Achilles tendinitis means you feel pain in the large tendon that extends from in the back of your heel to your calf muscle. It hurts most when you get up in the morning and when you start to walk or run. It will heal only if you stop running and find another sport that doesn’t hurt when you do it, such as cycling, swimming, or pulling on a rowing machine.

The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. But it also the most frequently ruptured tendon. The Achilles tendon is made up of thousands of individual fibers, like a rope with thousand of threads. The fibers are broken by applying a force greater than their inherent strength. No medicines hasten healing. As soon as the tendon stops hurting, doctors usually prescribe strengthening exercises, but you have to exercise against greater resistance to become strong and strong resistance prevents healing. If you want to try to resume your running program, start out by jogging very slowly daily until your tendon starts to hurt and then quit for the day. Soon you will be able to jog for more than a half hour, but that will not condition you enough to compete in any sport. When you no longer have any pain, you can strengthen the tendon by learning how to run fast. You must stop immediately if you feel a pulling behind your heel and each intense workout will require several easy days to allow you to recover. Try to run very fast once or twice a week, never on consecutive days. OR consider switching to another sport that uses smooth motions and does not pound on the pavement.

Achilles tendinitis often begins with mild pain after exercise or running that gradually worsens. It may be caused by:
• Hill running or stair climbing
• Lack of flexibility in the calf muscles
• Rapid increase in mileage or speed
• Starting up too quickly after a layoff
• Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.

• Recurring localized pain, sometimes severe, along the tendon during or a few hours after running
• Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
• Sluggishness
• Mild or severe swelling
• Stiffness that generally diminishes as the tendon warms up with use

• A bandage specifically designed to restrict motion of the tendon
• Non-steroidal anti-inflammatory medication
• Orthotics, devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert
• Rest or change to another exercise that does not stress the tendon, such as swimming
• Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors
• In extreme cases, surgery to remove the fibrous tissue and repair any tears.

More on achilles tendinitis

Contributed by Gene Mirkin, DPM

Checked 3/13/23