Achilles pain and stiffness after sitting? Five reasons why this might be

Is your Achilles tendon painful and stiff when you try to get up and walk after sitting for a while? Chances are you’ve got Achilles tendonitis. Here’s a five-point checklist to figure out why sitting may aggravate your symptoms and advice on what to do in each case. 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:

1. Decreased circulation

2. Feet too far under chair

3. Resting your heel on something

4. What other activities have you been doing?

5. How long you sit for

6. How we can help

We've also made a video about this:

1. Decreased circulation

When your Achilles tendon is injured, it accumulates more fluid than usual, and this is what creates that feeling of stiffness in your tendon. The injury also causes your tendon to produce chemicals involved in the healing process, but too much of those chemicals can irritate the nerve endings in your tendon, which contributes to your pain.

When you’re moving about, your circulation increases, and this speeds up the process that gets rid of the fluids as well as the chemicals.

However, when you sit still, your circulation slows down and the fluid and chemicals accumulate in your injured tendon. (The same happens when you sleep – see our article on a stiff and sore Achilles tendon in the mornings.)

And then, when you get up, you have to hobble painfully for the first few steps before things get better.

💡A short-term solution for this is to move your tendon gently before getting up (or before getting out of bed), just to get the circulation going again. For example, you could go up on your toes 10 times while sitting or move your foot up and down 10 to 20 times.

But be careful not to pull your toes up too far towards your shin (dorsiflexion) as it will stretch and compress your injured tendon against your heel bone, which can cause you more pain. It is natural to want to stretch a tendon (or other body part) that feels stiff, but in the case of injured tendons, this is usually not a good idea.

💡If you want long-term relief from that stiffness you get from sitting, you’ll need the right rehab plan as well as do some other things that can help your tendon to recover, and then that stiffness will finally disappear. Here’s our comprehensive overview of treatment options for Achilles tendonitis.

2. Feet too far under chair

If you sit with your feet too far under your chair, it will also stretch and compress your injured Achilles tendon against your heel bone, which will make it more painful.

Especially if you have insertional Achilles tendinopathy, when the tendon is injured right where it is attached to the heel bone, this dorsiflexed position can increase your pain.

💡So rather have your feet out in front of you, or even better, place something underneath your heels while you’re sitting so that your heels are slightly elevated.

3. Resting your heel on something

It’s nice to sit back and put your feet up, isn’t it? But if your injured heel is resting on something like an ottoman or a footstool, it can contribute to your tendon pain.

If your Achilles tendon is really annoyed with life, even resting it on something soft like a cushion or pillow can make it hurt more afterwards.

💡When you want to have your feet up, rather rest your calves on something so that the pressure isn’t directly on the painful part of your tendon.

4. What other activities have you been doing?

If your Achilles tendon pain and stiffness kicks in when you get up from sitting only some of the times, it’s probably not due to sitting as such, but to your activities in the run-up to your sitting down.

Tendons often have a delayed pain response. When you do something that's annoying and overworking it, it usually doesn't tell you in the moment; it's only several hours later or even the next day that you start feeling the pain or increased stiffness.

Tendons often have a delayed pain response. It might be yesterday's activities that are causing your Achilles to be more painful today.

Perhaps you walked more than usual, or on uneven terrain that worked the injured tendon more than usual, or the run you did was too much for your injured tendon. Maybe you wore flat shoes for a change or walked barefoot (both increase the stretch on the tendon).

💡So, if your tendon is not consistently painful when you get up and walk after having sat, it may depend on the activities you've either done a couple of hours before or even the previous day. Try to map those out and figure out what's going on.

5. How long you sit for

Lastly, it may simply be the case that you’re sitting for very long periods of time.

💡Try to take breaks from your sitting stints (this is healthy in any event – injured tendon or no injured tendon). Or try to move your foot from time to time while you’re sitting so that you can hit the ground running when you get up eventually.

But remember, for long term relief you must address the tendon injury through a rehab plan.

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.

Reference

Cook, J. L., et al. (2016). "Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?" British Journal of Sports Medicine 50(19): 1187-1191.