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Achilles Tendinitis

Achilles tendinitis is inflammation of the Achilles tendon — the large tendon connecting the calf muscles to the heel bone. It's one of the most common overuse injuries, particularly in runners and middle-aged athletes who have increased their activity level. There are two types: insertional (at the heel bone attachment) and non-insertional (in the middle portion of the tendon).

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Achilles Tendinitis - symptoms, treatment options and when to see an orthopaedic specialist

Symptoms

  • Pain and stiffness along the Achilles tendon, especially in the morning
  • Pain at the back of the heel that worsens with activity
  • Swelling or thickening of the tendon
  • Tenderness when touching the tendon
  • Decreased strength and flexibility in the calf
  • Pain that worsens the day after exercise

When to See a Doctor

See a foot and ankle specialist if Achilles pain persists for more than a few weeks, is getting progressively worse, or if you feel or hear a pop (which may indicate a rupture). Early treatment prevents progression to tendon degeneration.

Treatment Options

Rest and activity modification

Reducing high-impact activities. Switching to swimming or cycling to maintain fitness.

Eccentric heel drops

Specific calf-strengthening exercises shown in research to be highly effective for Achilles tendinitis.

Physical therapy

Stretching, strengthening, and load management. Manual therapy and shockwave therapy for chronic cases.

Orthotics and heel lifts

Shoe inserts that reduce stress on the Achilles tendon during walking and activity.

Surgery (rare)

Debridement of degenerated tendon tissue for cases that do not respond to 6 months of conservative treatment.

Recovery Timeline

Mild cases: 6-8 weeks with rest and eccentric exercises. Moderate to severe: 3-6 months of physical therapy. Chronic tendinopathy may take 6-12 months.

Frequently Asked Questions

What is the difference between Achilles tendinitis and a rupture?

Achilles tendinitis is inflammation and degeneration of the tendon without a complete tear. An Achilles rupture is a complete or partial tear, usually from a sudden forceful movement. Rupture causes immediate severe pain, swelling, and inability to push off the foot.

Should I stretch my Achilles if it hurts?

Gentle stretching is generally appropriate for Achilles tendinitis. Eccentric heel drops (lowering the heel slowly off a step) are more effective than passive stretching for strengthening the tendon. Avoid aggressive stretching during acute flares.

What type of doctor treats Achilles tendinitis?

Foot and ankle orthopaedic surgeons and sports medicine physicians treat Achilles tendinitis. Physical therapists are essential for the rehabilitation program.

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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.