Summer often encourages us to become more active. Longer evenings, warmer weather and holidays can mean more running, walking, hiking and outdoor sport than we might do during the rest of the year.
While this increase in activity can be great for your health, suddenly asking your body to do much more than it is accustomed to can sometimes lead to pain or injury. One area that can be particularly sensitive to a rapid change in activity is the Achilles tendon.
Pain at the back of the ankle or heel after running or walking may be a sign that the Achilles tendon is struggling to cope with its current workload.
Understanding why this happens — and responding appropriately to the early warning signs — can help you stay active throughout the summer.
What is the Achilles tendon?
The Achilles tendon is the strong band of tissue running down the back of your lower leg. It connects the calf muscles to the heel bone and plays an important role whenever you walk, run, climb stairs, jump or rise onto your toes.
Every step places load through the tendon. Running, hills and faster movements can increase that demand considerably.
Achilles tendinopathy is a condition associated with pain, stiffness and sometimes swelling around the tendon. Symptoms commonly occur at the back of the heel or slightly higher up the tendon.
Why can Achilles pain become more common in summer?
Summer itself does not cause Achilles problems. Instead, it is often the change in activity that comes with the season.
Perhaps you have started running again because the evenings are lighter. You might be walking considerably more while on holiday, tackling longer hikes or joining friends for outdoor sports.
Your cardiovascular fitness may make you feel capable of doing more, but tendons also need time to adapt to increased loading.
A sudden increase in running, walking or sporting activity is recognised as one of the factors that can contribute to Achilles tendinopathy.
Common summer triggers include:
- Increasing your running distance too quickly
- Running more frequently than usual
- Suddenly introducing hill running
- Long countryside or coastal walks
- Walking much further while sightseeing on holiday
- Starting a new sport
- Returning to exercise after a less active winter or spring
- Changing your footwear
- Exercising on unfamiliar terrain
- Combining several active days without enough recovery
It is often the amount of activity compared with what your tendon is accustomed to, rather than one particular movement, that creates the problem.
Why does running place so much demand on the Achilles tendon?
Running requires the calf muscles and Achilles tendon to repeatedly absorb and release force.
Each time your foot contacts the ground, your Achilles helps control movement before contributing to pushing you forwards again.
This normally happens without any problem. Tendons are designed to tolerate substantial forces and can adapt to exercise.
Problems may develop, however, when the increase in demand happens faster than the tendon can adapt.
For example, someone who normally runs 5km twice a week may decide to take advantage of the summer weather and suddenly run four or five times a week. Another person may maintain their normal mileage but add steep hills or faster sessions.
The total stress placed on the tendon has changed even though the person may still consider themselves an experienced runner.
Can walking cause Achilles tendon pain too?
Yes. Achilles problems are not limited to runners.
Walking also repeatedly loads the Achilles tendon, particularly when:
- Walking long distances
- Going uphill
- Climbing lots of stairs
- Walking over uneven ground
- Spending much longer on your feet than usual
This can become particularly noticeable on holiday.
Someone who normally takes 5,000 or 6,000 steps a day might suddenly spend several days sightseeing and walk two or three times that amount. Add hills, different footwear and limited recovery, and the Achilles tendon may begin to complain.
NHS guidance recognises increased walking as well as running as a potential contributor to Achilles tendinopathy.
What does Achilles tendon pain feel like?
Symptoms vary, but commonly include:
- Pain or tenderness at the back of the heel
- Pain slightly above the heel along the tendon
- Stiffness around the ankle
- Morning stiffness after getting out of bed
- Pain when starting to walk after sitting for a while
- Discomfort when climbing stairs
- Pain when running or walking uphill
- Tenderness when touching the Achilles tendon
- Thickening or swelling around the tendon
- Pain after exercise
A characteristic feature can be start-up stiffness. The tendon may feel particularly stiff when you first get out of bed or begin walking after a period of rest, before easing somewhat as you move.
Some people notice relatively little discomfort while exercising but experience more pain afterwards or the following morning.
Don’t ignore the early warning signs
One of the difficulties with Achilles pain is that people can sometimes continue running or walking despite the symptoms.
You may think:
“It loosens up once I get moving, so it must be fine.”
But pain settling during activity does not necessarily mean the tendon is coping well with the load.
Pay attention to how the tendon feels later that day and the following morning.
If your morning pain or stiffness is steadily increasing, or your normal walk is becoming more uncomfortable, this may indicate that your current level of activity needs adjusting.
Should you completely rest an Achilles tendon?
Not necessarily.
The appropriate response depends on the nature and severity of the problem. For Achilles tendinopathy, management often involves modifying load rather than simply stopping all activity indefinitely.
Relative rest may mean temporarily reducing activities that are particularly provocative while continuing with forms of exercise you can perform comfortably. NHS musculoskeletal guidance notes that activities such as cycling or swimming may sometimes be used to maintain fitness while reducing prolonged walking or running.
Long-term rehabilitation frequently involves gradually rebuilding the tendon’s ability to tolerate load through appropriate strengthening exercises.
The right starting point will vary from person to person, so an assessment can be useful when symptoms persist.
How can you reduce your risk when running this summer?
1. Increase your training gradually
One of the simplest precautions is to avoid increasing everything simultaneously.
