What Is Achilles Tendonitis and What Can You Do About It?

Feeling soreness or swelling in the back of your ankle after a run? Getting some inflammation after your weekly tennis match? You might be experiencing this common runner’s injury.

Achilles tendonitis is one of the most common runners’ ailments. It’s usually cured on its own, but you need to take it seriously to avoid other problems. You can help it by resting, ice, shoe choices and some basic conditioning exercises. Stretching will also release tension in your foot.

But if you want the full details, I go into depth on this, as well as offer some tips on how to avoid it.

What Are the Symptoms of Achilles Tendonitis?

The Achilles tendon is a strong, stringy tissue in the back of your foot, right above your heel. It attaches your heel bone to your calf muscles and is responsible for moving your foot up and down.

Achilles tendonitis can prevent this highly important tendon from operating effectively, with the key symptoms being:

• Pain.
• Swelling.
• Tendonosis.
• Bursitis.

Pain

The inflammation of this tendon is called tendonitis, and you’ll feel it on every step. Depending on the gravity of your injury, you might feel a dull ache or a burning sensation. It can also manifest as simply stiffness at the back of your leg. Getting on your toes might be painful if the inflammation gets bad.

Swelling

If you look at your ankle from the back in a mirror, you might see the inflammation around the tendon, right above your heel. You’ll have a better chance of spotting this if you only have tendonitis in one foot, by comparing them together.

Tendonosis

Tendon injuries are among the most common sports-related injuries. In one study, 66 percent of joggers complained about Achilles tendon pain. 

However, some of these runners had tendonosis, a chronic condition involving tiny tears to the tendon instead of inflammation. If there’s pain but no swelling, this might be the cause. Tendonitis can also develop into tendinosis if not treated.

Bursitis

If you’re experiencing inflammation and pain in the heel itself, you also might have bursitis of the heel. This means that the tiny fluid-filled sacs that work as lubricants between your bones and joints have become irritated. 

This injury is related to tendinitis, and they often happen together, but it will make your recovery a little longer.

Both bursitis and tendonosis may require different treatments. Have a checkup with your doctor to make sure you’re on the right path to recovery.

What Causes Achilles Tendonitis?

Achilles tendonitis is usually an overuse injury, and it can have many causes in both sedentary and athletic individuals. 

This condition is usually caused by sudden or explosive movements, like sprints or jumps. It can also happen due to repetitive movement, especially when your body’s not used to them.

Athletic Practice

For athletes, it’s especially common in sports that require explosive movements, like sprinting and jumping. Tennis players, dancers and football players, as well as sprinters, are among the main groups at risk.

Long-distance runners can also develop this condition as a result of repetitive impact on the heel and the tensing up of their muscles.

A New Fitness Regime

Tendonitis also occurs when you’re not used to a certain type or intensity of exercise. Your muscles might be enough for sprinting and jumping, but your joints and tendons aren’t necessarily used to the sudden changes. 

Among the normal population, men above the age of 30 are the most common sufferers of this condition. That might be because it’s the age range when they don’t exercise as regularly but might still participate in athletic activities on the weekends.

This is why it’s so important to gradually build up your capacity when you’re only starting to work out or run. If you’re a runner training for a race, be patient when amping up the intensity of your workouts.

Other Factors

Some contributing factors to Achilles tendonitis can be:

• Age.
• Gender.
• Obesity.
• High blood pressure.
• Psoriasis.

Flat feet can also play a part in developing this issue, as they cause more strain to the tendon. Some types of antibiotics may also make you more susceptible to it.

What Are the Consequences?

If you don’t treat your Achilles tendonitis accordingly, you’ll probably be in pain for longer than necessary. But there are other consequences you need to pay attention to before it’s too late.

Ankle, Knee and Hip Problems

When you suffer from tendonitis, you might be modifying your gait without even realizing it, to ease the pain. For example, you could be using a little extra force when you’re stepping or even twisting your foot slightly to avoid pain.

If you let this go on for a long time without addressing the problem, you’re setting yourself up for other issues. Even a slight unnatural twist of your knee or ankle will alter your body’s natural alignment. This can come back as pain in your leg muscles and joints or even your back.

Rupture

Continued inflammation can eventually weaken the tendon. As a result, sometimes, the Achilles tendon might even rupture or completely tear. While it’s not as common as inflammation, it does happen, and for similar reasons. This condition is most common for middle-aged to older men.

If you feel or hear a snap in your tendon, seek medical help immediately—it’ll be extremely painful, and you won’t be able to walk. This condition won’t cure itself, and you won’t be able to live normally with a ruptured tendon.

