Achilles Tendinitis

What is Achilles tendinitis?

Achilles tendinitis is swelling of the tendon that connects your calf muscle to your heel bone. It may happen suddenly or become a chronic condition. Your risk for Achilles tendinitis increases as you age.

What causes Achilles tendinitis?

• Overuse of your leg muscles
• A sudden increase in the amount or intensity of an activity
• Jumping or running on hard or uneven surfaces
• Wearing shoes that do not fit or support your foot and ankle
• Tight calf muscles
• A bone spur where your Achilles tendon attaches to your heel
• Medicines such as steroids or antibiotics

How is Achilles tendinitis diagnosed?

Your healthcare provider will examine your heel and calf for swelling. He may move your foot or ankle and ask if you have pain. Tell him when your symptoms started and which activities make the pain worse. You may need an x-ray, ultrasound, or MRI to check for bone spurs or tears in your Achilles tendon. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is Achilles tendinitis treated?

• Medicines may be given to decrease pain and swelling.
• Support devices may include a splint, orthotic, or brace. These devices will decrease pressure on your Achilles tendon and help relieve pain.
• Physical therapy may be needed. A physical therapist teaches you exercises to help improve movement and strength, and decrease pain. You may need to practice exercises at home.
• Surgery and other procedures may be needed if other treatments do not work. Surgery may be done to repair a tear in the tendon, or to remove parts of the tendon. Other procedures may include an injection of platelets or red blood cells into your Achilles tendon. It may also include therapy with electrical currents to treat swelling and pain.

What can you do to manage your Achilles tendinitis?

• Rest as directed. Rest decreases swelling and prevents your tendinitis from getting worse. Your healthcare provider may tell you to stop your usual training or exercise activities. Ask him when you can return to your normal activities or exercise plan.
• Apply ice on your Achilles tendon for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
• Wear a compression bandage or use tape as directed. This will decrease swelling and pain. Ask your healthcare provider how to wrap a compression bandage or apply tape. If you use a support device ask if you should wear a compression bandage or use tape.
• Elevate your heel above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your heel on pillows or blankets to keep it elevated comfortably.
• Stretch as directed when you return to your exercise program. Always warm up your muscles and stretch before you exercise. Do cool down exercises and stretches when you are finished. This will keep your muscles loose and decrease stress on your Achilles tendon.
• Do bilateral heel drop exercises as directed. Bilateral heel drops strengthen your Achilles tendon. Do not do the following exercise unless your healthcare provider says it is safe:
  • Stand at the edge of a stair or raised step. Hold onto the railing for balance.
  • Place the front part of your foot on the stair or step. Let the back of your foot hang off of the stair or step.
  • Slowly lift your heels off the ground and then slowly lower your heels past the stair. Do not move your heels quickly. This could make your injury worse. Repeat this exercise 20 times or as directed.
• Slowly increase the time and intensity when you return to your exercise program. Start with short and low intensity exercises. Ask your healthcare provider how and when to increase the time and intensity of your exercise.

When should I contact my healthcare provider?

• You have a fever.
• Your swelling or pain gets worse.
• You feel or hear a sudden pop near your ankle.
• You cannot bend your ankle or put pressure on your leg.
• You have questions about your condition or care.