Achilles Tendinitis

Achilles tendinitis is an overuse injury of the Achilles (uh-KILL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs.

Does massage help tendonitis?

Massage therapy can help with tendonitis. Some forms of massage therapy for this type of condition is deep transverse friction massage, deep tissue, active release and pin, and stretch techniques. These techniques help mobilize ligaments, helping restore mobility and relieve pain.

What is the fastest way to heal Achilles tendonitis?

To speed the process, you can:

  1. Rest your leg. …
  2. Ice it. …
  3. Compress your leg. …
  4. Raise (elevate) your leg. …
  5. Take anti-inflammatory painkillers. …
  6. Use a heel lift. …
  7. Practice stretching and strengthening exercises as recommended by your doctor, physical therapist, or other health care provider.

Do ankle supports help Achilles tendonitis?

As you return to activity, your doctor may suggest orthotics or an ankle brace to help support your Achilles tendon and to prevent the condition from reoccurring. The Aircast Airheel offers support for Achilles Tendinitis. It helps cushion the Achilles while providing pulsating compression to reduce swelling.

Is heat or cold better for tendonitis?

After the first three days, heat may provide a better benefit for chronic tendinitis pain. Heat can increase blood flow to an injury, which may help promote healing. Heat also relaxes muscles, which promotes pain relief. … The result is pain and swelling in the tendons around a joint, such as your ankle, elbow or shoulder.

Will compression socks help Achilles tendonitis?

So are compression socks or sleeves good for shin splints, calf cramps/strains, and Achilles tendonitis? The answer is yes, however, they will not cure any condition if the only thing you are doing to help your injury is to wear compression. All injuries should be assessed so that the real cause can be addressed.

Achilles Tendinitis
Achilles Tendinitis

Achilles tendinitis is an overuse injury of the Achilles (uh-KILL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.

Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.

Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor’s supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.


Achilles Tendinitis
Achilles Tendinitis

Achilles tendinitisOpen pop-up dialog box

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activities. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting.

You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity.

When to see a doctor

If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.


Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes.

The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs.

Risk factors

A number of factors may increase your risk of Achilles tendinitis, including:

  • Your sex. Achilles tendinitis occurs most commonly in men.
  • Age. Achilles tendinitis is more common as you age.
  • Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain.
  • Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury.
  • Medical conditions. People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis.
  • Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.


Achilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair.


While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk:

  • Increase your activity level gradually. If you’re just beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training.
  • Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest.
  • Choose your shoes carefully. The shoes you wear while exercising should provide adequate cushioning for your heel and should have firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don’t support your feet, try arch supports in both shoes.
  • Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise, and after exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis.
  • Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendons to better handle the stresses they encounter with activity and exercise.
  • Cross-train. Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and swimming.


From Wikipedia, the free encyclopedia

Achilles tendinitis
Other names Achilles tendinopathy, Achilles tendonitis, Achilles tenosynovitis
Drawing of Achilles tendonitis with the affected part highlighted in red
Specialty Rheumatology
Symptoms Pain, swelling around the affected tendon[1]
Usual onset Gradual[1]
Duration Months[2]
Types Noninsertional, insertional[2]
Causes Overuse[2]
Risk factors Trauma, a lifestyle that includes little exercise, high-heel shoesrheumatoid arthritis, medications of the fluoroquinolone or steroid class[1]
Diagnostic method Based on symptoms and examination[3]
Differential diagnosis Achilles tendon rupture[3]
Treatment Rest, ice, non-steroidal anti-inflammatory agents (NSAIDs), physical therapy[1][2]
Frequency Common[2]

Achilles tendinitis, also known as Achilles tendinopathy, occurs when the Achilles tendon, found at the back of the ankle, becomes inflamed.[2] The most common symptoms are pain and swelling around the affected tendon.[1] The pain is typically worse at the start of exercise and decreases thereafter.[3] Stiffness of the ankle may also be present.[2] Onset is generally gradual.[1]

It commonly occurs as a result of overuse such as running.[2][3] Other risk factors include trauma, a lifestyle that includes little exercise, high-heel shoesrheumatoid arthritis, and medications of the fluoroquinolone or steroid class.[1] Diagnosis is generally based on symptoms and examination.[3]

While stretching and exercises to strengthen the calf are often recommended for prevention, evidence to support these measures is poor.[4][5][6] Treatment typically involves rest, ice, non-steroidal anti-inflammatory agents (NSAIDs), and physical therapy.[1][2] A heel lift or orthotics may also be helpful.[2][3] In those whose symptoms last more than six months despite other treatments, surgery may be considered.[2] Achilles tendinitis is relatively common.[2]

Signs and symptoms

Symptoms can vary from an ache or pain and swelling to the local area of the ankles, or a burning that surrounds the whole joint. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as swelling impinges on the movement of the tendon. Many patients report stressful situations in their lives in correlation with the beginnings of pain which may contribute to the symptoms.[c


Demonstration of the right foot in pronation, neutral and supinated subtalar joint placements. Over-pronation (excessive pronation) occurs when the ankle begins to roll inward by more than 5 degrees, demonstrated with the arrows.

The walking gait cycle starting with the left leg demonstrated. The loading cycle is where foot pronation naturally occurs.

Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping. It is also a known side effect of fluoroquinolone antibiotics such as ciprofloxacin, as are other types of tendinitis.[7]

Swelling in a region of micro-damage or partial tear can be detected visually or by touch. Increased water content and disorganized collagen matrix in tendon lesions may be detected by ultrasonography or magnetic resonance imaging.

Achilles tendinitis is thought to have physiological, mechanical, or extrinsic (i.e. footwear or training) causes. Physiologically, the Achilles tendon is subject to poor blood supply through the synovial sheaths that surround it. This lack of blood supply can lead to the degradation of collagen fibers and inflammation.[8] Tightness in the calf muscles has also been known to be involved in the onset of Achilles tendinitis.[9]

During the loading phase of the running and walking cycle, the ankle and foot naturally pronate and supinate by approximately 5 degrees.[10] Excessive pronation of the foot (over 5 degrees) in the subtalar joint is a type of mechanical machine that can lead to tendinitis.[9][10]

An overuse injury refers to repeated stress and strain, which is likely the case in endurance runners.[11][12] Overuse can simply mean an increase in running, jumping or plyometric exercise intensity too soon. Another consideration would be the use of improper or worn-down footwear, which lacks the necessary support to maintain the foot in the natural/normal pronation.[12]


The Achilles tendon is the extension of the calf muscle and attaches to the heel bone. It causes the foot to extend (plantar flexion) when those muscles contract.

The Achilles tendon does not have a good blood supply or cell activity, so this injury can be slow to heal. The tendon receives nutrients from the tendon sheath or paratenon. When an injury occurs to the tendon, cells from surrounding structures migrate into the tendon to assist in repair. Some of these cells come from blood vessels that enter the tendon to provide direct blood flow to increase healing. With the blood vessels come nerve fibers. Researchers including Alfredson and his team in Sweden [13] believe these nerve fibers to be the cause of the pain – they injected local anesthetic around the vessels and this decreased significantly the pain from the Achilles tendon.


Calcification deposits forming an enthesophyte within the Achilles tendon at its calcaneal insertion. The Achilles tendon is wider than normal, further suggesting inflammation.

Achilles tendinitis is usually diagnosed from medical history and physical examination of the tendon. Projectional radiography shows calcification deposits within the tendon at its calcaneal insertion in approximately 60 percent of cases.[14] Magnetic resonance imaging (MRI) can determine the extent of tendon degeneration and may show differential diagnoses such as bursitis.[14]


This photo demonstrates a calf raise exercise that can be performed to strengthen two of the major ankle plantar flexor muscles, the gastrocnemius, and the soleus. This exercise can be performed with minimal to no equipment. A step can be added under the foot to enhance the range of motion and weights can be added to increase the resistance [15]

Performing consistent physical activity will improve the elasticity and strength of the tendon, which will assist in resisting the forces that are applied.[16]

While stretching before beginning an exercise session is often recommended evidence to support this practice is poor.[4][5] Prevention of recurrence includes following appropriate exercise habits and wearing low-heeled shoes. In the case of incorrect foot alignment, orthotics can be used to properly position the feet.[16] Footwear that is specialized to provide shock-absorption can be utilized to defend the longevity of the tendon.[17] Achilles tendon injuries can be the result of exceeding the tendon’s capabilities for loading, therefore it is important to gradually adapt to exercise if someone is inexperienced, sedentary, or is an athlete who is not progressing at a steady rate.[17]

Eccentric strengthening exercises of the gastrocnemius and soleus muscles are utilized to improve the tensile strength of the tendon and lengthen the muscle-tendon junction, decreasing the amount of strain experienced with ankle joint movements.[18] This eccentric training method is especially important for individuals with chronic Achilles tendinosis which is classified as the degeneration of collagen fibers.[17][17] These involve repetitions of slowly lowering the body while standing on the affected leg, using the opposite arm and foot to assist in repeating the cycle, and starting with the heel in a hyperextended position. (Hyperextension is typically achieved by balancing the forefoot on the edge of a step, a thick book, or a barbell weight so that the point of the heel is a couple of inches above the forefoot.)


Treatment typically involves rest, ice, non-steroidal anti-inflammatory agents (NSAIDs), and physical therapy.[1][2] A heel lift or orthotics may also be helpful.[3][2]

  • An eccentric exercise routine designed to strengthen the tendon.
  • Application of a boot or cast.


The evidence to support injection therapies is poor.[19]


Tentative evidence supports the use of extracorporeal shockwave therapy.[22]


The prevalence of Achilles tendinitis varies among different ages and groups of people. Achilles tendinitis is most commonly found in individuals aged 30–40[23] Runners are susceptible,[23] as well as anyone participating in sports, and men aged 30–39.[24]

Risk factors include participating in a sport or activity that involves running, jumping, bounding, and change of speed. Although Achilles tendinitis is most likely to occur in runners, it also is more likely in participants in basketball, volleyball, dancing, gymnastics, and other athletic activities.[23] Other risk factors include gender, age, improper stretching, and overuse.[25] Another risk factor is any congenital condition in which an individual’s legs rotate abnormally, which in turn causes the lower extremities to overstretch and contract; this puts stress on the Achilles tendon and will eventually cause Achilles tendinitis.[25]

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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