Achilles tendonitis: symptoms, exercises and recovery time

Based on NHS guidance and NHS physiotherapy leaflets.

Reviewed by Harvir Ubhi, HCPC-registered physiotherapist. Last reviewed 28 September 2026.

What is Achilles tendonitis?

Your Achilles tendon is the biggest and strongest tendon in your body. It joins your calf muscles to your heel bone and lets you rise onto tiptoes. Achilles tendonitis happens when the tendon can't keep up with the strain put on it, so it gets small amounts of damage that it keeps trying to repair. You'll also see it called tendinitis, tendinosis or tendinopathy. They all mean the same thing.

Symptoms

• stiffness around the tendon, worst in the morning or after resting
• pain that's worse during or after exercise
• swelling, tenderness when you squeeze the tendon, and mild heat
• sometimes a tender lump, or a clicking feeling when you move your ankle
• loss of strength and movement around the ankle and foot

Some people find the pain eases once they're warmed up, then comes back worse afterwards.

What causes Achilles tendonitis

It's more common from 30 onwards, in men, and in sports with lots of running, like football, tennis, badminton and distance running. It affects non-athletes too. Risk goes up with:

• tight or weak calf muscles
• carrying extra weight, or having diabetes
• standing for long periods, or being inactive
• unsuitable or worn-out footwear
• smoking, or inflammatory arthritis

Common training errors: running too far or too hard, increasing distance too quickly, too much hill running, and not varying your training.

Achilles tendonitis treatment

1. 1

   Keep active, differently

   Rest alone won't fix it. Keep fit with swimming, cycling or running in water while the tendon settles.

2. 2

   Ice or heat, and painkillers

   Ice wrapped in a damp tea towel for up to 20 minutes, up to 4 times a day or after exercise. Paracetamol or anti-inflammatories like ibuprofen. A pharmacist can tell you what's safe for you.

3. 3

   Calf stretches

   The two stretches below, on both legs.

4. 4

   Calf-strengthening programme

   The exercises below are the main treatment. Oxford's NHS physios call the lowering exercises the gold standard.

5. 5

   Physiotherapy

   A physio guides and progresses the programme, and may add hands-on treatment.

6. 6

   If that doesn't work

   Options include shoe inserts from a podiatrist, shockwave therapy, dry needling, some types of injection and, as a last resort, surgery. Oxford's NHS team doesn't recommend steroid injections for it.

Achilles tendonitis exercises from an NHS programme

This is Oxford University Hospitals' NHS programme. Do it every day for at least 12 weeks, and move to the next phase when the current one feels easy.

1. If it's too sore to start: holds. Holding a rail, stand on a step with your heels over the edge, not letting them drop below it. Hold for 45 seconds, rest 1 minute, and repeat 5 times. Do it with your knees straight and slightly bent, then on one leg as it gets easier.
2. Phase 1: both legs. Stand on both feet. Rise onto tiptoes using your good leg, shift your weight onto your sore leg, and lower slowly, using the good leg to help if you need to. 3 sets of 15, twice a day, with knees straight and then slightly bent.
3. Phase 2: one leg. Rise onto tiptoes on both feet, lift your good leg, and lower on the sore leg alone. 3 sets of 15, twice a day, knees straight and bent.
4. Phase 3: heel drops off a step. Stand with your heels over the edge of a step. Rise using your good leg, then lower on the sore leg until your heel drops below the step. 3 sets of 15, twice a day, knees straight and bent. Wear a rucksack with books in it to make it harder.

Calf stretches: with your hands on a wall and one foot planted flat behind you, lean forwards until you feel a stretch in the back of that calf. Do it once with the back knee straight and once with it bent. Hold each for 30 seconds to 1 minute, and keep your heel on the floor.

How much pain is OK? Expect 3 or 4 out of 10 while you do the lowering exercises. Don't go above 4. If you do, or your morning stiffness starts lasting longer, cut the repetitions until it settles. A physio can judge when you're ready to move up a phase.

When to get help

NHS inform says contact a healthcare professional, such as a GP or physio, if your symptoms haven't improved within 12 weeks or are getting worse.

Achilles tendonitis questions

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