October 03, 2023

Achilles Tendinitis

Runner holding his leg

The Achilles tendon connects your calf muscle to the back of your heel bone. It can become swollen and painful if you overuse or stress it. An inflamed Achilles tendon is called Achilles tendinitis. This article explains Achilles tendinitis, including symptoms, diagnosis, and treatment.

Achilles Tendinitis Symptoms

If you develop Achilles tendinitis, you may experience some or all the following symptoms:

  • Pain or stiffness in the heel or tendon in the morning
  • Swelling and warm sensation in the heel or tendon
  • Pain in the heel or along the length of the tendon when you walk or run
  • Pain in the tendon when you touch or move it
  • Trouble raising up on the toes of the affected foot

This condition has two main types: noninsertional Achilles tendinitis and insertional Achilles tendinitis. The noninsertional form affects fibers in the middle of the tendon, while insertional tendinitis involves the area where the tendon attaches to the heel bone (or calcaneus).

Diagnosing Achilles Tendinitis

Doctors diagnose Achilles tendinitis by conducting a physical examination and ordering tests if necessary. In the exam, your doctor checks for issues such as swelling, heel pain when stretching the calf muscle, pain in the middle of the tendon, reduced range of motion in your ankle, and bone spurs.

Imaging procedures like X-rays, magnetic resonance imaging (MRI), and ultrasound can reveal the extent of the tendinitis and other issues like tendon tears and bone spurs. Your doctor may also order imaging before surgery if nonsurgical interventions don’t improve your condition.

Nonsurgical Achilles Tendinitis Treatment

Achilles tendinitis usually responds to nonsurgical treatment. Your doctor can describe how to treat Achilles tendinitis at home. The first approach is often the RICE method (for rest, ice, compression, and elevation).

  • Rest. You avoid putting pressure or weight on the tendon for one or two days, using crutches if needed.
  • Ice. You apply a bag of ice to your heel and Achilles tendon for 20 minutes at a time to reduce swelling.
  • Compression. You wrap the tendon in athletic tape or a bandage to compress it and reduce swelling. (Note: It’s important that the wrap not be so tight that it cuts off your circulation.)
  • Elevation. Sitting or lying down in a position that raises your affected foot above the level of your heart (on a stack of pillows, for example) helps reduce swelling.

Other nonsurgical treatments include:

  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen as directed.
  • Performing exercises like Achilles tendon stretches at home.
  • Getting physical therapy and therapeutic massage to stretch and strengthen your Achilles tendon and calf muscle. You may also get instructions on changing your walking or running form to put less stress on the area.
  • Getting shockwave therapy that uses strong sound waves to reduce pain and support healing.
  • Receiving injections of cortisone, which is a powerful anti-inflammatory drug.
  • Wearing a splint that keeps your calf muscle stretched overnight and reduces morning pain and stiffness.
  • Wearing supportive shoes, orthotic devices, or heel lifts.
  • Wearing a walking boot for a prescribed period. (Note: How long you wear an ortho boot for Achilles tendinitis depends on the severity of your condition. You shouldn’t wear it longer than recommended, as doing so can weaken your calf muscle.)

Surgical Achilles Tendinitis Treatment

Doctors often see chronic Achilles tendinitis in runners. Your physician may recommend surgery if six months of nonsurgical treatment doesn’t improve your condition. Surgical options include debridement (“cleaning up” damaged tissue) and gastrocnemius recession (lengthening the calf muscle). Both procedures have very good success rates. In some cases, minimally invasive surgery techniques can be used.

Talk with Your Baptist Health Doctor About Achilles Tendinitis

If you experience frequent or continual pain in your heel or Achilles tendon that doesn’t respond to home treatment or is concerning, talk with your doctor. They can assess your condition and refer you to one of our orthopedic specialists if appropriate.

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