Achilles tendonitis can be a real pain—literally. As the podiatrist at Well Heeled Podiatry, I’ve seen countless patients struggle with this condition. The Achilles tendon, which connects your calf muscles to the heel bone, is the largest tendon in the body. When it’s inflamed or overused, it can seriously impact your ability to move freely. Whether you’re running, walking, or just doing your usual routine, the discomfort from Achilles tendonitis can quickly become a barrier to your day-to-day activities.
In this article, I’ll take you through the key signs and symptoms of Achilles tendonitis, the common causes, and the treatment options available. Early intervention is crucial, so let’s start by identifying the warning signs and figuring out how you can take action.
Key Signs of Achilles Tendonitis
Recognising the signs of Achilles tendonitis early is essential for preventing the condition from worsening. Here’s a breakdown of the key symptoms to look out for:
Pain Along the Back of the Heel
What It Feels Like:
The pain is usually sharp or aching, right where the Achilles tendon attaches to the heel bone. It can feel like a strain or tightness in the back of the leg.
When It’s Most Noticeable:
This pain tends to be worse first thing in the morning when you take your first few steps. It’s like your tendon has been “resting” and then gets a rude awakening with each step you take. By the end of the day, the pain might ease, but it can flare up again after long periods of standing or walking.
Aggravating Factors:
Anything that involves pushing off the foot, like climbing stairs, standing on tiptoes, or jumping, will make the pain worse.
Worsening Pain After Activity
What It Feels Like:
After a run or intense physical activity, the pain might start off as a dull ache but can escalate to a sharp, stabbing sensation, especially after you’ve pushed yourself.
Activities That Make It Worse:
Running, jumping, or any high-impact exercise can exacerbate the pain. Even something as simple as standing or walking for long periods can make it worse.
Recovery Time:
After you stop the activity, the pain might persist, and you may need to rest, ice, and elevate the foot to reduce the swelling and discomfort.
Causes of Achilles Tendonitis
Understanding what causes Achilles tendonitis is key to preventing it and managing its symptoms. There are a few factors that can put too much strain on the Achilles tendon, leading to inflammation. Let’s take a closer look at these causes.
Overuse
How It Happens:
Overuse is the most common cause of Achilles tendonitis, especially in people who engage in high-intensity activities like running or basketball. The Achilles tendon can only handle so much stress before it starts to become inflamed, particularly when there’s little time for recovery between activities.
Common Situations:
It’s not uncommon for athletes to suddenly ramp up their training intensity, whether they’re running longer distances, playing more games, or pushing themselves in the gym. When this happens without proper rest or conditioning, the tendon gets overloaded, leading to pain and inflammation.
Local Tip:
If you’re an avid runner or sportsperson, be mindful of increasing your training load too quickly. Gradually build up your intensity, allowing your body the time it needs to adapt.
Improper Footwear
How It Happens:
Wearing shoes that don’t fit properly or don’t offer enough support can put undue stress on the Achilles tendon. Footwear that forces your foot into an unnatural position or doesn’t provide enough cushioning can lead to misalignment, which increases the strain on the tendon.
What You Can Do:
I always recommend wearing well-fitted shoes with proper arch support and good cushioning. If you’re an athlete, make sure to replace your running shoes regularly. Over time, even the best shoes lose their ability to provide adequate support, which could set you up for problems like Achilles tendonitis.
Local Advice:
For those of us who spend a lot of time on our feet—whether you’re walking around the city, standing for long hours at work, or hitting the gym—it’s vital to pay attention to your footwear. A quick visit to a podiatrist can help you find shoes that suit your needs and prevent future injuries.
Tight Calf Muscles
How It Happens:
Tight calf muscles can make it harder for the Achilles tendon to do its job, putting extra strain on it. When your calves aren’t flexible, they don’t absorb as much force during activities, leaving the Achilles tendon to take on more stress.
What You Can Do:
Stretching your calves regularly is one of the easiest ways to prevent Achilles tendonitis. Incorporating calf stretches into your daily routine can help maintain flexibility and reduce the pressure on the tendon.
Pro Tip:
I always recommend my patients spend a few minutes each day stretching their calves—especially if they’re regularly engaging in high-impact activities. A simple calf stretch before or after exercise can go a long way in preventing tightness and tendon strain.
Bone Spurs
How It Happens:
Bone spurs are bony growths that form where the Achilles tendon attaches to the heel bone. These spurs can rub against the tendon, leading to irritation and inflammation. They’re often a result of wear and tear over time, particularly in older adults or those with conditions like osteoarthritis.
What You Can Do:
If bone spurs are contributing to your Achilles tendonitis, they might need to be addressed with medical intervention. In some cases, surgery to remove the spur may be necessary to relieve pressure and prevent further damage.
Long-Term Advice:
If you’ve been dealing with chronic heel pain and suspect bone spurs, it’s important to consult with a podiatrist. They can evaluate whether the spur is contributing to your condition and recommend the best course of action, whether it’s a change in footwear, physical therapy, or surgical intervention.
Treatment Options
Thankfully, Achilles tendonitis is treatable. Most cases can be managed with conservative methods, but in severe situations, surgery may be needed. Let’s explore the most common treatments available to help you get back on your feet.
1. Rest and Ice
Why It Helps:
Resting the affected tendon and avoiding activities that strain it is one of the first steps in managing Achilles tendonitis. When you rest, you give your tendon the chance it needs to heal. Ice helps by reducing inflammation and alleviating pain.
