Achilles Tendonitis

Overview

Achilles tendonitis is a condition where the Achilles tendon — the thick band of tissue at the back of your ankle that connects your calf muscles to your heel bone — becomes painful, swollen, or irritated. It is also called Achilles tendinopathy.

Yes, it is a common problem, especially among active people. It affects athletes and non-athletes alike.

It can affect anyone, but it is more common in middle-aged people who exercise regularly, and in runners, walkers, and people who play sports that involve jumping or quick changes in direction.

Symptoms

Common symptoms

• A feeling of pain, aching, or stiffness along the back of the heel or ankle, especially in the morning.
• Pain that worsens with activity, such as running, climbing stairs, or walking uphill.
• Tenderness or swelling in the area, sometimes with a warm feeling.

Causes

Main causes

• Overuse: repeatedly stressing the tendon through activities like running, jumping, or walking long distances.
• Sudden increase in exercise intensity, duration, or frequency.
• Tight calf muscles or a limited range of motion in the ankle.

Risk factors

• Age: the tendon becomes less flexible and more easily injured as we get older.
• Sports: any activity that involves running, jumping, or stopping and starting can increase the risk.
• Foot structure: flat feet or naturally high arches can change how your foot lands and put more strain on the tendon.
• Footwear: shoes that do not support your foot or do not fit well can contribute.
• Medical conditions: conditions such as diabetes or being overweight can increase the risk.

When to see a doctor

See a doctor urgently if:

• If you have sudden severe pain or heard a pop, go to an urgent care or emergency department immediately.
• If you cannot bear weight on your foot, seek medical care the same day.

Book a routine appointment if:

• If you have Achilles pain that does not improve after a few days of rest and home care.
• If the pain interferes with your daily activities, work, or exercise.
• If you have recurrent or worsening symptoms.

Diagnosis

A doctor or physiotherapist will usually diagnose Achilles tendonitis by asking about your symptoms and examining your ankle and foot. They will feel for tenderness, swelling, and weakness, and check your range of motion.

Tests that may be done

• Ultrasound scan: a painless imaging test that can show the tendon and any thickening or tears.
• Magnetic resonance imaging (MRI): a more detailed scan used if the doctor suspects a tear or other problems.

What to expect at your appointment

You may not need any scans for a simple case. The doctor may ask you to move your foot and calf in certain ways. Based on the findings, they will recommend a treatment plan, which may include rest, exercises, and physiotherapy.

Treatment

Treatment focuses on reducing pain and inflammation while allowing the tendon to heal. The right approach depends on how severe your symptoms are, how long you have had them, and what activities you want to return to.

Self-care at home

• Rest the foot: reduce or stop activities that cause pain, especially high-impact exercise.
• Apply ice: wrap an ice pack in a cloth and place it on the painful area for 15–20 minutes several times a day.
• Compression: use an elastic bandage or wrap to support the ankle, but make sure it is not too tight.
• Elevation: raise your foot above the level of your heart when you can, especially after activity.
• Gentle stretching: once the sharp pain settles, do slow, gentle calf stretches as advised by a professional.

Medical treatments

Your doctor may suggest over-the-counter pain relief or anti-inflammatory medicines to reduce pain and swelling. They may refer you to a physiotherapist for a structured exercise programme. In some cases, a podiatrist may recommend heel lifts or shoe inserts (orthotics). Cortisone injections are sometimes used, but they must be considered carefully because they can weaken the tendon. Always discuss the options and possible side effects with your healthcare provider.

When is surgery considered?

Surgery is usually only considered if the pain continues after several months of good conservative treatment, or if the tendon has torn. The procedure involves removing damaged tissue or repairing the tear. It is not the first choice and you should have a full discussion with a specialist.

Living with this condition

While recovering, modify your activities so you are not constantly straining the tendon. Use walking aids if needed, choose supportive shoes, and avoid hills, stairs, and sprinting until pain improves. Follow the advice of your physiotherapist.

Lifestyle tips

• Gradually increase your activity level: aim for around a 10% increase in distance or time each week.
• Warm up properly before exercise and cool down afterwards.
• Wear shoes with good cushioning and replace worn-out footwear.

Diet and exercise

There is no special diet for Achilles tendonitis, but eating a balanced diet helps your body heal. Some specialists suggest that getting enough protein and vitamin C may support tendon repair. Regular, pain-free movement — like swimming or cycling — can help you stay active without putting too much load on the tendon.

Mental health and emotional wellbeing

Dealing with ongoing pain can be frustrating and may affect your mood. It is normal to feel upset or concerned. If you are struggling, talk to your doctor or physiotherapist. Remember, if you ever have thoughts of self-harm or feel in crisis, contact your local emergency number or mental health crisis team right away.

Prevention

You can reduce your risk by keeping your calf muscles flexible and strong, increasing activity gradually, and wearing suitable shoes. Avoid excessive sudden changes in training load.

Complications

If left untreated

• Chronic pain that limits daily activities and exercise.
• Tendon tear or rupture, which may require surgery.
• Development of scar tissue or thickening of the tendon.

Long-term outlook

Most people with Achilles tendonitis recover well with time, appropriate rest, and a structured rehabilitation programme. The long-term outlook is good, especially when you start treatment early and follow your healthcare provider's advice.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.