The Achilles tendon is the largest tendon in the body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the foot and connects your heel bone to your calf muscle. It helps you to walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when overly stressed.

What is Achilles tendinitis?

Overuse of the Achilles tendon may cause the tendon to swell, become irritated, inflamed and cause pain. This is Achilles tendinitis. It is a common sports injury related to running, but can happen to anyone who puts a lot of stress on their feet (e.g.: basketball players and dancers). If you do not get treatment for Achilles tendinitis, the problem can become chronic and make it difficult for you to walk.

What causes Achilles tendinitis?

A lot of stress on the feet is the cause of Achilles tendinitis. It is a common athletic injury. Things that can cause tendinitis include:

  • Pushing your body too fast and too soon
  • Sudden increase in activity
  • Sports that cause you to quickly start and stop
  • Poor fitting shoes, bad footwear
  • Severe injury to the Achilles tendon
  • Running or exercising on uneven ground
  • Running uphill
  • Tight calf muscles
  • Bone spur (extra bone growth in heel that rubs the tendon and causes pain)
  • Flat arches, feet that roll in (overpronation), and weak calf muscles
  • Not warming up before exercising

What are the symptoms of Achilles tendinitis?

Common symptoms of Achilles tendinitis include:

  • Weakness in the leg
  • Slight pain above the heel in the lower leg after activity
  • Feeling of stiffness in the leg that usually appears in the morning and lessens throughout the day
  • Bad pain the day after exercising
  • Pain as you climb stairs or go uphill
  • Swelling in the area of the Achilles tendon
  • Creaking or cracking noise when you press on the Achilles tendon

How is Achilles tendinitis diagnosed?

If you think you have Achilles tendinitis, make an appointment to see your doctor. The doctor will ask you questions about your recent activity and look for signs. Including:

  • The foot not flexing when the calf muscle is pressed ( if Achilles ruptures or tears in half)
  • Swelling on the back of the foot
  • Pain in the back of the foot
  • Limited range of motion in ankle

An X-ray or MRI scan can check for tendinitis.

How is Achilles tendinitis treated?

Nonsurgical treatment at home can initially treat Achilles tendinitis. Pain lasting more than six months may require surgery.

Nonsurgical methods:

  • Rest and stop doing activities that cause stress to the tendon
  • Ice the area by applying ice to the tendon for 15 minutes after exercising
  • Compress the tendon by using an athletic wrap or surgical tape
  • Elevate your injury. You can reduce swelling by lying down and raising your foot at a level that is above your heart
  • Stretch your ankles and calf muscles
  • Take anti-inflammatory medication (e.g.: ibuprofen to reduce swelling)
  • Wear orthotics and running shoes
  • Take part in physical therapy

How can you prevent Achilles tendinitis?

There are several things you can do to reduce the risk of Achilles tendinitis:

  • Warm up every time before you exercise or play a sport
  • Switch up your exercises
  • Slowly increase the length and intensity of your workouts
  • Keep your muscles active and stay in shape all year-round
  • When you see symptoms of Achilles tendinitis, stop whatever activity you are doing and rest

What is an Achilles tendon rupture?

An Achilles tendon rupture is when the tendon that connects the heel bone to the calf muscle tears and the fibers separate. This happens mostly between the ages of 30 and 50, and usually is caused by sports.

Symptoms of Achilles tendon rupture

  • A pop or snap when the tendon tears
  • Severe pain in back of the ankle, making it nearly impossible to walk
  • Swelling and discoloration
  • Tenderness
  • Inability to rise on toes
  • A gap in the back of the ankle where the tendons are separated

What causes an Achilles tendon rupture?

The causes of an Achilles tendon rupture are very similar to Achilles tendinitis. Causes include:

  • Running uphill
  • Running on a hard surface
  • Quickly changing speeds from walking to running
  • Playing sports that cause you to quickly start and stop

How do you prevent an Achilles rupture?

Prevention methods for Achilles tendinitis and Achilles rupture are very similar.

  • Stay in good shape
  • Stretch before exercising or playing sports
  • Strengthen calf muscles slowly

How is an Achilles rupture diagnosed?

A doctor will look at the type of physical activity you have been doing. He or she will then look at your foot, ankle and leg. An MRI may also be used. This is to help determine the severity of the tear and the extent of separation of the fibers.

How do you treat an Achilles tendon rupture?

If you suspect you have an Achilles tendon rupture you should see your doctor right away. There are surgical and non-surgical ways to treat the rupture, though surgical options are rare.

Non-Surgical Treatment

The foot and ankle are flexed downward in a cast. The cast or a boot will stay on anywhere from 8 to 12 weeks. Physical therapy will follow.

Surgical treatment

Surgery is recommended to those who are young to middle-aged and active. The ruptured tendon is sewn together during surgery. This is an outpatient procedure. Afterward the leg is put into a splint cast or walking boot. Physical therapy will be recommended. In about 4 to 6 months, healing is nearly complete. However, it can take up to a year to return to sports fully.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/13/2013…#15225