Pain in the back of your ankle or around your heel can make even simple movements feel difficult, and knowing what’s causing it isn’t always straightforward. Two of the most common culprits are Achilles tendonitis and ankle sprains. While they can feel similar at first, they’re very different injuries that require distinct treatments.
At South Texas Podiatry in San Antonio, our board-certified podiatrists, Dr. Ed Davis, DPM, Dr. Silas Espino, DPM, and Dr. Bryan Sagray, DPM, are experts in diagnosing and treating both conditions with precision and care. If you’re experiencing heel or ankle pain, we’re here to help you find relief and prevent future injuries.
Let’s explore the differences between Achilles tendonitis and ankle sprains, so you can better understand your symptoms and get the right care.
What Is Achilles Tendonitis?
Achilles tendonitis is a condition involving irritation or inflammation of the Achilles tendon, which is the thick band of tissue at the back of your ankle connecting the calf muscles to the heel bone. It typically results from repetitive strain, especially in athletes and active individuals.
Common Achilles Tendinitis Symptoms
- Dull or aching pain in the back of the heel, especially after activity
- Stiffness in the tendon upon waking
- Swelling and a warm feeling above the heel
- Tenderness to touch along the tendon
- Difficulty performing heel raises or walking uphill
These symptoms can develop gradually and are usually more noticeable during or after physical exertion.
Pain Location
Pain is often centered 1 to 2 inches above the heel, where the tendon is most vulnerable to strain and microtears.
How Achilles Tendonitis Develops
Achilles tendonitis often develops from repetitive stress or improper movement patterns. You don’t have to be a competitive athlete to experience this condition. Common contributing factors include:
- Running on hills or uneven terrain
- Tight or inflexible calf muscles
- A rapid increase in training intensity or duration
- Unsupportive shoes with poor arch or heel cushioning
- Biomechanical issues like overpronation (foot rolling inward) or oversupination (rolling outward)
Without proper stretching, recovery time, or footwear, the tendon becomes overstressed, leading to irritation and pain.
Achilles Tendonitis Pain Treatment & Recovery
Most cases of Achilles tendonitis improve with non-surgical care when addressed early. At South Texas Podiatry, your treatment plan may include:
- Reducing activities that worsen symptoms
- Applying ice and elevating the foot to manage inflammation
- Calf stretches and Achilles strengthening exercises
- Orthotics to improve foot alignment
- Anti-inflammatory medications under medical guidance
- Manual therapies like ultrasound and soft tissue mobilization
- ESWT (extracorporeal shockwave therapy) for chronic pain
- Minimally invasive options, such as the Topaz procedure, for persistent cases
Healing times vary. Mild tendonitis may improve in a few weeks, while more advanced or chronic cases can take several months.
What Is an Ankle Sprain?
An ankle sprain is a soft tissue injury that occurs when the ligaments around the ankle are stretched or torn. It’s typically the result of a sudden misstep, fall, or twist, causing the foot to roll unnaturally.
Common Ankle Sprain Symptoms
- Sharp pain at the time of injury
- Swelling and bruising around the ankle joint
- Difficulty standing or walking
- A popping sensation at the time of the sprain
- Feeling of instability or looseness in the joint
Pain Location
Pain tends to be concentrated on the outer side of the ankle, especially with lateral (outside) sprains, which are the most common type.
How Ankle Sprains Occur
Ankle sprains typically occur during high-impact sports, uneven surface walking, or sudden changes in direction. Common causes include:
- Stepping into a hole or on an uneven surface
- Landing awkwardly after jumping
- Wearing unsupportive footwear
- Previous history of ankle injuries, which increases risk of recurrence
Sprains range from mild (grade 1) to severe (grade 3), depending on the extent of ligament damage.
Healing Time & Treatment for Ankle Sprains
Ankle sprains can vary in severity, and so does their healing time. While mild sprains may resolve within 2–4 weeks, more moderate or severe sprains can take several months to fully heal—especially without proper care.
At South Texas Podiatry, we focus on comprehensive, non-invasive treatment to support full recovery and prevent reinjury. Your care plan may include:
- RICE Protocol: Rest, ice, compression, and elevation to reduce swelling and manage pain in the early stages.
- Stabilization Devices: Temporary use of ankle braces, wraps, or walking boots to protect the joint and limit movement during healing.
