Plantar fasciitis vs Achilles tendonitis: symptoms and differences

Heel pain can make every step feel more loud or noticeable. Maybe it hits when you get out of bed and make contact with the ground. Or maybe pain strikes during a high-impact activity like running or after you’ve been walking on your feet all day.

The two leading culprits of heel pain include plantar fasciitis and Achilles tendonitis (also called Achilles tendinopathy), but they affect different tissues and tend to cause symptoms in different places — even though it can feel like the same spot.

“Plantar fasciitis often leads to pain on the bottom of your foot, while Achilles tendon pain is right at the back of your heel,” explains Nicholas Mercer, PT, DPT, a physical therapist at Hinge Health.

You don’t necessarily need to stop being active while you figure out what’s causing your heel pain. Both conditions often respond well to gradual movement and simple at-home treatments, including targeted strengthening exercises.

Ahead, learn the difference between plantar fasciitis vs achilles tendonitis, plus how you can manage both, especially with targeted exercises recommended by Hinge Health physical therapists.

Together, these exercises address ankle mobility, strength, and coordination throughout your foot and lower leg. You don’t have to do every exercise at once or push through significant pain. Start at a level that feels manageable and gradually progress as your symptoms and strength allow.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for plantar fasciitis and Achilles tendonitis

Treatment options for plantar fasciitis and Achilles tendonitis overlap in several ways. Both conditions generally benefit from keeping active, gradually building strength, and temporarily modifying activities that aggravate symptoms.

• Try physical therapy and targeted exercises. Targeted exercises can help build strength in your calf and foot muscles, improve flexibility and mobility, and gradually increase how much activity your plantar fascia and Achilles tendon can comfortably handle. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Regular movement helps maintain strength and mobility while your symptoms improve. It also helps increase nourishing blood flow to tender areas. Consider starting with walking, swimming, other low-intensity or impact activities and gradually build up from there. If something causes an increase in pain, try adjusting how long, how hard, or how often you do it rather than assuming you need to stop completely.

• Apply heat or ice. Either method may provide temporary symptom relief. Some people find ice soothing when their heel feels sore after activity, while others prefer heat when their foot or ankle feels stiff. Stick to the method that feels best to you.

• Take over-the-counter (OTC) medication as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have heel pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Look at your footwear. Shoes that feel comfortable and supportive can make it easier to stay active while your heel is sensitive. Some people also find temporary relief from using heel cups or over-the-counter orthotics as the area heals. There isn’t one “best” shoe for everyone, so focus on finding the footwear that feels good on your feet and works for the activities you do.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain associated with conditions like plantar fasciitis and Achilles tendonitis. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

When to see a doctor

Heel pain can often improve with movement, activity modifications, and other simple at-home treatments. But see a healthcare provider if your pain is severe, getting worse, or making everyday activities difficult. It’s also a good idea to seek medical attention if you have:

• Sudden pain after feeling or hearing a pop or snap

• Significant swelling or bruising

• Difficulty bearing weight or walking

• New numbness, tingling, or weakness in your foot

• Symptoms that aren’t improving after several weeks of consistent treatment

PT tip: Roll with it

Keep a frozen water bottle handy in your freezer. “You can roll your foot on it, or roll it on the back of your Achilles tendon, anytime you experience a pain flare,” says Dr. Mercer. Rolling may provide temporary relief and help the tissues in this area feel less stiff or uncomfortable. Think of it as one tool for managing symptoms rather than something you need to do to make the tissue heal.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.