Achilles Tendonitis
Acute Achilles tendon pain, or more specifically Achilles tendonitis, is a condition of the foot and ankle that can limit your mobility and impair your quality of life. While the pain and stiffness are often worse in the morning, easing with movement, they can return and worsen with activity.
Don't let Achilles tendonitis limit your life. The condition is highly treatable and often resolves with non-surgical tendon treatment. Trust the fellowship-trained, board-certified foot and ankle specialists at Hoag Orthopedic Institute to help you resume the life you love, unhindered by Achilles tendon pain.
What is Achilles Tendonitis?
Achilles tendonitis is painful inflammation in the Achilles tendon. The Achilles tendon is the fibrous band of tissue that connects the calf muscles to your heel bone (calcaneus). This tendon helps you walk, jump, pivot, run, and stand on the balls of your feet. Overuse or repetitive movements can place excessive strain on the Achilles tendon, limiting range of movement and causing painful inflammation. Although most cases of Achilles tendonitis can be treated conservatively, more severe cases, including tendon tears or ruptures, may require surgical repair and ample rest before you can return to athletic activities.
Types of Achilles Tendonitis
There are two types of Achilles tendonitis, affecting different parts of the tendon: insertional Achilles tendonitis and non-insertional Achilles tendonitis.
- Insertional Achilles tendonitis affects the lower portion of the tendon, where it attaches to the heel bone (calcaneus). This type may occur in both active and non-active individuals but is more likely after years of overuse, especially in long-distance runners and sprinters.
- Non-insertional Achilles tendonitis involves the middle portion of the tendon, where fibers begin to degenerate (break down with tiny tears). This form is more common in younger, more active people.
In both types of Achilles tendonitis, the damaged tendon fibers may calcify or harden. However, insertional tendonitis often leads to the formation of extra bone growth (bone spurs).
What Are the Symptoms of Achilles Tendonitis?
Symptoms of an Achilles tendon injury include:
- Pain radiating down the back of the leg, near the heel, that gets worse when physically active
- Stiff, sore Achilles tendon upon awakening
- A swelling or thickening of the Achilles tendon
- Achilles tendon pain that gets worse after exertion
- Bone spurs on the heel bone
- Limited range of motion when flexing the foot with the affected Achilles tendon
- Tight calf muscles, typically after suddenly starting an aggressive workout program
- A sudden “pop” sound followed by sudden, intense pain in the Achilles tendon
What Causes Achilles Tendonitis?
Overuse, repetitive strain, or a sudden increase in activities such as running, jumping, or dancing are the primary causes of Achilles tendonitis. Sports injury is most common among athletes, particularly runners who suddenly increase the length or intensity of their workout regimens. However, weekend warriors and older adults who suddenly begin an exercise routine that is too intense for them can also develop an Achilles tendon injury.
Poor footwear can also contribute to Achilles tendon pain. Wearing old or poorly fitting shoes during physical activity or wearing high heels daily or for prolonged periods without daily stretching can cause Achilles tendonitis symptoms.
If you have persistent Achilles tendon pain, an orthopedic surgeon who is fellowship-trained in foot and ankle treatments or a podiatrist is the best type of doctor to involve in your treatment.
How is Achilles Tendonitis Diagnosed
Achilles tendonitis is diagnosed primarily through a physical examination performed by your orthopedist or podiatrist. They will gently press on the affected area to determine which anatomical structure is involved, as well as to assess your level of pain, tenderness, or swelling. You may be asked to stand on the balls of your feet while your physician observes your range of motion and flexibility.
Your doctor may also recommend imaging tests, which can rule out other conditions that can cause similar symptoms. These tests may include:
- An X-ray of the foot and leg bones can reveal calcification in the tendon or the presence of bone spurs on the heel.
- Magnetic resonance imaging (MRI) produces highly detailed images of your affected tendon and can detect a tear, rupture, or tissue degeneration.
- Ultrasound offers real-time imaging that can show thickening, inflammation, or tears in the tendon, and may also be used to assess blood flow to the area.
When to See a Doctor for an Achilles Tendonitis
Most patients with Achilles tendonitis respond well to self-care, including the classic “RICE” therapy: Rest, Ice, Compression, and Elevation. If symptoms persist after a few weeks of self-care, it's time to see a doctor. Seek immediate medical attention if you hear a “pop,” feel sudden and severe pain, can’t bear weight, or notice a soft gap where the tendon normally feels firm and continuous. These may indicate a rupture of the Achilles tendon.
You don’t have to live with Achilles tendon pain. Whether you’re dealing with a mild strain or a more serious injury, the fellowship-trained, board-certified foot and ankle specialists at Hoag Orthopedic Institute offer comprehensive, personalized care. From diagnosis to advanced non-surgical Achilles tendonitis treatments and, when necessary, surgical repair, we’ll help you heal and get back to doing what you love.
Schedule a consultation with one of Hoag Orthopedic Institute's fellowship trained foot and ankle surgeons and take the first step toward recovery.