- Rehabilitation Therapy: Guided physical therapy focused on restoring strength, balance, and flexibility in the ankle.
- Custom Orthotics: Supportive shoe inserts designed to improve foot alignment and reduce the risk of future sprains.
- Sport-Specific Recovery Plans: For athletes, we offer tailored rehabilitation to safely transition back to activity and minimize re-injury risk.
Prompt diagnosis and early treatment not only speed up recovery but also reduce your chances of developing chronic ankle instability, which can affect long-term mobility.
Achilles Tendonitis vs. Ankle Sprain: Key Differences
Achilles tendonitis and ankle sprains often feel similar at first, but they’re very different injuries that require distinct treatment approaches. Understanding how to tell them apart is key to proper healing.
Pain Location
Achilles tendonitis causes pain just above the heel at the back of the ankle.
An ankle sprain, on the other hand, typically causes pain on the side of the ankle—either the outer or inner portion, depending on which ligaments are affected.
Cause
Achilles tendonitis is usually the result of repetitive stress or overuse, especially in runners, athletes, or individuals with tight calf muscles.
Ankle sprains occur suddenly—often from a misstep, twist, or fall that overstretches or tears the ligaments around the ankle.
Symptoms
With Achilles tendonitis, symptoms tend to develop gradually. You might feel ongoing stiffness, swelling, and a dull ache in the tendon, especially in the morning or after activity.
Ankle sprains are more abrupt. They’re usually marked by sharp pain at the time of injury, followed by swelling, bruising, and potential difficulty bearing weight.
Healing Time
Achilles tendonitis may take several weeks to months to heal, especially if left untreated.
Most mild to moderate ankle sprains improve in a few days to a few weeks with proper care.
Treatment Focus
For Achilles tendonitis, treatment involves reducing strain on the tendon, improving calf flexibility, and strengthening the surrounding muscles.
Ankle sprains are treated by controlling swelling, protecting the ligaments with bracing or taping, and restoring ankle strength and stability through physical therapy.
When Achilles Hurts After a Sprained Ankle
If you develop pain in your Achilles after an ankle sprain, it may be due to changes in how you walk or stand during recovery. Limping, favoring one side, or reduced mobility can increase stress on the Achilles tendon.
This kind of secondary pain is common and should be evaluated, especially if the discomfort continues or worsens. Our podiatrists at South Texas Podiatry can determine whether you’re dealing with lingering effects of the sprain or new Achilles tendonitis and help you heal properly.
Diagnosing the Right Injury
At South Texas Podiatry, we take the guesswork out of diagnosis. If you’re unsure whether you have tendonitis, a sprain, or both, we offer:
- Detailed clinical evaluations
- On-site diagnostic imaging (digital X-rays, ultrasound)
- Gait and movement assessments
- Custom treatment plans based on your specific needs
Accurate diagnosis ensures your treatment is targeted and effective.
Tips for Managing Foot Pain and Ankle Pain at Home
While it’s best to see a specialist for persistent or severe pain, early care at home can help. Try:
- Resting and avoiding painful movements
- Applying ice packs for 15–20 minutes several times a day
- Wearing supportive shoes with cushioning and proper arch support
- Gently stretching the calf only when pain allows
- Avoiding barefoot walking, especially on hard surfaces
If symptoms don’t improve within a few days or if pain worsens, it’s time to seek professional care.
Why Choose South Texas Podiatry?
At South Texas Podiatry, we offer compassionate, expert care for a wide range of ankle and foot conditions. Whether you're dealing with Achilles tendonitis, an ankle sprain, or chronic foot and ankle pain, our team is here to guide your recovery.
We provide:
- Advanced diagnostics and on-site imaging
- Personalized care from board-certified podiatrists
- Minimally invasive therapies, including ESWT
- Custom orthotics and rehabilitation strategies
- Preventive care for active and athletic lifestyles
Located in San Antonio, Texas, our practice is committed to helping you move comfortably again.
Get Back on Your Feet with South Texas Podiatry
Achilles tendonitis and ankle sprains can disrupt your routine and limit your mobility. With expert evaluation and targeted treatment, you can recover fully and prevent future injury.
Contact South Texas Podiatry today to schedule an appointment. We offer comprehensive Achilles tendonitis pain treatment and ankle pain management to help you return to what you love with confidence.
