Start with understanding
Achilles tendinopathy describes persistent pain and reduced function in the tendon that joins the calf to the heel. Symptoms can involve the middle of the tendon or its attachment at the heel.
Location matters because advice appropriate for midportion symptoms may not suit insertional symptoms. Assessment also separates tendinopathy from a sudden tendon rupture.
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Connect understanding to daily life
Explain the load and the location
Morning stiffness, pain during activity, and the response later that day can help describe the pattern. Point to the painful region rather than assuming all pain behind the heel is the same condition.
Rehabilitation is more than stretching
A tendon-loading plan may be part of rehabilitation. It should match the clinical findings, current capacity, and activity demands. Do not assume that a deep heel drop copied online is appropriate, especially when pain is at the heel attachment.
A sudden pop needs urgent assessment
A sudden pop or snap with difficulty pushing off can indicate rupture and warrants prompt medical assessment. It should not be managed as an ordinary tendinopathy flare. Tell a clinician about medication history and other health factors as part of assessment.
Build the plan around your life
Tell the team which part of your routine has become unreliable: the morning walk, a standing shift, or the push-off needed in sport. Ask what the next achievable milestone would be. A plan should help you approach that task with a clear purpose rather than collecting exercises without knowing how they relate to your goal.
Make your next visit useful
Describe where the pain sits, how it started, and what happens after an active day. Bring recent changes in training and footwear, as well as relevant medication history. Ask how the plan distinguishes ordinary symptom variation from a change that needs reassessment.
Educational information complements individual guidance. Your health history, goals, and examination determine appropriate care.
Build your understanding
Five ideas to build your understanding. Swipe, use the arrows, or focus the slides and use your keyboard.
Is heel pain always Achilles tendinopathy?
No. The precise location and examination help distinguish Achilles pain from plantar heel pain and other conditions.
Can I use the same routine for insertional and midportion pain?
Not automatically. Ask how the tendon location changes the exercise range and other choices in your individual plan.
What the evidence means for you
The painful location changes the clinical picture
AAOS distinguishes insertional and noninsertional Achilles problems and describes rupture warning signs.
Put it to use: Point to the painful region and explain whether symptoms were gradual or followed a sudden pop.
Keep in mind: The page is educational and cannot rule out a rupture remotely.
AAOS OrthoInfo →The current guideline is specific to midportion tendinopathy
The 2024 Achilles guideline updates examination, imaging, clinical course, and rehabilitation recommendations for midportion disease.
Put it to use: Ask whether your diagnosis falls within this guideline’s scope before applying a named protocol.
Keep in mind: A midportion guideline should not be applied automatically to insertional pain or rupture; this link includes the guideline abstract.
JOSPT · 2024 clinical practice guideline →