The Ankle

Achilles Tendinitis

The Achilles tendon is the largest and strongest tendon in the body. This tendon connects the calf muscles to the heel bone and enables people to walk, run and jump. Achilles tendinitis is an inflammation of the Achilles tendon and is almost always caused by overuse.

Any activity that requires a pushing off such as playing basketball or running can result in tendinitis. If Achilles tendinitis is left untreated, the tendon may become scarred, and the condition will be difficult to treat.

Symptoms of Achilles tendinitis often include:

  • Mild pain after exercise or running that gradually worsens
  • A noticeable sense of sluggishness in your leg
  • Pain, sometimes severe, along the tendon during a few hours after running
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
  • Stiffness that generally diminishes as the tendon warms up with use
  • Some swelling

Depending upon the severity of the condition, your provider and physical therapist will determine which treatments are best suited for you. Some commonly used treatment approaches for Achilles tendinitis include:

  • Rest
    Remain inactive until symptoms have subsided, then gradually return to activity.

  • Orthotics
    Wedges, heel lifts and stable shoes will help correct imbalances,which are considered a main contributor to Achilles tendinitis.

  • Medications
    NSAIDS (non-steroidal anti-inflammatory drugs) are used to control pain and increase healing.

  • Stretching
    Once the pain has subsided, stretching is considered the most important component in the treatment of Achilles tendinitis. Stretching should be pushed until tightness is felt. If stretching becomes painful, then you may be pushing too far, and should stop. A helpful stretching technique is called a wall lean. To perform a wall lean, remain flat-footed with your knee fully extended, then lean toward the wall, slowly stretching the calf muscles and Achilles tendon.

  • Ultrasound
    New tissue may be strengthened and swelling reduced through the use of ultrasound.

  • Rehabilitation Exercises
    Atrophy can sometimes occur after an Achilles injury. Elastic bands provide resistance during flexion exercises. As strength improves,toe-ups are recommended to further strengthen the calf muscles.

  • Surgery
    If symptoms fail to subside after six months of conservative treatment, surgery to repair the damaged tissue may be considered.