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, like running and jumping, can cause painful inflammation of the Achilles tendon. This is known as Achilles tendonitis (or tendinitis).
You can often treat Achilles tendonitis at home using simple strategies. 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 is a common cause of Achilles tendonitis. This is particularly true for athletes. However, factors unrelated to exercise may also contribute to risk. Rheumatoid arthritis and infection are both correlated with tendonitis.
In general, any repeated activity that strains the Achilles tendon can contribute to this problem. A few possible causes are:
- exercising without a proper warm-up
- straining the calf muscles during repeated exercise or physical activity
- playing sports such as tennis that require quick stops and changes of direction
- wearing old or poorly-fitting shoes
- wearing high heels daily or for prolonged durations
The main symptom of Achilles tendonitis is a feeling of pain and swelling in the posterior part of your heel as 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 the condition correctly, 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 will also palpate the area directly to pinpoint where the pain and swelling are most severe.
Confirming Achilles tendonitis may involve imaging tests, but they’re often unnecessary. If ordered, the tests include:
- X-rays, which can provide images of the bones of the foot and leg
- MRI scan, which are useful for detecting ruptures and the degeneration of tissue
- ultrasound, which can show tendon movement, related damage, and inflammation
There’s a variety of treatments available for Achilles tendonitis. These range from rest and ibuprofen (Advil) to steroid injections and surgery. Your doctor might suggest:
- reducing your physical activity
- very gentle stretching and later strengthening of the calf muscles
- switching to a different, less strenuous sport
- icing the area after exercise or when in pain
- elevating your foot to decrease swelling, if present
- wearing a brace or boot to prevent heel movement
- going to physical therapy
- taking anti-inflammatory medication, such as aspirin or ibuprofen, for a limited time
- getting steroid injections
- wearing a shoe with a built up heel to take tension off the Achilles tendon
Sometimes, more conservative treatments are not effective. In these cases, surgery may be necessary to repair the Achilles tendon. If the condition intensifies 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.
To lower your risk of Achilles tendonitis, try the following strategies:
- Stretch your calf muscles at the beginning of each day to improve your agility and make your Achilles less prone to injury. You should also try to stretch both before and after workouts. To stretch your Achilles, stand with a straight leg, and lean forward as you keep your heel on the ground.
- Ease into a new exercise routine, gradually intensifying your physical activity.
- Combine high- and low-impact exercises, such as basketball with swimming, to reduce constant stress on your tendons.
- Choose shoes with proper cushioning and arch support. Also make certain the heel is slightly elevated to take tension off the Achilles tendon. If you’ve worn a pair of shoes for a long time, consider replacing them or using arch supports.
- Reduce the heel size of shoes gradually when transitioning from high heels to flats. This allows the tendon to slowly stretch and increase its range of motion.