What is Achilles tendinitis?

Two large muscles in the calf create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel and allows you to push your foot down. You use your Achilles tendon when walking, running, and jumping. Achilles tendinitis occurs when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot.

If you have Achilles tendinitis, injury or overuse of your Achilles tendon has caused inflammation and swelling. The tendon may become thicker and harden. This tendinitis is characterized in two ways, depending on where it is located:

  • Noninsertional Achilles tendinitis: Small tears or injury to the middle of your tendon causes inflammation and pain.
  • Insertional Achilles tendinitis: This type of tendinitis occurs in the area where the tendon meets the heel. Bone spurs, or bony growths in the heel, may occur.

At Penn Orthopaedics, we have surgeons and sports medicine physicians dedicated to addressing foot and ankle pain and highly experienced in the treatment of Achilles tendinitis.

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Achilles tendinitis symptoms

Symptoms of Achilles tendinitis include:

  • Pain along the heel and tendon, especially when walking or running
  • Morning stiffness and discomfort in the affected area, which may lessen as the day progresses
  • Tenderness or pain in the Achilles tendon when touched or moved
  • Swelling and warmth around the heel or along the tendon
  • Difficulty or discomfort when attempting to stand on tiptoe

What causes Achilles tendinitis?

Achilles tendinitis is commonly caused by repetitive strain on the Achilles tendon, often from activities like running, jumping, or a sudden increase in exercise intensity. Wearing improper footwear, especially shoes with inadequate support, can also strain the tendon and increase the risk of injury. Additionally, tight calf muscles or weak ankle flexibility may cause extra stress on the Achilles tendon.

Several other risk factors can make tendinitis more likely. Chronic conditions such as diabetes, rheumatoid arthritis, and osteoarthritis can affect tendon health and make tissues more prone to inflammation. Lifestyle factors, including smoking and being overweight, can add strain to the tendon, affecting its ability to heal and increasing the likelihood of tendinitis.

Diagnosing Achilles tendinitis

To diagnose Achilles tendinitis, your care provider will review your medical history and ask about recent activities that could have contributed. You’ll likely undergo a physical exam, getting checked for tenderness, swelling, or thickening along the tendon and pain when you move your foot. The strength and flexibility of your ankle and calf muscles may also be assessed. To confirm the diagnosis and determine the extent of the injury, musculoskeletal imaging tests are done to obtain detailed views of tendon damage.

Achilles tendinitis treatment

Achilles tendinitis can often be treated without surgery. Your orthopedics care team may recommend changes to your daily activities, icing the area, anti-inflammatory medications, shoe inserts, and physical therapy to help with your symptoms. If pain does not improve, additional treatments or surgery may be recommended to repair tendon damage.

Can Achilles tendinitis be prevented?

Preventing Achilles tendinitis involves easing into new activities, stretching and strengthening the calf muscles, and wearing supportive, cushioned shoes. Maintaining a healthy weight and incorporating rest days also reduce tendon strain, lowering the risk of inflammation and overuse injuries.

Proactive care for painful flare-ups

Penn Orthopaedics’ specialists offer comprehensive surgical and nonsurgical options to address every type of foot and ankle condition, including Achilles tendinitis. We deliver coordinated, high-quality care from diagnosis and treatment to rehabilitation and aftercare.

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