Football (the sport that is also called ‘soccer’, not the one with the egg-shaped ball and the helmets) works the calves and Achilles tendon hard, and it can be tricky to know whether you can play football with an Achilles injury. This article provides some guidelines on whether and how to keep on playing football with an injured Achilles for players who are keen to get back out on the pitch. 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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The role of the Achilles tendon in football/soccer
Your Achilles tendon attaches the lower parts of your calf muscles – the gastrocnemius and the soleus – to your heel bone.
When you land on your foot and then push off onto your toes to move, your Achilles tendon acts like a spring. It stores the energy from landing on your foot and then releases the energy when you push off.
So, when you play football, you’re using your Achilles tendon all the time, for example when you’re sprinting for the ball, dribbling, jumping to smash a header, or lunging to make a save.
Why your Achilles tendon may hurt playing football
The most common reason why your Achilles may hurt while playing football is if you have Achilles tendonitis or tendinopathy. Achilles tendonitis is an overuse injury. It develops when you work your tendon too hard or don’t allow it enough recovery time between hard workouts.
Once the tendon is injured, its capacity (strength and endurance) is reduced, and it becomes quite sensitive. As a result, it struggles to cope with your normal training loads. Initially, you may find that it’s only painful at the start of a training session or match and feels better once it has warmed up. But if you continue to train on it, your tendon may become more irritated, causing it to hurt more easily – even when you’re just walking.
How to restore your tendon’s capacity
The best way to restore your tendon’s capacity and reduce its sensitivity is through a combination of relative rest and strength training.
Relative rest is needed to allow your tendon to calm down and for your other rehab exercises to be effective. You don’t have to rest completely; you just have to reduce the intensity of the activities that cause your pain to increase. I discuss how you can adapt your football training to allow your tendon to calm down in the next sections.
The only way to strengthen your tendon and restore its capacity to tolerate the loads it has to absorb when you play football is through strength training. It’s important that the exercises you do are set at the correct intensity. If they exceed your tendon’s current strength, they will likely just cause your tendon to feel more painful.
They should also be progressed as you recover. For example, you may have to start by doing double leg heel raises, but as you grow stronger and your tendon becomes less sensitive, these should be progressed to doing them with weights, or on one leg, and eventually include hopping and jumping actions.
Using Achilles pain levels to decide whether you can still play
Having an Achilles tendinopathy doesn’t necessarily mean that you have to stop playing football altogether. It will depend on the severity of the injury and how irritable your tendon is in terms of how quickly your symptoms come on and for how long they last after you’ve played.
If, while you’re playing football, your Achilles pain doesn’t go above a level of 2 out of 10, you may still be able to play. Typically, you’ll feel the pain at the start of play or training, and then it might fade away as your Achilles tendon warms up. Sometimes, it will come back towards the end of a session.
That’s not the end of it, though. Tendons are sneaky things – they may not complain while you’re playing, only to become painful the next day. Usually, it will feel painful and/or stiff first thing the next morning as you get out of bed. So, you also have to check the 24-hour response after you’ve played. If your tendon isn’t more painful and/or stiff the next day than before you started playing the previous day, it may mean that the session you did yesterday was OK.
If, however, your pain goes above 2 out of 10 either during play or in the next 24 hours, it’s a sign that you’ve been overdoing it. In this case, you’ll have to find ways to modify your training or match play, or you’ll have to stop playing altogether and rather focus on restoring your tendon’s capacity through rehab exercises.
How you can still play football/soccer with Achilles tendonitis
If it turns out that your symptoms are such that you can still play while your Achilles tendon is recovering, then what is the best way to go about it?
You’ll have to discuss with your coach how your training and match play can be modified in such a way that your tendon can recover over time.
In training sessions, could you cut out or minimise the running, sprinting, and jumping drills? Also, could you go easy on drills for agility, like ladder drills and going side-to-side? Instead, you could concentrate on set-piece tactics or doing walking football.
As for matches, an option would be to play only for a part of the game before being taken off or going on shortly before full time.
Of course, the endgame is to get your Achilles tendon back to full strength or even stronger than before, so that you don’t fall into the same injury trap again. Just taking it easy with the football for a while won’t be sufficient for this. You’ll need an Achilles tendon strength training programme, as mentioned earlier.
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.