Achilles tendonitis
Table of content
Achilles tendinitis, also known as Achilles tendinopathy, is common, especially among people who are active in running, walking, or sports where the Achilles tendon is repeatedly stressed. The Achilles tendon is the body's largest tendon and connects the calf muscles to the heel bone. When you experience Achilles tendon pain, it is usually an overuse injury rather than true inflammation. Often, the problems arise gradually, but sometimes the pain can come on suddenly in connection with a specific event, such as an intense training session or an unusually long walk.
Achilles tendinitis affects daily life as the pain makes it harder to walk, run, or even stand for longer periods. The discomfort is usually felt both during activity and at rest, and it is not uncommon to also experience stiffness, especially after sleeping or prolonged sitting.
Symptoms of Achilles tendinitis
The symptoms of Achilles tendinitis usually develop gradually. They can vary in intensity but share some common features:
- Pain in the middle of the Achilles tendon or down at its attachment to the heel bone, especially when pressured or strained.
- Stiffness in the Achilles tendon, often worst in the morning or after sitting still.
- Swelling and sometimes a feeling of warmth or tenderness along the tendon.
- Aching and fatigue that increases during or after activity, such as running, walking, or jumping.
- A creaking sensation when you move your ankle.
- In more severe cases, small lumps or thickenings may also be felt along the tendon.
Symptoms are often worst when you start moving after rest but usually lessen somewhat once you warm up. If you continue to strain the Achilles tendon without resting it, the pain can worsen and eventually occur even at rest.
Causes of Achilles tendinitis
The most common cause of Achilles tendinitis is overuse. This can be due to a sudden increase in your training volume or starting to train more intensely than your body is accustomed to. Poor shoes without sufficient cushioning, training on hard surfaces, or incorrect running technique can also lead to a higher risk of developing it. If you have a gait pattern where your foot rolls inward too much (overpronation), the Achilles tendon is subjected to extra stress. Calf muscle stiffness and a high BMI are other factors that increase the risk.
The condition is common among both recreational and elite athletes, but older individuals can also be affected if they increase their daily activity, for example, by walking longer distances than usual.
How the diagnosis is made
A doctor or physical therapist can often diagnose it by examining the foot and asking about your symptoms and training habits. Ultrasound is sometimes used to rule out other injuries, but a thorough clinical examination is often sufficient. If a tendon rupture is suspected, for example, if you felt a sudden "snap" and have difficulty standing on your toes, you should always seek medical attention immediately.
Treatment of Achilles tendinitis
The most important thing is to reduce the activity that caused the problems and instead focus on self-care and gradual rehabilitation. This does not mean you have to rest completely, but avoid painful movements and allow the tendon to heal.
Using heel wedges in your shoes can relieve the tendon and reduce pressure. Ergonomic shoes with good cushioning are important, as is avoiding walking barefoot on hard floors. Eccentric calf raises are a proven effective rehabilitation exercise where you train the calf muscles and tendon in a way that stimulates healing. You can also use compression sleeves or orthotics, such as AchilloTrain, to provide support and increase blood circulation. In more severe cases, shockwave therapy or laser therapy may be appropriate.
Painkillers can relieve symptoms but should be used cautiously and only as temporary relief. Cortisone injections are not recommended, as they can increase the risk of tendon rupture.
Preventive advice
To prevent Achilles tendinitis from recurring, it is important to gradually increase your training volume, choose good shoes, avoid hard surfaces, and stretch your calf muscles regularly. If needed, individually customized insoles can help correct incorrect gait or running patterns.
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How long does it take to recover?
Most people become symptom-free within 3–6 months with the right training and rest, but in some cases, it can take longer.
Can I continue to exercise?
You should avoid movements that trigger pain, but cycling or swimming are often fine. Consult a physical therapist for individualized advice.
When should I seek medical care?
If the symptoms do not improve after a few weeks of self-care, if the pain worsens, or if you experience sudden, severe pain with difficulty walking.
Do insoles and supports help?
Yes, heel wedges, insoles, and compression sleeves can reduce discomfort and speed up healing.
