Achilles Tendinopathy

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The Achilles tendon connects the calf muscle to the heel bone. Overuse of this tendon can cause structural injury, called an achilles tendinopathy, which occurs in the form of either:

  • Tendonitis — inflammation of the tendon
  • Tendinosis — tiny tears in the tendon with no significant inflammation

Overuse of the Achilles Tendinopathy can occur with activities such as:

  • Increasing your speed or running long distances too quickly
  • Suddenly adding strenuous hills or stair climbing to your exercise routine
  • Doing too much too soon after taking time away from exercising
  • A sudden or violent contraction of the calf muscles, such as during an all-out sprint
  • Running too much
  • Improper footwear
  • Normal wear and tear from age
inflammation of the achilles tendon
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To decrease your chances of getting Achilles Tendinopathy:

  • Wear appropriate footwear for your sport.
  • Do not use shoes beyond the recommended duration. This will depend on:
    • How frequently you exercise
    • The surface on which you exercise
    • The conditions in which you exercise
  • Gradually add hill work, stairs, speed and distance to your routine.
  • Stretch and strengthen the calf muscles regularly.

Achilles Tendinopathy Symptoms

Symptoms of tendinopathy may include:

  • Tenderness — usually just above the heel bone and often more noticeable in the morning
  • Stiffness that gradually eases as the tendon is warmed up
  • Pain after activity that gradually worsens
  • Radiating or localized pain along the tendon during and/or after running
  • Swelling in the area of the Achilles tendon
  • Pain at the back of the ankle

The doctor can diagnose your tendon pain using imaging scans.

Achilles Tendinopathy Treatments

Take a break from any activity that causes pain. Switch to activities that do not put stress on the tendon. Avoid uphill and irregular surfaces. Once the pain has gone, gradually increase your activity levels.

Foot and Ankle Support

You may be advised to wear a shoe insert. It will place your foot in the correct position for walking and running.

Taping your ankle during activity may also help. Talk to your doctor or a physical therapist before using this option. They can show you the proper way to wrap your foot.

Physical Therapy

More severe or recurring injuries may need physical therapy. Therapy may include:

  • Stretching
  • Massage
  • Ultrasound
  • Strengthening exercises, focused on the calf muscles


To help manage pain your doctor may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen
  • Topical pain relievers that are applied to the skin
  • Prescription pain relievers

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.