Your best bet is treating the inflammation before it turns into something more serious. Believe me; you don’t want your Achilles tendon to snap. It’s painful and requires surgery, and the recovery will take several weeks.

How to Prevent Achilles Tendonitis

Since Achilles tendonitis is such a common condition, it’s always good to keep in mind some basic ways to avoid developing it:

• Shoes.
• Go slow.
• Conditioning.
• Warm-up and stretch.

Shoes

Make sure your shoes are the right ones for the activity you’re doing. They should have enough cushioning and responsiveness to take the impact. 

Your shoes should also be lightweight enough so that they won’t make running even heavier for you. This might make you stomp, and the impact on the ground will be higher.

If you have underlying problems, such as flat or high arches, you should check what kinds of shoes you may need to correct them. When looking for running shoes, try to find the ones that fit your foot type specifically. They wrap themselves around your midfoot area and naturally correct your stride.

High arches usually require more support in the middle part of the shoe, but a pronounced arch could get painful for people with flat feet. Anything that makes your gait unnatural can potentially help you develop more Achilles tendon pain.

The important thing is that the shoe balances out your stride, so you don’t twist your ankle and cause unnecessary strain on your Achilles. It needs to fit your foot and be cushioned enough to reduce impact.

Also, check out our guides for the best shoes for Achilles Tendonitis

Go Slow

If you’re only starting to exercise, be careful and listen to your body. Even if you feel like your lungs and muscles are ready to start serious running, your tendons might need more time.

Start slow, and gradually build your way up to more strenuous workouts. Don’t run more than a couple of days a week at first. Be careful with high-impact, CrossFit-style classes as well, at least until your body is used to it.

You may want fast results, but jumping around is hard for your body. If you get injured, you’ll have to postpone your fitness plans altogether.

If you’re a weekend athlete playing occasional football or tennis, try to add some exercise into your weekdays. At least try some easy at-home workouts to add more power to your muscles.

Conditioning

Any exercise improves blood circulation in your body, which in turn will help you keep your tendons healthy. Conditioning your muscles will also help them prepare for the high-impact activities.

Some good conditioning exercises to avoid Achilles tendon problems incorporate the calf and upper leg muscles. Core muscles are also important since they’ll help you keep your stability in other activities, like running. This way, you’ll carry your upper body better and won’t put more strain on your legs than necessary.

The more prepared your whole body is, the better you’ll keep the pressure off of your feet.

Calves

Your calf muscles are the ones directly tied to the Achilles tendon, so it’s important to keep them in good shape. Try some calf raises at home to improve your strength.

1. Stand next to a wall or a table, wherever you can support yourself.
2. Lift one leg in the air, and lift yourself on the toes of the other foot.
3. Come back down, and repeat the movement 8 to 12 times.
4. Then turn and do the same thing on the other foot.

An easier, modified version of this exercise can be done with both your feet on the ground. You can also make this movement a little harder—keep a heavy object in your hand or find a staircase to get some stretch to the muscle.

If this exercise gets painful and you feel pain in your tendon, interrupt it and rest. Only perform any exercise when your body can handle it with good form.

Quads and Hamstrings

If you’re looking for a good way to add more muscle to your legs, few exercises beat the squat. It’ll help your quads, hamstrings and glutes, and indirectly, even your core muscles and calves. 

Most importantly, squats will give your legs more power for those explosive sprinting and jumping. This way, you won’t put an extra strain on your feet and ankles.

1. To perform a squat, stand with your legs about shoulder-width apart.
2. Lower your body with your back in a neutral position, your chest up and your knees behind the line of your toes.
3. Challenge yourself, but only go as low as you feel comfortable.
4. Make sure your knees don’t fall inwards as you go deep into the squat—they should stay over your knees.
5. Slowly, keep your shoulders back and stand back upright.
6. Repeat 8 to 12 times, or as many as you can with good form.

When you’re doing well with the basic squats, you can add some difficulty by performing a jump once you return to the standing position. This will help to prepare your tendons for running.

Core

You can do a bunch of different moves to help your core strength. The best ones involve moves that improve your overall stability, such as planks.

If you’re already capable of getting to a full minute, try adding some difficulty by extending one arm or foot in the air for a couple of seconds at a time. Otherwise, aim for 30 seconds, and if that’s too much, 15 seconds.

The important thing is to remember to breathe and keep your midsection tight.

