As we also run a lot during soccer matches and training, there is some risk of heel pain and Achilles tendon complaints. The risks are even higher than when just running, as the many changes of direction, sudden stopping and fast sprints can trigger heel and Achilles tendon pain. What is heel pain, what is Achilles tendon pain and what is the difference?

1. What do heel pain and Achilles tendon pain in soccer players have in common?
2. Triggers of heel pain and Achilles tendon pain in soccer
3. When children playing soccer suffer from Achilles tendon pain
4. Symptoms: how to recognize heel pain when playing soccer
5. Treatment for heel pain in soccer
6. Prevention: how to prevent heel pain when playing soccer
7. Alternative sports for soccer players suffering from heel pain
8. Resuming play after heel pain or Achilles tendon complaints

There are different types of heel pain:

1. degenerative change – tendinopathy – at the base of the Achilles tendon, on the heel bone
2. inflammation of the bursa – achillobursitis – at the base of the Achilles tendon, on the heel bone
3. protrusion of the back of the heel bone (Haglund’s deformity)
4. bony extension on the bottom of the heel bone (heel spur)

Here, a correct diagnosis is important as the treatment of this ‘heel pain’ is different in each case.

In addition to heel pain, other Achilles tendon complaints can of course arise when playing soccer:

1. degenerative change – tendinopathy – in the mid region of the tendon
2. inflammation of the gliding tissue of the Achilles tendon – peritendinitis
3. complete or partial Achilles tendon tear

Soccer practice and matches especially pose high risks for many muscles, ligaments and tendons as the mostly sudden forces acting upon them can be very strong. Not only in professional soccer does the list of injured players – also those with heel pain – often decide where they are in the league.

• These movements also place an increased load on the Achilles tendon when playing soccer. Especially during fast stop-and-go movements, strong forces are acting on the foot. The loads on different floor surfaces such as grass or a hard court, and especially artificial grass, contribute to an increasing number of different problems.
• A jump implies a sudden load on the Achilles tendon and enables very strong forces to act upon it.
• When running, forces of up to ten times the player’s body weight act on the Achilles tendon. During stop-and-go movements and jumps, these forces are even stronger!

When playing soccer, a kick from an opponent to the Achilles tendon poses a great risk. This usually causes a tear and when this happens, we often hear a snapping sound.

The height of the studs seems to have an influence: the higher the stud, the greater the risk of injury.

On the one hand, studs can be a great help when playing football; on the other hand, they also increase all the negative forces on the foot and ankle joint, as well as the heel and Achilles tendon. They can also be jointly responsible for different types of heel pain.

d. Artificial pitches – indoor pitches

The higher probability of injury on artificial pitches has not been proven, although separate studies have shown results that point in that direction. However, on indoor pitches the risk seems to be greater.

• In general, soccer boots do not have separate pronation supports. The insole too rarely has an anatomical design, meaning that soccer players with severe overpronation or flat feet should acquire suitable insoles to prevent constant loading due to these foot deformities.
• When playing soccer, heel pain can also arise because the heel cap in the boot is often very hard and tight-fitting boots are usually bought. This means that the heel cap presses excessively against the heel and so causes inflammation in the bursa or a reaction in the heel bone in the form of a bulge (Haglund’s deformity).

As many children play soccer, they also require special attention.

Generally, the load capacity of the Achilles tendon in children is lower. Especially up until 12 or 13 years of age the heel bone still has a growth plate which closes or ossifies at this age. This can lead to problems which become evident through heel pain

• typical pain when starting to move, especially in the morning when getting up
• the area can also be swollen and hurt when pressure is exerted on the top of the heel
• bony extension on the back of the heel bone
• pain on the bottom of the heel bone

• breaks from matches or training, at least from sessions where the load is great with sprints and jumps
• place heel cushions in soccer boots to relieve pressure
• if overweight, try to lose weight
• massage painful areas

• Generally speaking, stretching before and after a football match is extremely important. Eccentric training is recommended for the Achilles tendon.
• Also stretch the soles of your feet (crouching on tiptoes, with your knees pointing forwards so that there is tension in the toes and sole of the foot)

• Soccer-specific and general training for fast changes of direction
• General training involving the ABCs of running
• Barefoot running, especially on grass (both natural and artificial)
• Exercises on one leg with and without upper body and arm exercises or ball exercises with the head (also on a balance pad)
• Balance exercise, e.g. walking along or balancing on rolled-up towels

• During particularly intensive training sessions, wear FALKE Achilles socks; they will allow the blood to flow through the tendon better and enable it to recover more quickly. This is very important when the next training session is the following day.
• Warm up well on cold days, including your tendons – wear warm socks, including FALKE Achilles socks on a regular basis.

• Also roll out the Achilles tendon after soccer practice – preferably with rollers that have a dip in the middle for the Achilles tendon.
• Massage the sole of the foot with a ball (tennis ball, fascia massage ball).

Those who need to take a break from their soccer playing due to their Achilles tendon complaints can keep up their fitness level and continue strength training with other sporting activities:

• cycling: a good alternative for endurance, but please see the information in the ‘Achilles tendon and cycling’ section;
• swimming: although it obviously works out different muscle groups from running, it also gives your circulatory system and breathing a workout – however, it should not necessarily be recommended to soccer players as swimming makes your ‘sprint muscles’ slower;
• weights room: a good opportunity to give the core muscles required for running a workout. What’s more, other muscles needed for running such as the front and rear thigh muscles and hip muscles (particularly the smaller gluteus medius for hip stabilization) can of course also be trained;
• relaxed running: if this can be done pain free! At all events, avoid sprints, changes of direction and jumps.

According to the diagnosis and ensuing treatment, you will presumably be able to resume training in the form of running soon. However, you will not be able to play matches again until the Achilles tendon is completely healed.

The healing of the Achilles tendon must be your priority and not your next training session or match, even if an ascent or descent depends on it! Depending on the healing phase, continue with stretching exercises or running to put the tendon under load, but in moderation. Be honest with yourself and pay attention to the pain, because an incorrectly healed Achilles tendon can cause problems for the rest of your life.