Achilles Tendonitis

Categorized as an overuse injury, Achilles tendonitis is commonly found in runners who have increased their running duration or intensity.

Achilles Tendonitis

Achilles tendonitis is damage to the band of tissue that connects the heel bone to calf muscles in the lower leg. Categorized as an overuse injury, Achilles tendonitis is commonly found in runners who have increased their running duration or intensity. It is also seen in middle-aged patients who participate in recreational sports, such as basketball or tennis.

What Are the Symptoms?

Symptoms of Achilles tendonitis can include mild to severe pain in the back of the leg or above the heal after strenuous activity, such as prolonged running or playing a sport. Patients may also experience stiffness or tenderness in the morning that resolves after mild activity.

What Are the Causes of Achilles Tendonitis?

Achilles tendonitis is the result of repetitive strain on the tendon when patients walk, run, jump and stand on their tip-toes. This holds especially true for patients who abruptly increase their exercise activity.

In addition, the Achilles tendon tends to weaken with age, making it more vulnerable to injury. It may even be injured by a bone spur that develops and rubs against the tendon.

What Are the Treatment Options for Achilles Tendonitis?

Non-Surgical Treatments

In the majority of cases, Achilles tendonitis can be effectively treated using a variety of nonsurgical methods. These include:

  • Certain exercises, such as calf stretching
  • Discontinuing and avoiding use of floroquinolones
  • Extracorporeal shockwave therapy (ESWT) to stimulate healing in the tendon
  • Physical therapy
  • Prolotherapy injections
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil®, Motrin®) or naproxen (e.g., Aleve®)
  • The R.I.C.E. treatment: Resting after injury, Ice application to the injury site, Compression of the injury with a bandage, Elevating the injury
  • Wearing supportive shoes or orthotics

Surgical Treatments

 Surgery is usually only considered for Achilles tendonitis when all other treatment modalities have failed and pain has not improved after six months of treatment. The type of surgery performed depends on the amount of damage and the location of the damage on the tendon.

Surgical options include:

  • Debridement and repair, a procedure in which the damaged part of the tendon is removed and the remaining ends are surgically attached with sutures (designed for a tendon that has under 50 percent damage)
  • Debridement with tendon transfer, a procedure in which the damaged portion is removed and replaced with a tendon from the big toe (designed for a tendon that has over 50 percent damage)
  • Gastrocnemius recession, a surgical lengthening of the muscles in the calf (gastrocnemius) to decrease stress on the tendon and increase motion in the ankle
How Can Achilles Tendonitis Be Avoided?

To reduce the risk of developing or redeveloping Achilles tendonitis, patients should:

  • Choose shoes with good support, especially ones that elevate the heel
  • Gradually ease into any new physical activity
  • Mix up low-impact and high-impact exercises to avoid overusing the tendon
  • Reduce the heel size of shoes over a period of time to allow the tendon to stretch out slowly and increase range of motion
  • Stretch the calf muscles at the beginning of each day—as well as before and after workouts—to keep the tendon flexible
EUP: The Place for Achilles Tendonitis Treatment 

Essex Union Podiatry (EUP) is a complete foot and ankle practice, serving the podiatric needs of Essex and Union Counties. Our specialty-trained physicians utilize the latest tools and techniques to diagnose, treat and provide preventative care for all foot and ankle conditions. With an emphasis on patient education, our practice offers quality care by creating an informative and personalized treatment plan tailored to meet individual needs.

For more information or to schedule an appointment with one of our specialists, contact Essex Union Podiatry today.

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Jason P. Galante, DPM,

Jason Galante, DPM, AASPS

Nancy A. Kaplan, DPM, MBA, AACHE, FACFAS


Sarah E. Haller, DPM, AACFAS