Instead of adding more running days, longer distances, faster speeds and hills all at once, change one aspect gradually.
Give your body time to adapt before increasing the challenge again.
2. Be careful when adding hills
Hills place different demands on the calf and Achilles tendon.
If most of your usual running is flat, suddenly completing several hilly routes can represent a significant change in load.
Introduce hills progressively rather than turning every summer run into a hill session.
3. Include recovery days
More daylight does not mean you have to exercise hard every day.
Recovery allows your muscles and tendons to respond to training. Alternate demanding sessions with easier activity or rest days.
4. Warm up
Start with several minutes of easier movement before increasing the intensity of your session.
The NHS recommends warming up before exercise as one way of helping reduce the likelihood of tendon problems.
5. Don’t run through increasingly severe pain
Occasional minor aches do not always mean that you have an injury, but symptoms that progressively worsen deserve attention.
If your Achilles becomes increasingly painful, particularly if it begins affecting normal walking, consider reducing your running and seeking an assessment.
How can walkers reduce the risk?
The same principle of gradual progression applies.
If you are planning a walking holiday, long hike or sightseeing trip, try to build up your walking beforehand rather than going from relatively little activity straight into several long days.
You could:
- Gradually increase your normal walking distance
- Include some hills before a hilly holiday
- Take breaks on longer walks
- Alternate longer and shorter days
- Wear comfortable footwear you have already used
- Avoid introducing brand-new shoes on the first day of a long walking holiday
Your feet and legs generally appreciate preparation just as much as your cardiovascular system does.
Does footwear matter?
Footwear can influence how comfortable you feel when walking or running, although there is no single type of shoe that prevents every Achilles problem.
The NHS recommends suitable supportive footwear for exercise as part of general tendon-injury prevention advice.
Be particularly cautious about making a major footwear change at the same time as substantially increasing your activity.
For example, switching abruptly to very different running shoes while simultaneously increasing mileage gives your body several new variables to adapt to at once.
If you buy new running shoes, gradually introduce them alongside your existing pair where practical.
What about flip-flops and summer footwear?
Summer can mean spending much more time in sandals, flip-flops or other footwear that feels very different from what you normally wear.
That does not automatically make these shoes harmful. However, if you already have a sensitive Achilles tendon, dramatically changing your footwear while also walking much further than normal may aggravate symptoms.
If you are planning a long day of sightseeing or walking, choose footwear that you know is comfortable and suitable for the distance involved.
Strengthening the calf and Achilles tendon
Exercise-based rehabilitation is an important part of the management of many Achilles tendon problems.
Depending on your symptoms and stage of recovery, exercises may involve progressively loading the calf and Achilles through different types of calf raises and other strengthening movements.
However, the appropriate exercises, resistance, range of movement and progression can differ depending on where the tendon is painful and how irritable it is.
Simply copying an advanced Achilles programme online is therefore not always the best starting point.
A clinician can assess your symptoms and help determine an appropriate level of exercise.
When should you get Achilles pain assessed?
Consider arranging an assessment if:
- The pain keeps returning
- Symptoms are getting progressively worse
- Morning stiffness is increasing
- Walking is becoming uncomfortable
- You are unable to return to your normal running
- The tendon appears persistently swollen or thickened
- Symptoms have not improved despite reducing the aggravating activity
- You are unsure whether the pain is coming from the Achilles tendon at all
An assessment can help identify the likely cause of your symptoms and establish how much activity the tendon currently tolerates.
What if there is sudden severe Achilles pain?
Achilles tendinopathy usually develops differently from an acute Achilles tendon rupture.
If you experience sudden severe pain, particularly accompanied by a popping or snapping sensation, difficulty walking or difficulty pushing through the foot, seek urgent medical assessment.
The NHS advises urgent help if you think you may have ruptured a tendon.
Do not assume that sudden severe Achilles pain is simply another episode of tendinitis.
How can Exeter Chiro & Physio help with Achilles tendon pain?
At Exeter Chiro & Physio, Achilles tendon problems can be assessed to establish what may be contributing to your symptoms and how they are affecting your walking, running or sporting activity.
Management will depend on the individual and may include advice about activity modification, rehabilitation exercises and gradually restoring strength and function.
The clinic’s Sports Therapy service includes assessment, rehabilitation, patient education and exercise programmes for musculoskeletal injuries.
For some persistent tendon problems, Shockwave Therapy may also be considered where clinically appropriate. Exeter Chiro & Physio lists chronic tendinopathy among the conditions for which shockwave may be used alongside other treatment and rehabilitation approaches.
The goal is not simply to settle your symptoms temporarily, but to help you gradually regain the capacity needed for the activities you want to enjoy.
FAQs
Enjoy an active summer without ignoring your Achilles
Summer is a great opportunity to run, walk, hike and spend more time outdoors.
The key is giving your body time to adapt.
Increase activity gradually, include recovery, pay attention to persistent morning stiffness and avoid assuming that pain must simply be pushed through.
If Achilles pain is beginning to restrict your walking, running or sporting activities, Exeter Chiro & Physio can assess your symptoms and discuss an appropriate treatment and rehabilitation plan.
Contact Exeter Chiro & Physio or book an appointment to find out how the clinic may be able to help.
This article provides general information and should not be used as a substitute for individual medical advice, diagnosis or treatment.