Warm-Up and Stretching

Exposing your tendons to explosive exercises when they aren’t adequately warmed up is another surefire way to get tendonitis. Make sure you do some warm-up exercises before you start running, jumping or doing other intense activities.

1. Try walking at a moderate pace at first.
2. Alternate between walking on your toes and then back to normal to stretch the tendons.
3. Repeat as many times as you need until your feet and ankles are warmed up.
4. Roll your ankles around to get them moving.

Also, do a couple of squats or other leg exercises to make sure your muscles are awake before running.

If you’re running in a cold climate or during the winter, remember to keep your Achilles protected. Use a thick pair of socks or even leg warmers to cover your ankle to keep your tendons warm and comfortable.

Always stretch your muscles after exercise. Even tightness in your hamstrings might affect the mobility of your legs and extend down to your ankles. If your Achilles is sore after exercise, rest, elevate and use ice—more in the next section on this.

How to Treat Achilles Tendonitis

If you’re already dealing with Achilles tendonitis, the good news is that it doesn’t have to be eternal. Normally, this condition clears out with rest and treatment. You do, however, have to take it seriously.

If the pain doesn’t clear out on its own in a day or two, visit a doctor to make sure you have the right diagnosis. They’ll also be able to help you with the right treatment options.

These are the best ways to treat Achilles tendonitis:

• Rest.
• Ice.
• Compression and elevation.
• Painkillers.
• Correct night-time practice.
• Stretching.
• Adequate shoes.
• Rehab exercises.

Rest

The first thing you need to do is give yourself a little rest from the activity that’s causing you to have tendonitis. Avoid walking and running, as well as more strenuous activities, until you’re fully recovered.

If you need to get in some exercise, try some basic conditioning moves that don’t involve strain or stretch to the tendon. 

Ice

Icing can really help bring down inflammation and help you recover faster. Try icing for up to 20 minutes a couple of times a day or as needed.

Compress and Elevation

Wrap a bandage around your foot to reduce the swelling. Whenever you can, keep your foot elevated on a chair or a pillow.

Painkillers

If you’re in a lot of pain, you can use some non-prescription painkillers like ibuprofen or naproxen. However, always consult your doctor, especially if the pain lasts for longer than a couple of days.

At Night

Many people sleep with their toes pointing slightly downward, which can worsen your condition. This position tightens the Achilles tendon and shortens the calf muscle and the fascia tissue on the bottom of your foot. The result can be a worsening of your tendonitis, as well as plantar fasciitis, another painful foot condition.

What you can do to prevent this is to untuck your sheets. This way, they don’t force your toes down when you’re lying in your bed. Also, pay attention to your duvet and if it’s too heavy. The weight can bring your toes down.

If this doesn’t help, consider using night splints to keep your foot at a 90-degree angle for the whole night. Doing so will give you a nice stretch on your foot tissues, Achilles tendon and calf muscles.

Stretching 

Apart from stretching after exercise, try adding stretches to your nightly routines. Take 10–15 minutes at the gym or after your run and before bed to help your body wind down and release tension.

Stretch your calves, quads, hamstrings and your hips, and don’t forget your feet. Remember, everything is connected. Even if you wouldn’t think these muscles influence your tendon, they could be adding more tension to your heel.

Shoes

Find the right shoes for you. Avoid high heels and find the shoes that make you feel comfortable. You can add an orthopedic insole or a heel lift for extra help.

People with flat feet are more prone to developing Achilles tendonitis. This is why you should pay extra attention to your shoes if you have low or fallen arches. Find shoes that provide arch support and stabilize your foot.

Rehabilitation Exercises

There are many exercises to rehabilitate your Achilles and the muscles surrounding it to avoid pain in the future. Give these a try after you’ve first let your foot rest a little:

1. Stretch by having your foot extended in front of you.
2. Place a strap or belt on your toes and slowly pull them towards you.
3. Start strengthening your tendon in this same position by pushing your toes away from you. Use the resistance of the strap to help you.
4. When you’re feeling a little better, use the stairs to help your recovery. Get on your toes and then lower one heel over the edge of the step. Try to do 10 to 15 repetitions. 

The Bottom Line

Achilles tendonitis is a very common exercise-related injury, but you should always take it seriously. If you don’t treat it, you might expose yourself to some complicated issues with alignment or even risk debilitating the tendon. 

Give yourself some rest, use ice and keep your foot elevated. Visit the doctor to ensure the right diagnosis, especially if the pain lasts long or gets severe.

Pay attention to your shoes, and be careful with high-impact exercises if you’re only getting started. Be patient with your body and give it the time it needs to condition and prepare.