Achilles tendinitis is an overuse injury of the Achilles (uh-KILL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.
Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It's also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.
Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor's supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting.
You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity.
If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.
Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes.
The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs.
A number of factors may increase your risk of Achilles tendinitis, including:
Achilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair.
While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk:
During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range of motion and reflexes of your foot and ankle.
Your doctor may order one or more of the following tests to assess your condition:
Tendinitis usually responds well to self-care measures. But if your signs and symptoms are severe or persistent, your doctor might suggest other treatment options.
If over-the-counter pain medications — such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) — aren't enough, your doctor might prescribe stronger medications to reduce inflammation and relieve pain.
A physical therapist might suggest some of the following treatment options:
Exercises. Therapists often prescribe specific stretching and strengthening exercises to promote healing and strengthening of the Achilles tendon and its supporting structures.
A special type of strengthening called "eccentric" strengthening, involving a slow let down of a weight after raising it, has been found to be especially helpful for persistent Achilles problems.
If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.
Self-care strategies include the following steps, often known by the acronym R.I.C.E.:
You'll likely first bring your symptoms to the attention of your family doctor. He or she might refer you to a doctor specializing in sports medicine or physical and rehabilitative medicine (physiatrist). If your Achilles tendon has ruptured, you may need to see an orthopedic surgeon.
Before your appointment, you may want to write a list of answers to the following questions:
Be prepared to answer the following questions regarding your symptoms and factors that may be contributing to your condition:
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