Achilles Tendonitis: Causes, Symptoms, and Treatment

Key Takeaway

• Achilles tendonitis is the inflammation of the tendon connecting the calf muscles to the heel bone, causing pain or soreness at the heel and the back of the ankle, especially when standing up or walking.
• Warning signs that require medical attention include severe pain, swelling, redness, or persistent symptoms lasting several weeks. A doctor’s evaluation is recommended for accurate diagnosis and appropriate treatment planning.
• Mild Achilles tendonitis may resolve with rest and proper stretching. However, continued overuse or inadequate rest can lead to chronic symptoms requiring medical treatment or physical therapy.

Achilles tendonitis can develop due to overuse, improper footwear, or physical conditions affecting the tendon’s resilience. How does it occur, and how can you manage it? At Vibhavadi Hospital, orthopedic specialists and physical therapists provide precise diagnosis and advanced treatment techniques to help you return to movement with confidence.

What Is Achilles Tendonitis? Can It Heal on Its Own?

Achilles tendonitis is a condition involving inflammation of the Achilles tendon—the largest tendon in the body—connecting the calf muscles to the heel bone. It plays a key role in mobility such as walking, running, and jumping. When inflamed, it typically causes pain at the back of the heel, especially during activities involving foot pressure.

Mild or early-stage Achilles tendonitis can improve on its own with proper self-care, especially adequate rest and activity modification, which helps the tendon recover and return to normal function.

Causes and Risk Factors of Achilles Tendonitis

Achilles tendonitis may result from multiple factors, including movement habits and certain anatomical conditions. Key contributing factors include:

• Overuse of the tendon such as running, jumping, or high-impact exercises
• Sudden acute injuries like falls, ankle sprains, or direct impact to the heel
• Insufficient stretching before exercise, causing sudden tendon stress
• Wearing inappropriate footwear lacking heel support
• High-risk sports requiring repetitive tendon use (running, basketball, football)
• Increasing workout intensity or duration too quickly
• Aging, which reduces tendon elasticity
• Foot structure abnormalities such as flat feet or tight tendons
• Excess weight or obesity increasing stress on the Achilles tendon

Symptoms of Achilles Tendonitis

Symptoms usually begin gradually and worsen with continued activity. Common symptoms include:

• Pain at the back of the heel, slightly above the heel bone (tendon location), often starting as mild soreness after activity
• Morning pain and stiffness—symptoms typically worsen upon waking or after prolonged rest but improve slightly with gentle movement
• Increased pain with activity such as fast walking, running, climbing stairs, or standing on tiptoe
• Swelling and redness; the tendon may feel warm or thicker than usual

Warning Signs That Require Medical Attention

Seek medical care immediately if any of the following occur:

• Severe heel or tendon pain causing difficulty walking or standing
• Sudden sharp pain during activity
• Swelling, redness, or unusual warmth in the heel or ankle
• Visibly enlarged tendon or a palpable gap indicating possible tearing
• Limping, ankle instability, or inability to fully flex/extend the ankle
• Persistent pain for more than 2–3 weeks despite rest or physical therapy

A specialist can perform proper evaluation to prevent tendon rupture and long-term mobility issues.

Diagnosis of Achilles Tendonitis

Diagnosis usually involves:

• Medical history: Pain characteristics, injury history, activity level, risk factors like improper footwear or excess weight
• Physical examination: Checking swelling, redness, warmth, ankle mobility, and tendon tenderness
• Imaging tests (if needed):
  • Ultrasound to assess tendon thickness and structure
  • X-ray for bone abnormalities or calcium deposits
  • MRI for detailed assessment of partial or full tendon tears

Treatment for Achilles Tendonitis

Treatment depends on severity and duration. Early intervention prevents chronic issues.

1. Home Care

For mild cases, home management using the RICE method helps reduce pain and inflammation:

R – Rest: Avoid activities stressing the tendon such as running, jumping, or prolonged standing.
I – Ice: Apply cold packs for 15–20 minutes every 2–3 hours.
C – Compression: Use bandages or ankle supports to reduce swelling.
E – Elevation: Elevate the affected leg above heart level to minimize swelling.

2. Medication

Doctors may recommend NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) in oral or topical form. Muscle relaxants may also be used in some cases. Always follow medical guidance.

3. Physical Therapy

Physical therapy is essential for recovery. It may include:

• Massage
• Stretching exercises (e.g., wall calf stretch, towel-assisted stretch)
• Strengthening exercises, especially eccentric training (e.g., slow heel raises on a step) to build tendon resilience

4. Medical Devices and Advanced Treatments

For chronic or persistent cases:

• Shockwave Therapy to stimulate healing and reduce pain
• Ultrasound therapy
• Laser therapy
• Heel pads or customized footwear to reduce pressure on the tendon

5. Surgery

Surgery is considered when conservative treatments fail or in cases of tendon rupture. Procedures involve repairing or removing damaged tissue, often using minimally invasive techniques to reduce recovery time.

Preventing Achilles Tendonitis

Prevention focuses on strengthening and reducing strain on the tendon:

• Regular calf stretching before and after exercise
• Strengthening exercises for the calf muscles
• Gradual progression in workout intensity
• Wearing proper shoes with heel support
• Avoiding high-impact activities when experiencing pain or swelling
• Weight control to reduce tendon stress
• Avoiding high heels that tighten the tendon

Achilles Tendonitis Treatment at Vibhavadi Hospital

Vibhavadi Hospital provides care by orthopedic specialists and professional physical therapists. With accurate diagnostic techniques and comprehensive rehabilitation programs—including stretching, strengthening, and advanced treatments such as Shockwave Therapy—we personalize treatment plans for the best recovery outcomes.

Summary

Achilles tendonitis occurs when the tendon connecting the calf to the heel becomes inflamed, leading to pain, swelling, and stiffness behind the ankle. Overuse, acute injury, and foot structure issues are common causes. Early symptoms may be mild but can worsen if untreated. Treatment typically begins with rest, ice, stretching, and activity modification. Severe or persistent cases may require medication, physical therapy, advanced technology like Shockwave Therapy, or surgery. Prevention includes stretching, strengthening, proper footwear, and weight management.

If heel pain or Achilles tendon inflammation interferes with your daily activities, Vibhavadi Hospital offers specialist-led, modern treatment solutions to reduce pain, repair the tendon, and restore confident movement.

Frequently Asked Questions (FAQ)

How long does Achilles tendonitis take to heal?

Recovery time depends on severity and self-care. Mild cases improve within 2–6 weeks, while severe or poorly managed cases can take months. Medical care and physical therapy shorten recovery time.

What medications can help with Achilles tendonitis? Can I self-medicate?

NSAIDs (anti-inflammatory pain relievers) are commonly used. Some are available over the counter, but you should consult a doctor if you have underlying conditions or if symptoms persist for personalized and safe dosage recommendations.

Should I use hot or cold therapy?

During the acute inflammatory phase, use cold therapy to reduce swelling and pain. After the acute phase improves, heat therapy helps relax muscles and improve circulation to support healing.

Will massage help Achilles tendonitis?

Massage may relieve muscle tension but does not directly treat inflammation. It should be done gently or by a physical therapist to avoid worsening the condition. Full recovery requires rest, stretching, and a proper rehabilitation program.