may consist of different jumping, landing, or hopping components. This phase is extremely important for athletes and those physically active as it is a major step towards going back to your previous activity level.

Examples of plyometric exercises are: skipping (jumping rope), double or single leg hops, bound jumps, etc. All of the exercises can be made more difficult by performing jumps in different directions, more repetitions, or with additional weight.

Manuel Therapy for Achilles Tendon Pain

As mentioned earlier, a physical therapist may want to use manual therapy. Manual therapy consists of hands-on work where your joints and muscles get mobilized. Our body functions as one. If you have dysfunction in one part, now the Achilles tendon, it can cause limitations in the other. By mobilizing other joints and muscles, your body will be able to heal faster and be in less discomfort. In some cases, therapists may even use a different kind of tape for increasing stability and by that even decrease pain.

Manual therapy, still effective but not most optimal, can be performed by yourself. You will need different kinds of equipment such as foam rollers, hard massage balls, massage guns, tapes, etc. All this equipment works by an increase in blood flow and providing new healing substances to your injured body part.

If you have recurring issues it can be a good investment to get yourself one of the tools mentioned above. Some of them such as foam rollers and hard massage balls require more active work on your part. A massage gun is not as cheap but it is easier and more enjoyable to use.


Overuse, poor circulation, and flexibility without proper rest time can lead to the Achilles tendon wearing out. Macro injuries that occur and do not heal properly can cause Achilles tendon pain. The most common cause of this type of pain is called Achilles tendinopathy. The repetitive strains are the number one reason, followed by poor training and footwear for developing this condition. Start by getting active rest. Visit a physical therapist if possible. Take time to perform rehabilitation exercises. 

Your body and health are most important.