Fast facts

  • Achilles tendonitis is the result of damage to the Achilles tendon.
  • It is typically a result of tendon overuse or sudden force through the tendon
  • It is commonly experienced by athletes. It may also occur in walkers or young people who are physically active.  

What is Achilles tendonitis?

Achilles tendonitis happens when the Achilles tendon becomes inflamed.

Cause

Tendons are a type of connective tissue that connect muscle to bone. The Achilles tendon (also known as the calcaneal tendon) connects the calf muscle to the heel bone. It is one of the largest and strongest tendons in the body.

The Achilles tendon enables the heel to lift when we walk, run or jump. Despite its strength, strains, tears or ruptures are common, particularly when we make fast, sudden movements such as sprinting, stumbling or falling.

 

Inflammation and tearing of the Achilles tendon in Achilles tendonitis. 

Connective tissue

A category of body tissue that connects and supports other body tissues.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Risk factors

Risk factors for Achilles tendonitis include:

  • Physical stress on the Achilles tendon, resulting in injury;
  • Arthritis - tendon structure can be affected by inflammatory types of arthritis, such as rheumatoid arthritis;
  • Shoes that do not provide good support, such as high heels;
  • Foot problems such as flat arches or feet that turn inward while walking;
  • Obesity - being overweight or obese puts strain on the Achilles tendon, and;
  • Quinolone antibiotics - these antibiotics have been associated with tendon inflammation.

Antibiotics

Chemical substances that kill or suppress the growth of bacteria.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Types

There are three types of Achilles tendonitis:

  • Mild - in which pain is felt during a particular physical activity or shortly after it;
  • Moderate - the tendon is swollen. In some cases a hard lump can be felt, or;
  • Severe - in which any kind of weight-bearing activity causes pain, or the Achilles tendon may be ruptured. A ruptured tendon will usually be felt as a snap or a pop, accompanied by a sharp pain in the heel and ankle area.

Signs and symptoms

Signs and symptoms of Achilles tendonitis include:

  • Pain in the rear of the heel;
  • Difficulty and pain during walking, and;
  • Swelling, tenderness or inflammation of the heel and the surrounding area.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Methods for diagnosis

Achilles tendonitis can be diagnosed by a physical examination. Other tests, such as an X-ray, ultrasound or magnetic resonance imaging (MRI) may be recommended to confirm the diagnosis. An MRI is typically used in cases of a torn Achilles tendon, or when surgery may be required.

Magnetic resonance imaging

A type of imaging that uses a magnetic field and low-energy radio waves, instead of X-rays, to obtain images of organs.

Ultrasound

A scan that uses high-frequency soundwaves to produce images of the body’s internal structures.

X-ray

A scan that uses ionising radiation beams to create an image of the body’s internal structures.

Types of treatment

Reducing strain

Treatments for Achilles tendonitis are aimed at reducing the strain on the affected tendon to promote healing. This can be done by:

  • Avoiding strenuous physical activities, or;
  • Wearing footwear inserts, called orthoses. These are made by a podiatrist.

Reducing inflammation

Inflammation can be reduced by:

  • Using icepacks on the heel, and;
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections.

Your doctor can also suggest exercises to stretch and strengthen the muscles in the surrounding area once the inflammation has settled.

Surgery

If the tendon has ruptured, surgery may be needed to reconnect the torn ends of the tendon.  

Corticosteroid

A medication that resembles the cortisol hormone produced in the brain. It is used as an anti-inflammatory medication.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

NSAIDs

Non-steroidal anti-inflammatory drugs are commonly used to manage arthritis-related pain and inflammation and other musculoskeletal disorders. NSAIDs include aspirin and ibuprofen.

Potential complications

The main complication of Achilles tendonitis is the weakening of the Achilles tendon, increasing the risk of more serious rupture in the future.   

Prognosis

With treatment, Achilles tendonitis that is not severe will generally heal within a few months.

A more severe case of Achilles tendonitis will require more time and supportive physiotherapy to recover completely.  

Physiotherapy

A healthcare profession that treats bodily weaknesses or defects with physical remedies, such as massage or exercise.

Prevention

You can prevent Achilles tendonitis by:

  • Maintaining a healthy weight;
  • Taking care when wearing high heels;
  • Wearing supportive shoe inserts;
  • Avoiding strenuous exercises if you feel pain or discomfort in the Achilles tendon, and;
  • Performing gentle stretching exercises before and after sport or general exercise.