Definition

Achilles tendonitis is an inflammation and/or degeneration of the Achilles tendon. The Achilles tendon connects the calf muscles to the heel bone.

Achilles Tendonitis

Achilles Tendonitis

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Causes

The Achilles tendon can become irritated for several reasons including:

  • Increasing your speed or running long distances too quickly
  • Suddenly adding strenuous hills or stair climbing to your exercise routine
  • Doing too much too soon after taking time away from exercising
  • A sudden or violent contraction of the calf muscles, such as during an all-out sprint
  • Running too much (overuse)
  • Lack of flexibility of the calf muscles

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Improper or badly worn footwear
  • Improper warm-up for your activity
  • Inflexibility of the calf muscles
  • Improper cool-down
  • An improper training program

Symptoms

Symptoms may include:

  • Tenderness usually located one to two inches above the point where the Achilles tendon attaches to the heel bone (noticeable in the morning upon rising)
  • Stiffness that gradually eases as the tendon is warmed-up
  • Pain after activity that gradually worsens
  • Radiating or localized pain along the tendon during and/or after running
  • Swelling in the area of the Achilles

Diagnosis

The doctor will ask about your symptoms and exercise habits, and perform a physical exam.

Tests may include:

  • X-rays—to see if there is calcium in the tendon
  • MRI scan—to view areas of interior damage to the tendon

Treatment

Rest

Take a break from the activity that caused the tendonitis. Switch to an activity, such as swimming, that doesn't put stress on the tendon.

Orthoses

You may be advised to wear a shoe insert that will place your foot in the correct position for walking and running.

Physical Therapy

  • Stretching
  • Massage
  • Ultrasound
  • Strengthening exercises

Medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease the pain and decrease inflammation. This is not curative and must be combined with other treatment.

Prevention

To decrease your chances of getting Achilles tendonitis:

  • Take the time to warm-up and cool-down properly.
  • Wear appropriate footwear for your sport.
  • Do not use shoes beyond the recommended duration. This will depend on:
    • How frequently you exercise
    • The surface on which you exercise
    • The conditions in which you exercise
  • Gradually add hill work, stairs, speed, and distance to your exercise routine.
  • Stretch and strengthen the calf muscles regularly.