How to Apply Ice:
Wrap an ice pack or a bag of frozen peas in a thin cloth and apply it to the affected area for 15-20 minutes. Be sure not to apply the ice directly to your skin to avoid frostbite. You can repeat this several times a day, particularly after activities that cause discomfort.
Local Tip:
In Melbourne, where the weather can vary, if you’ve been out for a walk or jog in the cooler months, applying ice after can really help reduce inflammation and ease the ache. It’s something I always suggest to my patients who are active outdoors.
2. Physical Therapy
How It Helps:
Physical therapy is crucial for recovery. By strengthening the muscles around the Achilles tendon, you can reduce the strain on the tendon itself. A good physical therapist will guide you through exercises that promote healing, improve flexibility, and prevent the injury from coming back.
Benefits Beyond Stretching:
In addition to strengthening exercises, techniques like ultrasound or deep tissue massage can help improve blood flow to the tendon, speeding up recovery. If you’re dealing with Achilles tendonitis, physical therapy is often a key part of the healing process.
What You Can Expect:
Your therapist might introduce exercises such as eccentric calf raises to rebuild tendon strength, along with stretches to ensure flexibility. It’s one of the most effective treatments I recommend for patients experiencing chronic Achilles pain.
3. Orthotics
Why It Works:
Custom-made orthotics, or shoe inserts, help redistribute pressure on the foot and relieve strain on the Achilles tendon. If your foot has structural issues, like flat feet, orthotics can help correct alignment and reduce stress on the tendon.
When to Consider Orthotics:
If you’re dealing with chronic Achilles tendonitis, it might be worth consulting with a podiatrist to see if orthotics could help. They’re particularly useful for those who spend a lot of time on their feet or engage in sports.
Local Tip:
Orthotics are often a game-changer for people who work long hours on their feet. Whether you’re in retail, hospitality, or just spend a lot of time walking around Melbourne’s busy streets, the right pair of orthotics can make a big difference.
4. Medication
How It Helps:
Over-the-counter pain relievers, such as ibuprofen or naproxen, can help reduce pain and inflammation. These medications are especially useful if you need some relief while you’re focusing on rest and recovery.
Precautions:
While medication can be helpful, it’s important to use it with caution. Prolonged use of anti-inflammatory medications can cause side effects like gastrointestinal issues. Always check with your healthcare provider before starting any new medication.
5. Surgery
When It’s Necessary:
Surgery is usually reserved for severe cases of Achilles tendonitis that don’t respond to conservative treatments. In these cases, surgical intervention may be needed to remove bone spurs, repair the tendon, or even lengthen the calf muscles to reduce tension on the tendon.
What to Expect After Surgery:
Post-surgery recovery involves a period of immobilisation, followed by physical therapy to rebuild strength and flexibility. While surgery isn’t common, it’s an option for those whose tendonitis has become chronic and doesn’t respond to other treatments.
Achilles tendonitis can be a painful condition, but with early intervention and the right treatment, you can get back to your active lifestyle. From simple remedies like rest and ice to more advanced treatments like physical therapy and orthotics, there are plenty of options to manage and prevent Achilles tendonitis.
If you’re experiencing symptoms, don’t wait for the pain to get worse. Listen to your body, and seek help from a podiatrist or medical professional who can guide you through recovery and help prevent future flare-ups.
Frequently Asked Questions
What Are The Common Signs And Symptoms Of Achilles Tendonitis?
Achilles tendonitis typically presents with pain at the back of the heel, especially in the morning or after physical activity. The pain can be sharp or aching and may worsen with activities like running, climbing stairs, or standing on tiptoes. Other symptoms include swelling, warmth around the tendon, and stiffness, particularly after periods of inactivity or in the morning.
What Causes Achilles Tendonitis?
Achilles tendonitis is mainly caused by overuse or repetitive stress on the Achilles tendon. Common contributing factors include sudden increases in physical activity, improper footwear, tight calf muscles, and pre-existing conditions like bone spurs. Athletes, especially those involved in high-impact sports, are more susceptible, as are individuals who don’t properly warm up or stretch before physical activity.
Can Achilles Tendonitis Be Treated Without Surgery?
Yes, most cases of Achilles tendonitis can be treated conservatively without surgery. Treatment typically involves rest, ice, and over-the-counter pain relievers to reduce inflammation and pain. Physical therapy, stretching exercises, and custom orthotics can help relieve strain on the tendon and promote healing. Surgery is usually only considered for severe or chronic cases that don’t respond to other treatments.
How Can I Prevent Achilles Tendonitis From Recurring?
To prevent recurrence of Achilles tendonitis, it’s important to warm up properly before exercise, stretch the calf muscles regularly, and gradually increase the intensity and duration of physical activities. Wearing supportive shoes with good cushioning, using orthotics if necessary, and allowing adequate recovery time between strenuous activities can also help reduce the risk.
When Should I See A Doctor For Achilles Tendonitis?
If you experience persistent pain, swelling, or difficulty walking due to Achilles tendonitis, it’s important to see a healthcare provider. You should seek professional help if the pain worsens over time, if there’s visible swelling or warmth around the heel, or if you notice any signs of infection, such as redness or pus. A doctor or podiatrist can provide a thorough evaluation and recommend the best treatment plan.
