Persistent heel pain after a workout or stiffness in the morning might seem minor, but they can be early signs of Achilles tendonitis—a condition that, if ignored, can lead to long-term injury.
At South Texas Podiatry, we specialize in diagnosing and treating Achilles tendonitis with expert care and advanced therapies. Located in San Antonio, our board-certified podiatrists, Dr. Ed Davis, Dr. Silas Espino, and Dr. Bryan Sagray, are here to help you return to pain-free movement with personalized, non-invasive treatment options. If you’ve been dealing with tendon pain, now’s the time to schedule an evaluation.
Let’s take a closer look at the warning signs and how to know when it’s time to seek professional help.
Understanding the Achilles Tendon’s Role
The Achilles tendon connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It’s the largest and strongest tendon in the human body, capable of withstanding forces over 1,000 pounds. Every step, jump, or sprint depends on it.
But as durable as it is, the Achilles is also vulnerable to overuse and strain, making Achilles tendonitis one of the most frequent tendon injuries among runners, walkers, and even sedentary individuals returning to activity too quickly.
7 Signs of Achilles Tendonitis You Shouldn’t Ignore
Recognizing the early signs of Achilles tendonitis is crucial to prevent further damage, chronic pain, or even a complete tendon rupture.
Below are the most common symptoms that may signal inflammation or injury in the Achilles tendon:
1. Morning Stiffness
One of the earliest Achilles tendonitis symptoms is a noticeable stiffness in the back of the ankle when you first get out of bed. This discomfort typically eases as you begin moving and blood flow increases to the tendon. Morning stiffness occurs due to reduced overnight circulation and the tendon tightening during periods of rest.
2. Pain During or After Walking
If you feel Achilles pain when walking, especially after periods of inactivity or during uphill movement, it may indicate underlying tendon inflammation or microtears. This pain often begins gradually and worsens over time if left untreated.
3. Swelling Just Above the Heel
Swelling 1–2 inches above the heel bone is a hallmark of Achilles tendonitis. This may present with warmth, redness, or visible thickening of the tendon. In some cases, swelling can become more pronounced after physical activity.
4. Pain Following Physical Activity
Experiencing Achilles tendon pain during or several hours after jogging, stair climbing, or other repetitive movements is common. The pain may be sharp during exercise and develop into a dull ache later, particularly if the tendon is overused or irritated.
5. Localized Tenderness
Tenderness to the touch is often felt along the tendon, especially in the thickened or swollen area. This pain may increase with light pressure and can become more pronounced after activity or prolonged standing.
6. Weakness or Instability in the Leg
Some individuals report a sense of weakness in the lower leg or instability when pushing off the toes. Difficulty performing heel raises or tiptoeing may indicate tendon impairment, especially in more advanced stages of tendonitis.
7. Limited Ankle Mobility
A tight or inflamed Achilles tendon may restrict ankle movement, reducing your ability to flex the foot upward or downward. This limited range of motion can affect daily activities and athletic performance, especially when climbing stairs or running.
Common Causes and Risk Factors
Achilles tendonitis often develops due to repeated strain on the tendon or sudden changes in physical activity. Whether you're a seasoned runner or returning to exercise after time off, it’s important to understand what might increase your risk.
Below are some of the most common heel pain causes and contributing factors for Achilles tendonitis:
- Overuse or repetitive strain from activities like running, stair climbing, or high-impact sports
- Tight calf muscles, which place extra tension on the Achilles tendon
- Sudden increases in workout intensity or mileage without adequate progression
- Skipping warm-ups or stretching, reducing flexibility, and blood flow before activity
- Poor footwear, especially shoes with weak arch support or worn-out soles
- Foot structure issues, such as overpronation (rolling inward) or oversupination (rolling outward), can increase tendon stress
- Returning to activity too quickly after an injury or an extended period of inactivity
- Acute trauma or forceful ankle movements, such as during sprinting or jumping, leading to tendon overload
Stages of Achilles Tendonitis
Achilles tendonitis typically develops gradually and progresses through distinct stages. Understanding these stages can help patients seek care at the right time before permanent damage occurs.
Stage 1: Reactive Tendonitis
This is the early, short-term response of the tendon to sudden increases in load or activity, such as a new workout routine or running on hills.
- Mild pain and stiffness after activity
- Temporary swelling or tenderness
- Symptoms often improve with rest and load reduction
At this stage, the tendon is still structurally intact, and early intervention, such as stretching, supportive footwear, and modifying activity, can reverse the condition.
Stage 2: Tendon Disrepair
As the tendon is repeatedly stressed without proper recovery, the collagen fibers begin to break down.
- Visible thickening of the tendon
- Ongoing pain, even during moderate activity
- Swelling and stiffness may persist despite rest
This stage reflects more serious internal changes in the tendon and often requires structured treatment, including physical therapy and possibly non-invasive interventions like ESWT (extracorporeal shockwave therapy).
Stage 3: Degenerative Tendonitis
At this point, chronic damage has led to disorganization of tendon fibers, scar tissue formation, and microtears.
- Constant pain with limited improvement
- Significant weakness and loss of function
- High risk of partial or complete tendon rupture
In this advanced stage, conservative treatments may still help, but surgical or minimally invasive procedures (e.g., Topaz procedure) may be considered depending on severity.
When to See a Specialist
If you're experiencing ongoing discomfort in your Achilles tendon, early evaluation can make all the difference in your recovery. Left untreated, Achilles tendonitis may progress to chronic pain or, in more severe cases, tendon rupture.
You should consult a podiatrist promptly if you notice any of the following:
- Persistent or worsening Achilles tendon pain, especially with activity
- Morning stiffness that doesn’t ease after light movement
- Swelling, warmth, or tenderness in the Achilles region
- A “pop” sound or sudden sharp pain in the back of the ankle, followed by difficulty walking
- Recurring heel pain that hasn’t improved with rest, stretching, or over-the-counter care
If these symptoms sound familiar, don’t wait. Delaying treatment may increase your risk of long-term tendon damage and more invasive interventions.
How South Texas Podiatry Can Help
At South Texas Podiatry, we provide expert care for Achilles tendonitis, offering personalized treatment plans that address the root cause of your pain. Whether you’re an athlete, a weekend walker, or returning to activity after time off, we’ll help you recover safely and effectively.
Our treatment options may include:
- Custom orthotics: Correct structural foot issues and relieve stress on the Achilles tendon
- NSAIDs (non-steroidal anti-inflammatory drugs): Provide short-term relief from inflammation under physician guidance
- Activity modification and cross-training: Reduce tendon load while maintaining overall fitness
- Stretching and strengthening programs: Improve flexibility and support muscle balance in the calves and lower legs
- Therapeutic modalities: Use of ultrasound therapy, deep tissue massage, and manual therapy to reduce inflammation and promote healing
- ESWT (Extracorporeal Shockwave Therapy): A non-invasive treatment that encourages tendon healing in chronic cases
- Minimally invasive procedures: Including the Topaz procedure, for patients whose symptoms persist despite conservative care
Our board-certified team offers personalized care using state-of-the-art diagnostics and conservative treatment plans.
Get Relief from Achilles Tendonitis at South Texas Podiatry
If you’re noticing the warning signs of tendonitis, like heel pain, stiffness, or swelling, don’t ignore them. The team at South Texas Podiatry offers advanced solutions to help you feel better, faster.
Schedule an appointment today with our expert podiatrists in San Antonio for customized Achilles tendonitis care. Let us help you get back on your feet stronger and pain-free.
