Heel Pain vs Achilles Tendonitis Care in London
Pain in the heel or back of the ankle is extremely common, but not all foot pain is the same.
Two of the most frequent conditions we see are:
- Plantar fasciitis (pain under the heel)
- Achilles tendonitis (pain at the back of the heel or ankle)
They can feel similar early on, but the cause, tissue involved, and care approach are different.
At Reset Chiropractic & Rehab in London, we focus on accurate diagnosis and structured recovery plans so you’re not guessing your way through care.
Key Differences at a Glance
| Feature | Plantar Fasciitis | Achilles Tendonitis |
|---|---|---|
| Pain Location | Bottom of heel | Back of heel / above ankle |
| Morning Pain | Sharp with first steps | Stiff, improves with movement |
| Pain Pattern | Worse after rest | Worse during/after activity |
| Tenderness | Heel underside | Achilles tendon |
| Cause | Load intolerance (foot) | Tendon overload |
What Is Plantar Fasciitis?
Plantar fasciitis is a load-related condition involving irritation of the plantar fascia, a structure that supports your arch.
Common signs:
- Sharp heel pain with first steps in the morning
- Pain after sitting or rest
- Tenderness under the heel
- Pain that eases slightly with movement
It is often associated with:
- reduced load tolerance
- tight calves
- weak foot musculature
- sudden increases in activity
What Is Achilles Tendonitis?
Achilles tendonitis (tendinopathy) is an overuse condition affecting the tendon that connects your calf to your heel.
Common signs:
- Pain at the back of the heel
- Morning stiffness
- Pain during or after activity
- Tenderness along the tendon
- Thickening over time
It is typically associated with:
- repetitive loading
- insufficient calf strength
- sudden increases in activity
Why the Difference Matters
Although these conditions are close in location, they respond to different loading strategies.
- Plantar fasciitis → responds to foot and calf loading
- Achilles tendonitis → requires tendon-specific loading programs
Misidentifying the condition can:
- delay recovery
- worsen symptoms
- contribute to longer-term issues
How We Diagnose the Difference
We perform a hands-on, functional assessment to help determine what may be driving your pain.
This includes:
- precise pain location mapping
- tissue palpation
- strength and load tolerance testing
- walking and movement analysis
If needed, we coordinate imaging with your family physician.
Our Evidence-Based Care Approach
Both conditions are typically managed with a structured plan built around progressive loading, supported by targeted therapies.
1. Progressive Rehabilitation (The Foundation)
This is a key part of recovery.
Your program will focus on:
- improving load tolerance
- strengthening the foot and calf
- restoring movement patterns
- gradually returning to activity
- For plantar fasciitis: → focus on foot + calf loading
- For Achilles tendonitis: → focus on progressive tendon loading
This supports long-term recovery, not just short-term relief. Research suggests that progressive loading programs may help improve pain and function in plantar fasciitis.
2. Chiropractic Care (Improving Joint Mechanics)
Chiropractic care is used to:
- improve mobility in the foot and ankle
- reduce compensatory movement patterns
- decrease stress on irritated tissues
By improving joint mechanics, we can reduce unnecessary strain and support rehabilitation.
Evidence suggests that manual therapy may be most effective when combined with exercise-based rehabilitation to support outcomes. https://pubmed.ncbi.nlm.nih.gov/29100820/
3. Physiotherapy (Strength and Functional Recovery)
Physiotherapy supports:
- structured strengthening
- improved muscle capacity
- gradual return to activity
The goal is not just symptom relief, but building long-term resilience in the tissue.
4. Shockwave Therapy (For Persistent Cases)
Shockwave therapy may be considered when symptoms persist.
It may help:
- support tissue healing
- reduce pain sensitivity
- improve outcomes in some chronic cases
There is evidence supporting its use in chronic plantar fasciitis. https://pubmed.ncbi.nlm.nih.gov/27641073/
5. Acupuncture (Pain Modulation)
Acupuncture may be used to:
- reduce pain
- decrease muscle tension
- improve comfort during movement
It may be helpful as a short-term pain modulation option, especially early in recovery.
Why Our Approach Works
We combine:
- rehabilitation (to address contributing factors)
- hands-on care (to improve movement)
- adjunct therapies (to support recovery)
This approach aims to support more consistent, longer-term outcomes.
When Should You Get It Checked?
You should seek care if:
- pain lasts more than 1-2 weeks
- symptoms are worsening
- walking or activity is affected
- stiffness or weakness is present
Early assessment may support a smoother recovery process and reduce the risk of symptoms becoming persistent.
Why Choose Reset Chiropractic & Rehab
- Evidence-based, conservative care
- Clear diagnosis and structured plans
- Chiropractic, physiotherapy, and rehab under one roof
- Direct billing available
- Focus on long-term outcomes
Frequently Asked Questions
Can both conditions happen at the same time?
Which condition takes longer to heal?
Start Your Recovery Today
The first step is getting the diagnosis right.
With a structured plan, both plantar fasciitis and Achilles tendonitis can often be managed with conservative care. Book an appointment today!
Call (519) 649-4046 or Book Online Today
This content is for informational purposes only and does not constitute medical advice.