The Achilles tendon attaches your calf muscles to your heel bone, or calcaneus. You use this tendon to jump, walk, run, and stand on the balls of your feet.
Continuous, intense physical activity, such as running and jumping, can cause painful inflammation of the Achilles tendon, known as Achilles tendonitis (or tendinitis).
There are two types of Achilles tendonitis: insertional Achilles tendonitis and noninsertional Achilles tendonitis.
- Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
- Noninsertional Achilles tendonitis involves fibers in the middle portion of the tendon and tends to affect younger people who are active.
Simple home treatments can help Achilles tendonitis. However, if home treatment doesn’t work, it’s important to see a doctor. If your tendonitis gets worse, your tendon can tear. You may need medication or surgery to ease the pain.
Excessive exercise or walking commonly causes Achilles tendonitis, especially for athletes. However, factors unrelated to exercise may also contribute to your risk. Rheumatoid arthritis and infection are both linked to tendonitis.
Any repeated activity that strains your Achilles tendon can potentially cause tendonitis. Some causes include:
- exercising without a proper warmup
- straining the calf muscles during repeated exercise or physical activity
- playing sports, such as tennis, that require quick stops and changes of direction
- sudden increase in physical activity without allowing your body to adjust to increased training
- wearing old or poorly fitting shoes
- wearing high heels daily or for prolonged durations
- having bone spurs in the back of your heels
- being older, as the Achilles tendon weakens with age
- discomfort or swelling in the back of your heel
- tight calf muscles
- limited range of motion when flexing your foot
- skin on your heel overly warm to the touch
The main symptom of Achilles tendonitis is pain and swelling in the backside of your heel when you walk or run. Other symptoms include tight calf muscles and limited range of motion when you flex your foot.
This condition can also make the skin on your heel feel overly warm to the touch.
To diagnose Achilles tendonitis, your doctor will ask you a few questions about the pain and swelling in your heel or calf. Your doctor may ask you to stand on the balls of your feet while they observe your range of motion and flexibility.
The doctor also feels around, or palpates, the area directly to pinpoint where the pain and swelling are most severe.
Imaging tests may help confirm Achilles tendonitis, but you usually don’t need them. If ordered, the tests include:
- X-rays, which provide images of foot and leg bones
- MRI scans, which can detect ruptures and tissue degeneration
- ultrasounds, which can show tendon movement, related damage, and inflammation
Many treatments are available for Achilles tendonitis, ranging from home remedies, like rest and anti-inflammatory medication, to more invasive treatments, like steroid injections, platelet-rich plasma (PRP) injections, and surgery. Your doctor might suggest:
- reducing your physical activity
- very gently stretching and later strengthening your calf muscles
- switching to a different, less strenuous sport
- icing the area after exercise or when in pain
- elevating your foot to decrease any swelling
- wearing a brace or walking boot to prevent heel movement
- going to physical therapy
- taking anti-inflammatory medication, such as aspirin (Bufferin) or ibuprofen (Advil), for a limited time
- wearing a shoe with a built-up heel to take tension off your Achilles tendon
The rest, ice, compression, and elevation (RICE) method is usually effective in treating Achilles tendonitis right after you’re injured. This method works in the following way:
Rest: Don’t put pressure or weight on your tendon for one to two days until you can walk on the tendon without pain. The tendon usually heals faster if no additional strain is placed on it during this time.
Your doctor may suggest that you use crutches if you need to go long distances while resting your tendon.
Ice: Put ice in a bag, wrap the bag in cloth, and place the wrapped bag of ice against your skin. Hold the bag on your tendon for 15 to 20 minutes, then take the bag off to let the tendon warm up again. The ice usually makes inflammation or swelling go down faster.
Compression: Wrap a bandage or athletic tape around your tendon to compress the injury. You can also tie an article of clothing around this area.
This keeps the tendon from swelling too much. But don’t wrap or tie anything too tightly around your tendon, as it can limit blood flow.
Elevation: Raise your foot above the level of your chest. Because your foot is higher than your heart, blood returns to the heart and keeps the swelling down. This is easiest to do by lying down and putting your foot on a pillow or other raised surface.
In a case where this treatment isn’t effective, surgery may be necessary to repair your Achilles tendon. If the condition worsens and is left untreated, there’s a greater risk of an Achilles rupture, which requires a surgical intervention. This can cause sharp pain in the heel area.
Your doctor may recommend a few options for a tendon rupture surgery based on how severe your rupture is and whether you’ve had a rupture before. Your doctor will usually refer you to an orthopedic surgeon to decide which procedure is best for you.
One surgical method is called open repair. In this…