What is Achilles tendinitis?

Achilles tendinitis | tendinopathy | tendinosus

Achilles tendinitis is an overuse injury of the Achilles tendon (TA), the band of tissue that connects the muscles of the calf at the back of the lower leg to your heel bone.

It most commonly occurs in runners who have suddenly increased the intensity, duration or overall training volume of their runs. It's also common in many middle-aged ‘weekend warriors’ who play social sports such as basket ball, touch and tennis on weekends and place undue, intermittent and irregular forces through their lower limb.

Achilles Tendon Injuries and Treatment

How is it treated?

Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your physiotherapist’s supervision. Self-care strategies are usually necessary to prevent recurring episodes and includes strengthening and stretching exercises. Left untreated, more serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.

Achilles tendonitis occurs when the Achilles tendon becomes inflamed causing pain and swelling symptoms. This may be the result of poor tendon alignment due to fallen arches, poor footwear choices or repetitive overuse injuries.

If left untreated it can become chronic, requiring more intensive treatment. Long standing injury or chronic poor alignment of the TA can result in a tendinosus which unlike its predecessor (tendonitis) is characterised by a thickening to the tendon itself due to neo-vascularisation (new blood vessels and nerve ending) of the tendon in an attempt to heal the damaged connective tissues.

Signs & Symptoms

Onset of symptoms tend to be gradual. usually developing over a period of several days, or weeks.  Symptoms may include:

  • Pain - this may be mild at first and may only be noticeable after exercise. Over time the pain may become constant and severe
  • Stiffness - usually first thing in the morning (this is usually relieved by activity) and by the end of the day due to fatigue
  • Weakness in the affected leg
  • Tenderness - particularly in the morning
  • Swelling

Factors that can lead to the development of Achilles tendonitis include:

  • Tight or weak calf muscles
  • Rapidly increasing the amount or intensity of exercise (such as training for a half marathon)
  • Hill climbing or stair climbing
  • Changes in footwear
  • Wearing inadequate, inappropriate or worn out shoes for sport
  • Not adequately warming up and stretching prior to exercise
  • A sudden sharp movement that causes the calf muscles to contract and the stress on the Achilles tendon to be increased. 
  • Old age
  • A side-effect of a certain type of antibiotics called fluoroquinolones

If you suspect you’ve injured your Achilles’ tendon...

Avoid any exercise or aggravating activity. Make an appointment to see a physiotherapist promptly so that an accurate diagnosis can be made and appropriate treatment recommended. Treatment will depend on the severity of the injury. In general terms, the longer the symptoms are present before treatment begins, the longer the timeframe until complete recovery is achieved.