In this article, I’ll explain why your heel can be sensitive when you press on it or even just touch the skin, why this sensitivity can vary quite dramatically throughout the day, and also why some sensitivity might remain even when all the signs are that your injury has healed. Remember, if you need 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 most of our articles.
In this article:
Scenario 1 – Your heel has suddenly become sensitive to press on
This usually indicates that you’ve injured something in the back of the heel. The most common injuries that can cause pain and sensitivity in that area are:
an injury to the little nerves that run in that area,
or an injury to your lower back (L5 nerve root) that is referring pain into your heel.
💡 Here’s our detailed article on the causes of heel pain that can help you to identify your specific cause.
Scenario 2 – You know you’re injured but you’re wondering why the sensitivity varies so much
There can be two reasons for this.
The obvious answer is that you’ve done something to aggravate your injury, which might have increased the inflammation (depending on the type of injury), which in turn has irritated the nerve endings in the skin, causing it to be more sensitive.
But an increase in pain or sensitivity doesn’t always mean that the injury has become worse.
When we’ve had pain for a while, the body gets better at creating pain and creates it long before we reach an activity level that can cause actual tissue damage. I mean, what’s the point of only warning you when you’re already caused more damage?
So, in most cases, the increase in sensitivity is just the body dialling up the pain system to warn you to take things easy. It’s a bit like repeatedly pressing on a bruise – it doesn’t cause damage but will make the bruise hurt more if you continue doing it.
You can read more about different factors that can combine to dial you pain and sensitivity up.
💡 Ideally, you should aim to pitch your activities and rehab exercises at a level that only causes very mild discomfort (like a niggle rather than pain) – this allows the body to grow stronger but avoids dialling the pain system up. Here's how to use pain to guide your activities.
Scenario 3 – You’re back to your normal activities but pressing on your heel still causes pain
My patients are often worried when, even after they’re back to full sport and discharged from rehab, their previously injured Achilles tendons still feel more sensitive compared to the other side when they squeeze or press firmly on it.
This is just the pain system that is still on high alert – think of it as a “memory” of pain.
Research has shown that if you’ve had pain for more than three months, your body creates more of the little sensors that send the messages associated with pain to the brain. These sensors are also triggered more easily, even for things that shouldn’t be triggering them.
It takes time for the body to reverse these changes.
💡 In my experience, if your only symptom is that your tendon feels a bit tender when you press on it, it can usually be ignored, and the sensitivity will settle down after a few months. It’s only if you also start noticing pain or stiffness during activities or first thing in the morning (without even touching it) that one has to take notice.
How we can help
Need 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 or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.