How heel and Achilles pain can develop
Sometimes symptoms begin after a change in running, walking, exercise or the amount of time you spend on your feet. In other cases, they build gradually without a single obvious trigger.
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Pain beneath the heel and pain around the Achilles tendon often involve different tissues. Where you feel it, when it is most noticeable and what brings it on can all help us build a clearer picture of what may be happening.
Common heel and Achilles problems
Heel and Achilles pain can come from several different tissues. Where you feel the pain and how it behaves can help us understand what may be involved.
Plantar heel pain
Pain beneath the heel, often called plantar fasciitis, is commonly most noticeable with the first few steps after rest or after spending longer periods on your feet.
Mid-portion Achilles pain
Pain and stiffness a few centimetres above the heel can occur with Achilles tendinopathy and may become more noticeable with running, hills or repeated loading.
Insertional Achilles pain
Pain can also occur where the Achilles tendon attaches to the heel bone. This can behave differently from pain higher in the tendon and may need a different approach.
Other causes of heel pain
Not all heel pain comes from the plantar fascia or Achilles tendon. Other tissues can produce similar symptoms, which is why assessment is important before deciding on treatment.
Understanding what may be contributing
Changes in activity, training or the amount of time spent on your feet can alter the demands placed on the heel and Achilles tendon. Sometimes, though, symptoms develop without an obvious change.
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We’ll look at where your pain is, how it behaves and how your foot and ankle are functioning. Depending on the problem, this may include looking at ankle movement, calf strength and how your symptoms respond to loading.
Knowing when something needs more attention
A sudden Achilles injury, particularly with a snapping sensation or marked difficulty pushing off or walking, needs prompt medical assessment.
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We’ll also consider whether your heel pain may involve another structure or whether further investigation would be useful.
Getting back to activity
With many heel and Achilles problems, reducing pain is only part of the picture. Gradually rebuilding strength and your ability to tolerate walking, running and other activity can be an important part of recovery.
We can help you understand what you can keep doing, what may be worth adjusting for a while and how to build your activity back up gradually.
When shockwave therapy may be appropriate
For some persistent plantar heel pain and Achilles tendinopathy, radial shockwave therapy may be considered when symptoms have not improved sufficiently with initial care.
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At Back In Motion, treatment is delivered using a handheld applicator over the affected area. The response varies, and shockwave is not the right option for everyone. We’ll explain the potential benefits and limitations and discuss whether it is appropriate for you.
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Exercise, gradual loading and advice about activity can still be important alongside treatment, particularly for Achilles tendon problems.
How we can help.
Clear assessment
We look at where your pain is, how it behaves, your movement and strength and the activities that bring on your symptoms.
Shockwave therapy
Radial shockwave therapy may be considered for suitable persistent plantar heel pain or Achilles tendinopathy as part of a wider treatment plan.
Strength & movement
Progressive exercise can help rebuild strength and improve your ability to tolerate walking, running and everyday activity.
Practical advice
We’ll help you understand what you can keep doing and whether temporary changes to activity, training or footwear may be useful.