Achilles Tendon Pain: Why It Often Appears When You Return to Activity in Spring

As the weather warms up, many people start running again, return to weekend sport or simply spend more time walking outdoors. It is a great time to become more active—but a sudden increase in activity can expose a gap between what your body is being asked to do and what it is currently prepared to tolerate.

One area that commonly feels this change is the Achilles tendon.

If the back of your ankle is stiff when you first get out of bed, sore at the beginning of a run or increasingly painful after activity, it may be an early sign of Achilles tendinopathy. Addressing it early can make it easier to manage your training and begin rebuilding the tendon's capacity.

What is the Achilles tendon?

The Achilles is the strong tendon that connects the calf muscles to the heel bone. It helps transfer force through the ankle when you walk, run, jump, accelerate and change direction.

Because it works hard during these activities, the tendon must be able to tolerate repeated loading. Problems can develop when that loading increases faster than the tendon can adapt—for example, when someone goes from doing little running during winter to several runs or sports sessions each week.

Common signs of Achilles tendinopathy

Achilles tendinopathy usually develops gradually. Common symptoms include:

- Pain or tenderness at the back of the ankle, either a few centimetres above the heel or where the tendon attaches to the heel

- Stiffness during the first few steps in the morning

- Pain when beginning a run or training session

- Symptoms that temporarily improve as you warm up, then return later or the next morning

- Pain with calf raises, running, jumping, hills or stairs

- Reduced calf strength or difficulty pushing off through the affected side

Morning stiffness can be a useful warning sign. Even if the tendon settles during exercise, increasing stiffness or soreness the next day can indicate that the recent workload was more than it was ready for.

Why does it flare when activity increases?

Achilles pain is not always caused by one dramatic injury. It often follows a change in the amount or type of load placed on the tendon.

Common spring triggers include:

- Returning to running after a winter break

- Increasing distance, speed or training frequency too quickly

- Adding hills, sprinting or jumping sessions

- Returning to soccer, netball, tennis or other change-of-direction sports

- Completing several demanding sessions on consecutive days

- Changing footwear or moving from softer surfaces to more road running

- Combining a busier exercise schedule with reduced recovery or calf weakness

The important point is that the activity itself is not necessarily the problem. The issue is often the size and speed of the change relative to your current capacity.

Should you stop exercising completely?

Complete rest is not usually the best long-term solution for gradual-onset Achilles tendinopathy. Rest may settle the pain temporarily, but it does not rebuild the strength and load tolerance needed for running or sport.

Instead, management commonly involves temporarily modifying the activities that are most provocative while maintaining suitable exercise. This might mean reducing running volume, replacing sprint sessions with lower-impact conditioning or allowing more recovery between high-load days.

The right level of activity varies from person to person. A physiotherapist can help determine what you can continue, what should be adjusted and how to progress without repeatedly aggravating the tendon.

What does effective rehabilitation involve?

Current clinical guidance supports progressive tendon-loading exercise as a key part of rehabilitation for midportion Achilles tendinopathy. A program may include:

1. Managing the current workload

The first step is identifying which activities are producing the biggest response and adjusting them to a level the tendon can tolerate. This does not automatically mean stopping all activity.

2. Progressive calf strengthening

Exercises are selected and progressed according to your symptoms and capacity. Rehabilitation may begin with controlled calf work before progressing to heavier strengthening, faster movements and single-leg tasks.

3. Rebuilding spring and power

Running and field or court sports require the Achilles to store and release energy quickly. Later-stage rehabilitation may therefore include hopping, jumping, acceleration, deceleration and change-of-direction work—not just slow calf raises.

4. A graded return to running or sport

Return is based on more than pain alone. Calf strength, hopping ability, response to loading and the demands of your chosen activity all help guide the progression. Training volume and intensity should be rebuilt in a planned way, with recovery between demanding sessions.

Three ways to reduce problems when returning to spring activity

1. Build one variable at a time

Avoid increasing distance, pace, hills and weekly frequency all at once. Change one main training variable, then monitor how your body responds.

2. Keep strength training in your week

Running or playing sport does not always provide enough targeted strength work. Regular calf and lower-limb strengthening can help prepare you for higher loads.

3. Pay attention to the next morning

Do not judge a session only by how you feel while warmed up. Note whether pain or stiffness is worse later that day or during your first steps the following morning. A consistent increase may mean that your workload needs adjusting.

When should Achilles pain be assessed?

Come and see one of our experienced physios for an assessment if:

- Pain or morning stiffness is persisting or becoming more frequent

- Symptoms are changing how you walk, run or play sport

- You repeatedly improve with rest but flare when activity resumes

- You are unsure how much exercise is appropriate

- You want a structured return-to-running or return-to-sport plan

A physiotherapy assessment can help distinguish Achilles tendinopathy from other causes of heel or ankle pain and identify relevant factors such as calf strength, ankle mobility, recent workload and sport-specific demands. Imaging is not automatically required; whether it is useful depends on the clinical presentation.

A sudden pop is different

Sudden sharp pain, a popping or snapping sensation, the feeling of being kicked in the back of the leg, or an immediate loss of push-off strength may indicate an Achilles rupture rather than gradual-onset tendinopathy. Seek prompt medical assessment if this occurs—even if the pain begins to settle or you can still walk.

Get ready for an active spring

If Achilles pain is limiting your running, walking or sport, an early assessment can help you understand the problem and put a realistic plan in place. At Winston Hills Physiotherapy Centre, we can assess your tendon, review your recent training load and develop a progressive rehabilitation program matched to the activities you want to return to.

**Winston Hills Physiotherapy Centre**

43 Langdon Road, Winston Hills NSW 2153

Book an appointment online at https://www.winstonhillsphysio.com.au/online-booking) or contact the clinic on 9838 8449.

*This article provides general information and does not replace individual medical or physiotherapy advice. Seek urgent assessment for a sudden injury, severe pain, marked weakness or loss of function.*

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Frequently asked questions

1. Can I keep running with Achilles tendon pain?

Some people can continue a modified amount of running while rehabilitating; others need a temporary reduction or a switch to lower-impact training. The decision should consider your pain response, morning stiffness, strength and how the tendon responds over the following 24 hours.

2. Will stretching fix Achilles tendinopathy?

Stretching alone is unlikely to rebuild the tendon's capacity. It may be useful for some people with restricted ankle movement, but progressive strengthening and appropriate load management are usually more important. Stretching can also aggravate pain at the heel insertion in some presentations, so the exercise choice should match the diagnosis.

3. Do I need a scan for Achilles pain?

Not always. Achilles tendinopathy can often be identified from the history and physical examination. Imaging may be considered if the diagnosis is uncertain, symptoms are unusual or a tear or another condition is suspected.

4. How long does Achilles rehabilitation take?

Recovery varies with the location and duration of symptoms, current strength, general health and the demands of your activity. Tendons adapt gradually, so a progressive program is usually more effective than repeatedly resting until pain settles and then returning immediately to full activity.