Sports, Pain​ & ​

Regenerative Institute

Achilles Tendon Q & A

The Achilles tendon attaches your calf muscles to your heel bone, or calcaneus. You use this tendon to jump, walk, run, and stand on the balls of your feet. Continuous, intense physical activity, such as running and jumping, can cause painful inflammation of the Achilles tendon, known as Achilles tendonitis.


Causes of Achilles Tendon Injuries

Achilles tendon injuries are common in people who do things where they quickly speed up, slow down, or pivot, such as:

  • Running
  • Gymnastics
  • Dance
  • Football
  • Baseball
  • Softball
  • Basketball
  • Tennis
  • Volleyball

These injuries tend to happen when you start moving suddenly as you push off and lift your foot rather than when you land. For instance, a sprinter might get one at the start of a race as he surges off the starting block. The abrupt action can be too much for the tendon to handle. Men over 30 are particularly prone to Achilles tendon injuries.


Symptoms of Achilles Tendon Injuries

Common symptoms of Achilles tendinitis include:

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Bone spur (insertional tendinitis)
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.


Treatment of Achilles Tendon Injuries

Treatment aims to relieve pain and reduce swelling. The choice of treatment will depend on the severity of the condition and whether the patient is a professional athlete or not. Methods of treating Achilles tendinitis include:


Ice packs: Applying these to the tendon, when in pain or after exercising, can alleviate pain and inflammation.


Rest: This gives the tissue time to heal. The type of rest needed depends on the severity of the symptoms. In mild cases, it may mean reducing the intensity of a workout, but severe cases might require complete rest for days or weeks.


Elevating the foot: Keeping the foot raised above the level of the heart can reduce swelling.


Pain relief: Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, can reduce pain and swelling. People with asthma, kidney disease, or liver disease should first check with a doctor.


Steroid injections: Cortisone, for example, can reduce tendon swelling, but it has also been associated with a greater risk of tendon rupture. Giving the injection while scanning the area with ultrasound can reduce this risk.


Compression bandages and orthotic devices: Ankle supports and shoe inserts can aid recovery as they take the stress off the tendon. Heel lifts, which move the foot away from the back of the shoe, may help patients with insertional Achilles tendinitis.


Extracorporeal shockwave therapy (ESWT): High-energy shockwaves are used to stimulate the healing process. Results have not been consistent, but if other measures do not work, it might be worth trying before opting for surgery.