ACHILLES TENDINITIS: CAUSES, SYMPTOMS, AND WHEN TO SEEK HELP

The Achilles tendon is a strong tendon in the human body, connecting the calf muscles to the heel bone. Without it, you wouldn’t be able to run, jump, or even walk normally. Yet, despite its strength, the Achilles tendon is prone to injury, especially in people who engage in repetitive or high-impact activities. One of the most common problems affecting this vital structure is Achilles tendinitis (also called Achilles tendonitis).

This condition can range from mild irritation to severe, long-term pain, and in some cases, it may even lead to a rupture. Understanding achilles tendon pain, its causes, symptoms, and the right time to seek medical help can make a world of difference in recovery and long-term foot health.

What Is Achilles Tendinitis?

Achilles tendinitis is inflammation or degeneration of the Achilles tendon. It develops when the tendon is subjected to repetitive stress without adequate recovery time. Over time, the fibers in the tendon can develop small tears, leading to swelling, stiffness, and discomfort. The condition isn’t limited to athletes—anyone can develop it. People who suddenly increase their physical activity, wear improper footwear, or have certain biomechanical issues are all at risk.

There are two main types of Achilles tendinitis:

1. Insertional Achilles Tendinitis – affects the lower part of the tendon where it attaches to the heel bone.
2. Non-insertional Achilles Tendinitis – involves fibers in the middle of the tendon and is more common in younger, active individuals.

Achilles Tendon Pain:

Most people describe achilles tendon ache as a dull or burning sensation just above the heel, which may worsen during physical activity. Pain can also be felt first thing in the morning, often accompanied by stiffness that eases once you start moving.

In more advanced cases, pain may be constant, and the area can feel warm or thickened to the touch. Ignoring early tendonitis symptoms can lead to more severe injury, including tendon degeneration or rupture.

Achilles Tendonitis Causes:

The most common achilles tendonitis causes include:

• Overuse – repetitive jumping, running, or sudden increases in exercise intensity without proper conditioning.
• Poor Footwear – shoes without adequate heel cushioning or arch support.
• Tight Calf Muscles – placing extra strain on the Achilles tendon.
  Your calf muscles—made up of the gastrocnemius and soleus—play a key role in every step you take. These muscles connect directly to the Achilles tendon, which in turn attaches to your heel bone. When the calf muscles become tight, either from lack of stretching, overtraining, or long periods of sitting, they shorten and lose flexibility.
  
  This reduced flexibility means the Achilles tendon must work harder to accommodate the movement your calf muscles can no longer perform efficiently. Over time, this extra load increases Achilles tendon strain, making it more susceptible to microtears, irritation, and eventually achilles tendon pain or tendonitis.
• Biomechanical Issues – flat feet, high foot arches, or misalignment of the legs.
• Age-Related Changes – tendons lose elasticity as we get older, increasing injury risk.
• Medications – certain antibiotics (like fluoroquinolones) and corticosteroids can weaken tendon tissue.

What Causes Achilles Tendon Rupture?

A rupture is a complete or partial tear of the Achilles tendon and is far more serious than tendinitis. It often occurs during activities that require sudden bursts of speed, such as football, sprinting, basketball, or tennis.

Common triggers for rupture include:

• Hyperlipidemia
• Sudden change in direction or explosive movement
• Falling or tripping unexpectedly
• Overstretching the tendon beyond its capacity
• Weak tendon tissue due to previous injury or chronic tendinitis

A rupture is often described as feeling like a “pop” in the back of the ankle, followed by severe pain and difficulty walking.

Ankle Tendonitis Symptoms to Look Out For

While Achilles tendinitis is the most well-known form, ankle tendonitis symptoms can overlap, including:

• Pain around the back or sides of the ankle
• Swelling and redness
• Weakness or instability in the ankle joint
• Pain that increases with activity and subsides with rest

Recognizing these early signs is key to preventing long-term damage.

When to Seek Medical Help

You should see an orthopedic surgeon if:

• Pain persists for more than a few days despite rest and self-care
• You hear or feel a “pop” in the tendon
• Walking becomes difficult or impossible
• Swelling and redness increase
• Pain interferes with daily activities

Early diagnosis and treatment help prevent chronic pain and serious complications like rupture.

Achilles Tendonitis and Plantar Fasciitis:

It’s not uncommon for Achilles tendon pain and plantar fasciitis to occur together. Both conditions involve inflammation in structures that support the foot and ankle.

Achilles tendonitis affects the tendon at the back of your ankle, while plantar fasciitis impacts the thick band of tissue (plantar fascia) running along the bottom of the foot, from the heel to the toes.

Why They Sometimes Happen Together

When the Achilles tendon is tight or inflamed, it can pull on the heel bone, increasing strain on the plantar fascia.

Managing Both Conditions

If you’re dealing with both Achilles tendonitis and plantar fasciitis, treatment often includes:

• Pulsating shockwave

• Stretching exercises for the calf and plantar fascia
• Supportive shoes or orthotics to improve foot mechanics
• Gradual return to activity after symptoms improve
• Ice therapy for pain relief
• Physical therapy to restore flexibility and strength

Addressing both conditions simultaneously can help you recover faster, prevent recurrence, and restore natural movement without lingering discomfort.

Diagnosis: How Achilles Tendinitis is Confirmed

A doctor will typically:

• Take a medical history to understand your symptoms and activity level
• Perform a physical examination to check for tenderness, swelling, and range of motion
• Order imaging tests (ultrasound and MRI) to assess tendon structure and rule out a tear

Treatment Options for Achilles Tendinitis

Non-Surgical Treatments

• Rest & Activity Modification – reduce strain on the tendon by avoiding high-impact activities.
• Shock Wave
• Stretching exercises
• Ice Therapy – apply ice packs for 15–20 minutes several times a day to reduce swelling.
• Compression & Elevation – helps manage inflammation.
• Physical Therapy – eccentric strengthening exercises for the calf muscles are proven to aid recovery.
• Orthotics – heel lifts or supportive insoles can take pressure off the tendon.
• Medications – NSAIDs can help manage pain and inflammation.

Surgical Treatment

If non-surgical methods fail after 6 months or more, surgery may be recommended to remove damaged tissue and stimulate healing.

Post-Injury Care & Prevention

After treatment, proper care is essential to prevent recurrence:

• Warm up before exercise and stretch calf muscles regularly
• Wear shoes with good heel support
• Increase training intensity gradually
• Cross-train to avoid repetitive strain
• Maintain a healthy body weight to reduce pressure on the tendon

Conclusion

The Achilles tendon plays a critical role in everyday movement, and injuries can seriously limit mobility. Whether you’re dealing with achilles tendon pain from overuse or wondering what causes achilles tendon rupture, understanding the risks and symptoms is the first step toward effective prevention and treatment.

If you have persistent tendonitis symptoms or experience sudden pain, don’t ignore it—early intervention leads to better outcomes and a faster return to activity.