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Achilles Tendonitis

Kim didn't do much over the summer except hang out at the pool. When she did wear something on her feet, it was often heels. But as soon as school started, she laced on a pair of sneakers and went out for the cross-country team, running a couple of miles each day.

Within a week, Kim noticed a pain just above her heel. At first it wasn't too bad, and she kept running. But before too long, the pain got worse and wouldn't go away. Kim had to stop running, and her coach told her to go see a doctor. The doctor examined her heel and told Kim she had Achilles tendonitis.

What Is Achilles Tendonitis and Who Gets It?

Your Achilles tendon is located at the back of your foot, just above your heel. It connects your heel to the two muscles of your calf and helps your foot push forward every time you take a step.

If the tendon becomes swollen or irritated due to overuse, it can lead to the painful condition called Achilles tendonitis. If Achilles tendonitis goes untreated, it can become a chronic condition that makes just walking around almost impossible.

Achilles tendonitis is a very common running injury. But it can also affect basketball players, dancers, or people who put a lot of repeated stress on their feet. It can be very painful.


What Are the Symptoms of Achilles Tendonitis?

Most cases of Achilles tendonitis start out slowly, with very little pain, and then grow worse over time. Some of the more common symptoms include:

  • mild pain or an ache above the heel and in the lower leg, especially after running or doing other physical activities
  • pain that gets worse when walking uphill, climbing stairs, or taking part in intense or prolonged exercise
  • stiffness and tenderness in the heel, especially in the morning, that gradually goes away
  • swelling or hard knots of tissue in the Achilles tendon
  • a creaking or crackling sound when moving the ankle or pressing on the Achilles tendon
  • weakness in the affected leg

How Is Achilles Tendonitis Diagnosed?

If you suspect you might have Achilles tendonitis, check in with your doctor so it doesn't get worse. Your doc will ask about the activities you've been doing as well as examine your leg, foot, ankle, and knee for range of motion.

If your pain is more severe, the doctor may also examine you to be sure you haven't ruptured (torn) your Achilles tendon. To check this, the doc might have you lie face down and bend your knee while he or she presses on your calf muscles to see if your foot flexes. Any flexing of the foot means the tendon isn't completely torn.


What Causes Achilles Tendonitis?


Other things that contribute to Achilles tendonitis include:

  • Sports that require sudden starts and stops; for example, tennis and basketball.
  • Weak calf muscles, flat arches, or "overpronation" (feet that roll in when running). Overpronation makes the lower leg rotate inward and puts a twisting stress on the tendon.
  • Running or exercising on a hard or uneven surface.
  • A traumatic injury to the Achilles tendon.

How Can You Prevent Achilles Tendonitis?

Take these steps to reduce your risk of Achilles tendonitis:


How Should You Treat Achilles Tendonitis?

Most cases of Achilles tendonitis can be treated at home. Here's what to do:

  • Use the RICE formula:
    • Ice: Apply ice or a cold compress to your tendon for 15 minutes or more after you exercise or if you feel pain in the tendon.
    • Compress: Use tape or an athletic wrap to keep swelling down and help support and immobilize the tendon.
  • Take anti-inflammatory medications. Painkillers like ibuprofen can help relieve pain and reduce swelling in the affected area.

Achilles tendon surgery is rare. It's usually only required if the tendon breaks, and then only as a last resort after other methods of therapy have been tried. Most cases of Achilles tendonitis will get better on their own with rest and minor treatment.

Reviewed by: Kathleen B. O'Brien, MD
Date reviewed: March 2011