Pain at the Back of the Foot | Galleria Podiatry

Pain at the back of the foot, especially above the heel, can be caused by several conditions, but two of the most common are Achilles tendinitis and Achilles rupture. Achilles tendinitis is an inflammation of the Achilles tendon, the thick band of tissue that connects the calf muscles to the heel bone. This condition is typically caused by repetitive stress to the tendon, often seen in athletes or individuals who engage in activities that involve sudden increases in running or jumping. On the other hand, an Achilles rupture involves a complete tear of the tendon, which can occur from a sudden, forceful movement. Both conditions lead to significant discomfort and can impair mobility, necessitating timely medical attention for proper diagnosis and management.

pain at the back of the foot diagram
Achilles tendon rupture vs Achilles tendinosis illustration (pain at the back of the foot)

Achilles Tendinitis


Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. It commonly occurs in runners who have suddenly increased the intensity or duration of their runs, as well as in middle-aged people who play sports like tennis or basketball on weekends.

Pain Caused by Achilles Tendinitis

Gradual onset of pain along the Achilles tendon that initially occurs as a mild ache in the back of the leg or above the heel after sports or other activities. Pain may get worse following prolonged running, stair climbing, or sprinting.

  • Stiffness and tenderness along the tendon, especially in the morning, which usually improves with mild activity.
  • Severe pain the day after exercising, indicating more serious tendon damage.
  • Swelling or thickening along the tendon can be felt when touching the Achilles area.

The pain associated with Achilles tendinitis can make it difficult to engage in everyday activities, especially those that involve walking or running. Treatment often focuses on resting the affected leg, applying ice to reduce swelling, taking anti-inflammatory medications, and doing exercises designed to strengthen the tendon. In some cases, physical therapy or orthotics may be recommended to help recovery. If conservative treatments fail to relieve symptoms, surgical intervention might be considered.

Achilles Rupture


An Achilles rupture is a serious injury that involves the complete tearing or separation of the Achilles tendon, which connects the calf muscles to the heel bone. This type of injury is often associated with sports and activities that require bursts of jumping, pivoting, or rapid accelerations.

Pain Caused by an Achilles rupture

  • Sudden, severe pain at the back of the ankle or calf often described as feeling like being kicked or hit in the back of the leg. This pain can be acute and debilitating immediately following the rupture.
  • Swelling, bruising, and tenderness in the area around the Achilles tendon.
  • “Snapping” or “popping” sensation at the time of injury, indicating that the tendon has forcefully snapped or torn.
  • Difficulty walking and inability to stand on the toes on the injured leg. The loss of the Achilles tendon function makes it nearly impossible to push off the affected foot while walking or to properly climb stairs.
  • A noticeable gap in the tendon just above the heel bone can sometimes be felt, especially in complete ruptures.

The immediate treatment for an Achilles rupture typically involves immobilising the ankle and foot and seeking medical attention as soon as possible. Treatment options may include surgery of the tendon or non-surgical methods such as casting or using a walking boot to allow the tendon to heal over time. Rehabilitation exercises and physical therapy will be crucial, regardless of whether surgery is performed, to help restore strength and mobility to the tendon and surrounding muscles.

Achilles rupture and Achilles tendinitis are related to the Achilles tendon, but they differ in severity and treatment. Achilles rupture is an acute and severe injury that requires immediate medical attention and possibly surgical intervention. On the other hand, Achilles tendinitis is a chronic condition that develops over time and can often be managed with conservative treatments.


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