What Are the Basics of Achilles Tendonitis?


Achilles tendinitis is a common condition refers to the irritation and inflammation of the large tendon that runs down the back of your lower leg.

It can occur within the tendon itself or at the point where it attaches to the heel bone, called the Achilles tendon insertion.

Based on which part of the tendon is inflamed, Achilles tendinitis is classified into two types:

  1. Non-insertional Achilles tendinitis: fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell and thicken.
  2. Insertional Achilles tendinitis: involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.


Achilles tendinitis often results from repetitive stress to the tendon.

Following are factors may increase your risk of Achilles tendinitis:

  • Gender. It occurs most commonly in men.
  • Age. It is more common as one ages.
  • Sudden increase in the amount or intensity of exercise activity
  • Tight calf muscles and obesity
  • Bone spur
  • Medical conditions
  • Medications


Common symptoms of Achilles tendinitis include:

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Bone spur (insertional tendinitis)
  • Swelling that is present all the time and gets worse throughout the day with activity

See your doctor to get treated if you experience the above symptoms.


Nonsurgical treatment

  • Rest
  • Ice
  • Non-steroidal anti-inflammatory medication
  • Exercise, e.g. calf stretch,
  • Physical therapy
  • Eccentric Strengthening Protocol, e.g. bilateral heel drop, single leg heel drop
  • Cortisone injections
  • Supportive shoes and orthotics
  • Extracorporeal shockwave therapy (ESWT)

Surgical treatment

  • Gastrocnemius recession
  • Débridement and repair (tendon has less than 50% damage)
  • Débridement with tendon transfer (tendon has greater than 50% damage)


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

  • Increase your activity level gradually
  • Take it easy
  • Choose your shoes carefully
  • Stretch daily
  • Strengthen your calf muscles
  • Cross-train

Keywords: achilles heel tendonitis; achilles heel pain; achilles heel

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.