Your Achilles tendon connects your heel bone to your calf. If it’s overly stressed, you can get Achilles tendinitis, the main cause of Achilles tendon pain. If untreated, it can lead to an Achilles tendon rupture. Achilles tendinitis treatment includes rest, physical therapy and supportive shoes. You may need surgery if the symptoms don’t go away.
The Achilles tendon is the largest and strongest tendon in the body. It’s in the back of the heel, connecting the heel bone to the calf muscle.Tendons are the long, tough, ropy and fibrous tissues that connect muscles to bones. The Achilles tendon is named for the Greek god Achilles.The Achilles tendon helps you walk, run and jump by raising the heel off the ground. It’s very strong, but overstressing it can injure it.
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Common causes of Achilles tendon pain are:
Tendinitis is when a tendon becomes irritated or inflamed. Inflammation is the body’s response to injury or disease. Tendinitis can be very painful.It’s important to treat Achilles tendinitis. Otherwise, it can become a long-term, chronic problem, making it difficult to walk.
The two types of Achilles tendinitis describe which part of the tendon is affected:
Achilles tendon disorders are common sports injuries. People at high risk for Achilles tendon disorders include those who:
You may also be at higher risk for Achilles tendinitis because of your anatomy (body shape and structure). For example, if you have:
Achilles tendinitis is a common condition. It most often affects active people and athletes.
In Achilles tendinitis, overuse of the Achilles tendon causes swelling, irritation and inflammation. You can get Achilles tendinitis by being active on your feet. It’s usually not related to a specific injury — it happens because of stressing the tendon repeatedly. Because it’s difficult to avoid using the Achilles, the body doesn’t have time to repair the injured tissue.
Symptoms of Achilles tendinitis affect the lower leg above the heel. You might notice:
You may notice more discomfort:
Your healthcare provider will ask you about your symptoms and recent activity. They’ll look for signs of Achilles tendinitis or Achilles tendon rupture. They will check your range of motion and look for signs of bone spurs.
Your provider can often diagnose Achilles tendinitis based on the physical exam alone. You may need imaging to show the condition’s details or severity.Imaging exams may include:
Your provider will first recommend nonsurgical treatment. It may take a few months for the pain to get better — especially if you’ve already had symptoms for a few months.
Nonsurgical treatment methods include:
Protect your tendon. Avoid walking up steep inclines or overstretching the tendon, such as by standing on a ladder rung. Wear:
Other nonsurgical treatments that can help:
Brisement is a treatment option in earlier stages of Achilles tendinitis, before it progresses to Achilles tendinosis. Providers inject anesthetic into the space around the tendon to break up scar tissue. You may need to have this procedure a few times.
If you’ve tried nonsurgical methods for six months and you’re still in pain, talk to your provider. You may need surgery. A foot and ankle surgeon can suggest options based on your injury, age, preferences and activity level.
Surgical options include:
Some people still experience pain after surgery. The other complication that can occur is a wound infection. Infection can be challenging to treat because of the location of the Achilles tendon.
To reduce your risk of Achilles tendinitis:
If you notice symptoms of Achilles tendinitis, such as pain, stop what you’re doing and rest. Then talk to your provider about next steps.
People can recover from Achilles tendinitis. But get treatment as soon as you feel symptoms. The longer you live with the pain, the harder and longer the treatment process will be.
Most people have good results from Achilles tendinitis surgery. The factor that affects your recovery is how much of the tendon was damaged. People with a lot of tendon damage need a longer recovery period.
Physical therapy plays a big role in your rehabilitation, either as a treatment method or as part of your recovery from surgery. It can help you regain your strength and function.
Achilles tendinitis can be frustratingly slow to heal. It can take time for your symptoms to disappear completely. Follow your healthcare provider’s instructions, so you don’t re-injure the tendon and worsen the symptoms.
If you’re trying nonsurgical treatments to avoid or delay surgery, expect to wait a few months to see improvement. To keep the tendon healthy:
If you’re recovering from surgery, follow your provider’s instructions for the recovery period:
Call your provider or go to an urgent care center if you have:
If you have Achilles tendon pain or Achilles tendinitis, ask your provider:
A note from Cleveland Clinic
Achilles tendon pain is common in athletes and active people. If you have Achilles tendon pain, talk to your healthcare provider. The longer you wait to take care of it, the longer it takes to treat. You can treat Achilles tendinitis using nonsurgical methods, such as avoiding certain activities, using custom orthotics and attending physical therapy. If nonsurgical treatments don’t provide relief, talk to your provider about surgery for Achilles tendinitis.
Last reviewed by a Cleveland Clinic medical professional on 05/12/2021.
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