Achilles Tendonitis Care and Relief

What You Need To Know

Understanding Achilles tendonitis, its symptoms, and how it is treated.

Understanding Achilles Tendonitis

The Achilles tendon is the band of tissue that runs down the back of the lower leg, connecting the calf muscle to the heel bone. Also known as the heel cord, it helps raise the heel off the ground prior to the push-off phase of gait. Achilles tendonitis is inflammation of the tendon, typically caused by repetitive use, overuse, or trauma such as an ankle sprain. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendinosis), in which the tendon loses its organized structure and is likely to develop microscopic tears and thickening.

Symptoms include aching, firmness, or soreness within the tendon, anywhere from the attachment behind the heel upward to the area below the calf muscle. Pain often appears upon getting out of bed in the morning or standing after periods of rest, then improves somewhat with motion. As the disorder progresses, the tendon may become enlarged and develop firm nodules where the tissue is damaged.

Achilles tendonitis is usually caused by a sudden increase in activity that places too much stress on the tendon too quickly. Athletes, manual laborers, and people with flat or overpronated feet are at higher risk. If you are experiencing persistent heel or calf pain, schedule an evaluation so treatment can begin before the condition worsens.

Treatment Options and Recovery

Whenever possible, Artisan Foot and Ankle Specialists uses conservative methods of treatment to provide relief from Achilles tendonitis. In the early stage, when there is sudden inflammation, immobilization with a cast, posterior splint, or removable walking boot may be used to reduce forces through the tendon and promote healing. Applying ice over a thin towel for 20 minutes each waking hour can help reduce swelling, and nonsteroidal anti-inflammatory medications may ease pain.

For patients with overpronation or gait abnormalities, custom orthotic devices may be prescribed. Night splints help maintain a stretch in the Achilles tendon during sleep, and physical therapy may include strengthening exercises, soft-tissue massage and mobilization, gait and running re-education, stretching, and ultrasound therapy.

As a general rule, unless there is a rupture present, we tend to avoid surgery of the Achilles tendon. Less invasive techniques can often improve Achilles tendinosis without a larger incision to open up the tendon for repair. If pain persists after conservative care, surgical intervention may be necessary.

To prevent recurrence, your doctor may recommend strengthening and stretching exercises that build the tendon’s ability to withstand higher loads while improving flexibility of the tendon, calf, and hamstring muscles. With the right treatment plan and consistent follow-up, most patients return to their normal activities.