If you wake up to Achilles pain in the morning, you’re not the only one. Our podiatrists in Medford, Oregon see numerous patients experiencing stiffness or pain in their Achilles tendon. And it’s often worst when they first wake up and walk out of bed.  If that sounds familiar, you may be experiencing Achilles tendinitis or tendinopathy. And, to help you find relief from your discomfort, we’ll explore both conditions in today’s post.

Achilles tendonitis vs Achilles tendinopathy: Similarities and Differences 

When you have been diagnosed with Achilles tendinitis, that means you’ve developed painful inflammation in the tendon. Typically, this conditions results from overuse of your Achilles tendon. (It’s a band of tissue that runs through the calf muscle at the back of the leg, terminating at the heel bone.) Sometimes, this injury is also described as Achilles tendinopathy. But both are terms for the same cause of Achilles pain in the morning. 

But what causes this injury? If you exert excessive force on the Achilles tendon it becomes inflamed. Soon, that inflammation becomes painful, both first thing in the morning and all day long. Anyone can develop tendinitis, but it’s most common in athletes who suddenly increase training speed, intensity or distance; it’s also an issue for people who are sedentary all week long, then get very active on the weekends.  It’s also an issue for people who work out every day, avoiding recovery days or cross training activities in between exercise sessions.

In some cases, you don’t even need to get in a workout to develop tendinitis. In fact, if you spend a few days walking around in unsupportive shoes, you just might wake up with Achilles tendon pain. 

Why is Achilles Pain Worst in the Morning?

When you wake up and feel pain or stiffness in the backs of your legs, it’s the result of pressure on your Achilles tendon affecting the tissue’s internal structure. How could that be? Well, when your tendon is not inflamed, it’s formed of tightly-packed collagen fibers. Because the fibers are so close together, there isn’t room for other substances to travel in between them. 

But when you have tendinitis or tendinopathy, those collagen fibers spread apart enough for substances such as fluid to flow between them, increasing the volume of the tendon. During the day, that volume increase may not be problematic. But after a night in bed, when your body has been still for hours, the fluid in your tendon collects, making your nerve endings more sensitive. 

The result? When you first wake up, the Achilles pain in the morning will be at its worst, gradually improving throughout the day as you move around, breaking up the fluid deposits. However, if you don’t treat your tendinitis, the pain and inflammation will eventually become an all-day concern. 

Achilles Pain in the Morning and Other Tendonitis Symptoms person holding Achilles tendon

In addition to discomfort and stiffness when you wake up, you may also experience symptoms such as: 

•    Heel pain, localized at the spot where your tendon connects to the heel bone
•    Back of leg or calf pain, particularly when walking or running. 
•    Tenderness to touch along the length of the tendon

Of course, every individual experiences his or her own unique symptoms. But regardless of whether your Achilles tendon pain is worst in the morning, or bothers you throughout the day, one thing is certain. If you don’t treat Achilles tendinitis or tendinopathy, your symptoms will worsen and your condition will progress, ultimately leaving you vulnerable to an Achilles tendon rupture.  

Treating Achilles Tendinitis in Southern Oregon and Northern California 

Our podiatrists in Medford, OR see patients in the office with symptoms of Achilles tendinitis, Dr. Evan Merrill and Dr. Devin Dimond create customized treatment plans that address the severity of your unique symptoms, along with the underlying cause of your tendon pain. 

For some patients, that means managing pain and inflammation by recommending over the counter, anti-inflammatory medications such as ibuprofen or Aleve. We may fit you for custom orthotics, to help provide additional support for your feet and arches, reducing irritation and tugging on the tendon. At the same time, we’re likely to recommend reducing your current physical activity level, since athletics can irritate your Achilles tendon. 

Now, if those words have you panicking, there’s no need. Just because we want you to rest doesn’t mean you’ll have to spend the day in bed. Instead, we’ll help steer you away from high-intensity exercises, embracing lower impact activities such as swimming or taking short walks. By making these swaps, we can keep you moving while reducing pressure on the Achilles tendon, helping facilitate a faster healing process. 

We may also recommend a series of stretching exercises, designed to help reduce tension on the tendon that may be coming from tight calf muscles.  Then, when some of the pain and inflammation in your tendon has gone away, we can start focusing on rebuilding strength in the injured area, gradually working back toward your former activity levels to help you get back to doing what you love while reducing your risk for re-injury. 

Can you Avoid Another Tendonitis Flare Up?

Even if you carefully follow our recovery plan, there is a chance that your Achilles tendon pain in the morning will return. And that’s more likely to happen if:  

1.    You are obese, or suddenly put on weight
2.    Your calf muscles tighten up
3.    The shoes you wear are too flat, or if their internal supports are worn out 
4.    You walk or run on lots of hills, instead of sticking to flat surfaces, since the elevation puts more pressure on the Achilles tendon. 

How Can I Stop My Achilles Pain in the Morning? 

If we work together, we can find a lasting solution to Achilles tendinitis or tendinopathy. And part of that cooperation involves seeking early treatment. Because, if you want to find lasting relief from tendinitis pain, it’s important to schedule an appointment in the office as soon as you notice stiffness or irritation along your Achilles tendon. 

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