Achilles Tendinitis

ByPaul L. Liebert, MD, Tomah Memorial Hospital, Tomah, WI
Reviewed/Revised Nov 2023
VIEW PROFESSIONAL VERSION

    Achilles tendinitis is inflammation of the Achilles tendon, the tough band of tissue connecting the calf muscles to the heel.

    (See also Overview of Sports Injuries.)

    Achilles tendinitis is very common in runners. During running, the calf muscles help with the lift-off phase of gait (raising up on the toes from the foot being flat on the ground). Repetitive forces from running combined with insufficient recovery time from exercise can inflame the Achilles tendon.

    Pain in the lower calf and back of the heel is usually the first symptom of tendinitis. Pain initially increases when exercise is begun and often lessens as exercise continues. Doctors diagnose Achilles tendinitis based on the symptoms and results of an examination.

    Ice and nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation. Refraining from running and from pedaling a bicycle as long as the pain persists is important. Exercises to stretch and strengthen the hamstring muscles can be started as soon as they can be done without pain. Other measures depend on what conditions are causing tendinitis. Measures may include wearing shoes with flexible soles or placing heel lifts in running shoes to reduce tension on the tendon and stabilize the heel. People should return to running gradually, stretch the tendon before running, and, at the beginning, apply ice after running.

    A complete tear of the Achilles tendon can occur with a sudden forceful change in direction, such as can occur when running or playing tennis. Sometimes people feel as if they have been kicked behind the ankle, and they sometimes hear a pop. The calf is very painful and walking is difficult, particularly when the tear is complete. The calf may be swollen and bruised. Splinting and sometimes surgery are required.

    Exercises to Stretch the Achilles Tendon
    Sitting Ankle Plantar Flexion Stretch
    1. Sit in chair. 2. Bend knee on involved side to place top of involved foot on the floor with toes pointing backwards.... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Standing Ankle Plantar Flexion Stretch
    1. Stand facing or next to wall with hands on the wall. 2. Bend knee on involved side to place top of involved foot on ... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Standing Gastrocnemius Stretch
    1. Stand facing or next to wall with hands on the wall for support. 2. Place uninvolved leg forward. 3. Keep rear leg s... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Standing Soleus Stretch
    1. Stand facing or next to wall with hands on the wall for support. 2. Place uninvolved leg forward. 3. Keep heels on t... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Toe Walking
    1. Stand on balls of feet with heels off the floor. 2. Walk on balls of feet while keeping knees straight. 3. Walk as f... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Heel Walking
    1. Stand on heels with balls of feet off the floor. 2. Walk on heels while keeping knees straight. 3. Walk as far as ab... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

    Heel Raises
    1. Stand with both feet on step with heels off edge of step. Hold on to something for support. 2. Raise up on balls of ... read more

    Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC.

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