They describe the same area of pain, but tendinopathy is the more accurate term. Tendinitis implies active inflammation, and research on long-standing Achilles pain shows the main change is to the structure of the tendon itself rather than classic inflammation. That matters for treatment, because it explains why anti-inflammatory measures alone often fall short and why graded loading is the priority.

It is usually the tendon itself, which thickens as it responds to overload. The area is often firm, tender to pinch and slightly wider than the same spot on your other leg. The thickening can persist even after pain settles, and a tendon that looks different on a scan can still work perfectly well. Your podiatrist tracks function and pain, not the size of the lump.

A painful tendon does not automatically progress to a rupture, and many ruptures happen in people who had no previous pain. That said, a tendon with reduced capacity is less able to handle sudden explosive load, such as sprinting for a ball after months off. Building strength progressively is the practical way to reduce that risk rather than avoiding the leg altogether.

Not always, and stretching is often the wrong first move. Where the tendon attaches to the heel bone, pulling the foot up compresses the tendon against the bone and can make pain worse. Mid-portion pain tolerates gentle stretching better. Your podiatrist tells you which pattern you have and whether stretching earns a place in your program.

Yes. Fluoroquinolone antibiotics, such as ciprofloxacin, carry a known association with Achilles tendon pain and, rarely, rupture, particularly in older adults and people taking corticosteroids. Bring a current medication list to your appointment. Do not stop a prescribed medicine on your own; talk to your GP or pharmacist if you are concerned about a link.

Less often than adults. In growing children and teenagers, pain at the back of the heel is more commonly Sever’s disease, which involves the growth plate rather than the tendon. The two feel similar but are managed differently, so an accurate diagnosis matters. If your child has heel pain that limits sport, book an assessment rather than waiting it out.