The Achilles tendon
attaches your calf muscles to your heel. You use this tendon to jump, walk, run, and stand on the balls of your feet. Continuous, intense physical activity, like running and jumping, can cause
inflammation of the Achilles. This is known as Achilles tendonitis (also spelled tendinitis). Achilles tendonitis can often be treated at home using simple strategies. However, if home treatment
doesn?t work, it is important to see a doctor. If your tendonitis gets worse, it can lead to a tendon tear. You may need medication to ease the pain or a surgical repair.
Poorly conditioned athletes are at the highest risk for developing Achilles tendonitis, also sometimes called Achilles tendinitis. Participating in activities that involve sudden stops and starts and
repetitive jumping (e.g., basketball, tennis, dancing) increases the risk for the condition. It often develops following sudden changes in activity level, training on poor surfaces, or wearing
inappropriate footwear. Achilles tendonitis may be caused by a single incident of overstressing the tendon, or it may result from a series of stresses that produce small tears over time (overuse).
Patients who develop arthritis in the heel have an increased risk for developing Achilles tendonitis. This occurs more often in people who middle aged and older. The condition also may develop in
people who exercise infrequently and in those who are just beginning an exercise program, because inactive muscles and tendons have little flexibility because of inactivity. It is important for
people who are just starting to exercise to stretch properly, start slowly, and increase gradually. In some cases, a congenital (i.e., present at birth) condition causes Achilles tendonitis.
Typically, this is due to abnormal rotation of the foot and leg (pronation), which causes the arch of the foot to flatten and the leg to twist more than normal.
The main symptom of Achilles tendonitis is a feeling of pain and swelling in your heel as you walk or run. Other symptoms include tight calf muscles and limited range of motion when flexing the foot.
This condition can also make the skin in your heel feel overly warm to the touch.
Confirming Achilles tendonitis may involve imaging tests. X-rays provide images of the bones of the foot and leg. Magnetic resonance imaging (MRI) is useful for detecting ruptures and degeneration of
tissue. Ultrasound shows tendon movement, related damage, and inflammation.
Treatment depends on severity of pain. The most effective long-term treatment for Achilles tendinitis/tendinopathy is physical therapy, particularly therapy that focuses on eccentric muscle/tendon
strengthening. Calf and Achilles stretching are also an important part of the treatment. In severe cases, treatment may begin with a period of rest and immobilization in order to calm down the tendon
before physical therapy is initiated. Anti-inflammatories may be prescribed. Avoiding activities that aggravate the Achilles tendon will help the healing process. Improvement and resolution of
symptoms can take months. Exercise might be the cause of Achilles tendonitis, but it can also help prevent it and aid in recovery. Healing will occur more quickly if there is no pressure on the
injured tendon, and if the foot is at least partially immobilized.
Surgery is an option of last resort. However, if friction between the tendon and its covering sheath makes the sheath thick and fibrous, surgery to remove the fibrous tissue and repair any tears may
be the best treatment option.
While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk. Increase your activity level gradually. If you're just beginning an exercise regimen, start
slowly and gradually increase the duration and intensity of the training. Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a
strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest. Choose your shoes carefully. The shoes you wear while exercising
should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good
condition but don't support your feet, try arch supports in both shoes. Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after
exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis. Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to
better handle the stresses they encounter with activity and exercise. Cross-train. Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and