Quick answer
Common symptoms include localised Achilles pain, morning stiffness, discomfort at the start of activity, pain with running or hills, and reduced push-off capacity. The exact pain location helps distinguish mid-substance from insertional disease.
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Typical symptom pattern
Patients often describe stiffness with the first steps in the morning or after sitting. The tendon may “warm up” during activity and become sore again afterwards. More irritable cases hurt during ordinary walking or stairs.
Mid-substance versus insertional symptoms
Mid-substance pain is typically felt above the heel. Insertional pain is felt where the tendon attaches to the back of the heel and may be aggravated by shoe pressure or positions that compress the tendon against the calcaneus.
Symptoms that deserve prompt assessment
A sudden pop, acute loss of push-off strength, a palpable gap, marked bruising or inability to perform a heel raise can suggest rupture. Severe redness, systemic symptoms or rapidly escalating pain also require assessment rather than being assumed to be routine tendinopathy.
Key points
- Morning stiffness is common but not specific to one tendon disorder.
- Insertional pain can be aggravated by both tensile and compressive load.
- Sudden functional loss changes the clinical priority because rupture must be considered.
Frequently Asked Questions
Can Achilles tendinopathy hurt at rest?
Yes, particularly when irritable, although load-related pain is characteristic.
Can the tendon look swollen?
Yes. Thickening can occur, especially in mid-substance disease, but swelling alone does not determine severity.