The Achilles tendon attaches your calf muscles to your heel bone, or calcaneus. You use this tendon to jump, walk, run, and stand on the balls of your feet. Continuous, intense physical activity, such as running and jumping, can cause painful inflammation of the Achilles tendon, known as Achilles tendonitis (or tendinitis).

Causes of Achilles tendonitis

Excessive exercise or walking commonly causes Achilles tendonitis, especially for athletes. However, factors unrelated to exercise may also contribute to your risk. Rheumatoid arthritis and infection are both linked to tendonitis.

Any repeated activity that strains the Achilles tendon can potentially cause tendonitis. Some causes include:

• exercising without a proper warmup
• straining the calf muscles during repeated exercise or physical activity
• playing sports, such as tennis, that require quick stops and changes of direction

Symptoms of Achilles tendonitis

Symptoms include:

• discomfort or swelling in the back of your heel
• tight calf muscles
• limited range of motion when flexing the foot
• skin on your heel is overly warm to the touch

The main symptom of Achilles tendonitis is pain and swelling in the back side of your heel when you walk or run. Other symptoms include tight calf muscles and limited range of motion when you flex your foot. This condition can also make the skin on your heel feel overly warm to the touch.

Diagnosing Achilles tendonitis

To diagnose Achilles tendonitis, your doctor will ask you a few questions about the pain and swelling in your heel or calf. Your doctor may ask you to stand on the balls of your feet while they observe your range of motion and flexibility. The doctor also feels around (palpates) the area directly to pinpoint where the pain and swelling are most severe.

Imaging tests may help confirm Achilles tendonitis, but you usually don’t need them. If ordered, the tests include:

• X-rays, which provide images of foot and leg bones
• MRI scans, which can detect ruptures and tissue degeneration
• ultrasounds, which can show tendon movement, related damage, and inflammation

 Treating Achilles tendonitis

Many treatments are available for Achilles tendonitis, ranging from rest and ibuprofen (Advil) to steroid injections and surgery. Your doctor might suggest:

• reducing your physical activity
• very gentle stretching and later strengthening of the calf muscles
• switching to a different, less strenuous sport
• icing the area after exercise or when in pain
• elevating your foot to decrease any swelling
• wearing a brace or walking boot to prevent heel movement
• going to physical therapy
• taking anti-inflammatory medication, such as aspirin or ibuprofen, for a limited time
• wearing a shoe with a built-up heel to take tension off the Achilles tendon

Preventing Achilles tendonitis

To lower your risk of Achilles tendonitis, try to:

• Stretch your calf muscles at the beginning of each day to improve your agility and make your Achilles less prone to injury. Try to stretch before and after workouts. To stretch your Achilles, stand with a straight leg, and lean forward as you keep your heel on the ground.
• Ease into a new exercise routine, gradually intensifying your physical activity.
• Combine high- and low-impact exercises, such as basketball with swimming, to reduce constant stress on your tendons.
• Choose shoes with proper cushioning and arch support. Also make certain the heel is slightly elevated to take tension off the Achilles tendon. If you’ve worn a pair of shoes for a long time, consider replacing them or using arch supports.
• Reduce the heel size of shoes gradually when transitioning from high heels to flats. This allows the tendon to slowly stretch and increase its range of motion.