Achilles tendon

Overview

Achilles tendinitis is inflammation of the Achilles tendon, which is the tendon that connects the calf musculature to the heel bone. Inflammation can occur in this tendon after a sudden injury or can occur over time based on the demands placed on the tendon. Risk factors for developing Achilles tendinitis include a tight hamstring or calf muscles (gastrocnemius or soleus) or a tight Achilles tendon, abrupt changes in activity level such as increasing running mileage too quickly or walking further distances than normal, changing running surfaces such as trail running or including hills, or starting new activities that involve sprinting, jumping, or changing directions quickly.

Achilles tendinitis may present with pain, tenderness, and stiffness along the tendon. This can occur directly over your heel bone or higher up towards your calf muscle. You may also notice swelling in the area. The calf may also feel weak. Numbness and tingling are not typically associated with this condition. Often times, the first few steps after sitting are more painful or you may only notice pain after participating in walking, running, or jumping activities.

Treatments typically include rest, avoiding activities that cause pain, ice, and anti-inflammatories. If the pain persists or comes back with resumption of activities, you should contact your doctor. Physical therapy will be recommended. This will include improving the flexibility of the hamstring and calf musculature, stretching the tendon, and starting a specialized strengthening program. Orthotic intervention may also be considered. If pain persists, your doctor may consider a patch that increases blood flow to the tendon. In rare cases, your doctor may recommend a needle procedure that stimulates healing of the tendon. Surgery is not generally recommended unless there is a large tear of the tendon.

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