The disease mostly presents as discomfort or pain in the Achilles tendon area at the back of the lower leg. Early symptoms present as discomfort or pain that occurs intermittently, after or before exercise. In some cases, the symptoms disappear after preparatory activities. This may be due to a reduction in pressure in the Achilles tendon as a result of increased local blood supply, increased tissue fluid and lymphatic circulation following preparatory activities. Some patients present with pain in the Achilles tendon area during specific forceful strokes. As the disease progresses, the pain becomes more intense and may manifest as pain on standing or walking. At the end of the disease, rest pain may develop. The pain is mainly in the Achilles tendon at the back of the heel and there is localised pressure pain. Sometimes swelling may also occur. The pain increases when the toes are pointed down and away from the calf. The patient may also feel tension and stiffness in the area of the calf. The attack is often preceded by a history of prolonged overuse of the Achilles tendon and is commonly seen in professional athletes.