"Is it OK to walk with Achilles tendonitis?" This is a question that worries many of our patients for whom walking is their primary way of being active and keeping fit or who have to spend quite a bit of time on their feet for work. This article explains the dos and don'ts of walking with Achilles tendonitis. Remember, if you need more help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in our articles.
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Can walking cause Achilles tendonitis?
When an Achilles tendon gets irritated and angry, it’s most often a response to overloading – when you’re asking it to work a bit too hard. It’s quite understandable how this can happen with too much running or jumping around, but walking is a part of everyday life, so how can this overload the Achilles tendon?
When we ask our patients about their recent day-to-day activities to figure out how they injured their Achilles tendon, it often turns out that something that seems quite innocuous has changed in terms of their walking. For example, they’ve changed their footwear from shoes with a bit of a heel to flat shoes, or they’ve done much more walking uphill than usual, or they’ve gone on holiday and walked for miles in flip-flops while sightseeing.
All these changes place the Achilles tendon in a more stretched position than usual, which means that it has to work through a larger range of motion than what it is used to, and too much of this can cause symptoms to occur.
It could also be that they’ve had to take a break from their normal walking activities for quite some time and then started again, but now their Achilles tendon isn’t used to this anymore.
How to walk with Achilles tendonitis
So, if the above describes your situation, should you continue walking with the Achilles pain, or do you need to rest your Achilles tendon while it gets better?
We’re great proponents of relative rest, which means that, if at all possible, it’s better to do some sort of activity while you’re recovering from an injury rather than rest it completely.
At the moment, your tendon may not be able to cope with all the walking you want to do, but it will likely be able to tolerate some. You can help your Achilles tendon to recover by staying active but limiting your walking and other activities to a level that doesn’t aggravate your symptoms too much.
A useful rule that we ask our patients to use is the "niggle rule". If you feel only a niggle in your tendon while you’re walking – meaning a level of pain or discomfort of no more than 3 out of 10 – and the pain, stiffness, or discomfort doesn’t increase above this in the next 24 hours, then the volume and intensity of the walking was OK.
This rule has to be applied over a period of 24 hours after you’ve walked, because tendons can be sneaky things – sometimes they’ll only tell us that we’ve asked them to work too hard the day after the aggravating activity.
How can I safely increase my walking?
Obviously, our patients would like to get back to their normal walking activities in due course without having to observe the niggle rule all the time.
Just staying within the niggle-rule parameters won’t strengthen your tendon sufficiently to cope with the walking loads it used to be able to cope with. So, you have to add some specific strength training exercises – typically, heel raises – that you progress over time in terms of volume and intensity.
For instance, you might start with doing double-leg heel raises at floor level with no added weight and then gradually progress to single-leg heel raises over the side of a step with some added weight.
It’s important not to start with exercises that are too difficult and not to increase the difficulty too quickly, otherwise you’ll just flare your tendon back up again. If you’ve tried exercises and found that they made your symptoms worse, it may be that they weren’t the right ones for you.
A physiotherapist can help you to figure out at what level you should start, taking into account factors such as your current strength and the severity of your injury. They can also advise you on how to progress these exercises safely until your tendon is strong enough to cope with your usual walking activities.
How we can help
Need more help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Treat My Achilles we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram, and Twitter.