Achilles Tendonitis

Photo of a woman stretching her calf.
You can do the runner's stretch to improve flexibility of your Achilles' tendon. Buff spandex / Getty Images

In Greek mythology, Achilles was a Greek hero of the Trojan War. According to legend, his entire body was invulnerable, except for his heel. Today, the large tendon on the back of the heel is known as the Achilles tendon, after this Greek hero. Due to the amount of stress and strain that we place on this part of the body, it is susceptible to injury during many athletic activities. Achilles tendonitis is a painful condition that occurs when there is damage to the Achilles tendon.

Achilles' tendonitis is an overuse injury, meaning that repetitive use of this tendon results in little tears of the tissue. Over time, swelling and pain result. Common activities/conditions that result in Achilles tendonitis include:

  • Running
  • Jumping
  • Tight Calf Muscles
  • Excessively Flat Feet

The symptoms of Achilles tendonitis usually progress gradually over time. You may initially experience them first thing in the morning, or during times of increased activity. Common symptoms of Achilles tendonitis include:

  • Pain in the back of the heel when pushing off your foot during walking or standing on your toes
  • Tenderness over the back of your heel
  • Stiffness that improves as your tendon warms up
  • A "bump" on the back of your heel
  • A crackling sound when you move your Achilles tendon

While it may not always be possible to prevent developing Achilles tendonitis, taking steps to reduce your risk is important. Some preventative measures include:

Management of this condition includes: medications to decrease pain and swelling, rest, and physical therapy for appropriate rehabilitation. Your physical therapist will likely use therapeutic modalities to help control inflammation and decrease pain.

Therapeutic exercises may be prescribed to strengthen your ankles, knee, and hips. One specific exercise protocol for Achilles tendonitis is the Alfredson Protocol. This requires that you perform eccentric heel lowering exercises off a step. (Check in with your physical therapist to learn how to properly perform the Alfredson Protocol for Achilles' tendonitis.

Some physical therapists use kinesiology tape for their patients with Achilles tendonitis. This tape can be used to facilitate a proper calf contraction or to inhibit spasm in your calf muscles.

Many patients with Achilles tendonitis exhibit problems with proprioception and balance. Your PT may assess your balance and prescribe exercises to improve your body's perception of the position of your lower extremity, thus taking pressure off of your Achilles tendon.

If you develop pain in the back side of your lower leg, you may be dealing with Achilles tendonitis. If so, check in with your doctor, and then visit your physical therapist to learn the proper treatment so you can get back to your normal activity quickly and safely.

Edited by Brett Sears, PT, the Expert in Physical Therapy.

American Family Physician: Common Injuries of the Achilles Tendon; Vol. 65/No. 9
J Am Acad Orthop Surg: Achilles tendon injuries; 6:316-25
Stevens, M. and Tan, C. (2014) Effectiveness of the alfredson protocol compared with a lower repetition-volume protocol for midportion achilles tendinopathy: a randomized controlled trial. JOSPT 44(2) 59-67.

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