Achilles Tendonitis: Causes and Treatment


Tendonitis, also spelled tendinitis, is a condition in which a tendon is put under too much strain, often causing microtears in the tendon. It’s a painful condition that can happen in any of the tendons in the body. One of the most common forms of tendonitis is in the Achilles tendon. The Achilles tendon is located on the heel of the foot, and stretches up to connect to the calf muscle


The symptoms for Achilles tendonitis are typically mild pain in the back of the leg, or down at the heel of the foot. The pain can intensify over time with prolonged running and exercise. It will hurt more when the Achilles tendon is stretched. It may also hurt worse in the morning, but ease up as daily tasks are performed. 

Causes and Risk Factors

The most common cause of Achilles tendonitis is the overuse of the tendon. The tendon is used when you jump, walk, run, and reach up on your toes. This tendonitis is most commonly seen in runners, especially in runners who are trying to increase their speed or endurance. The Achilles tendon weakens over time, so Achilles tendonitis is also common with older age. There are many other causes and risk factors, some of which include:

  • Sex/gender. It is more common in men than in women.
  • Foot shape. A flat arch can make a foot more susceptible to Achilles tendonitis.
  • Training conditions. Ill-fitting shoes and colder weather put feet more at risk for Achilles tendonitis.
  • Obesity.
  • Medical conditions. People who have psoriasis or high blood pressure are at higher risk for developing Achilles tendonitis.

Diagnosis and Treatment

To diagnose Achilles tendonitis, a doctor will lightly press on the tendon to determine the severity of pain, location of pain, and the amount of swelling. They may also order an x-ray, ultrasound, or magnetic resonance imaging (MRI) to see the tendon more clearly. 

Once diagnosed, treatment is typically effective through self-care and over-the-counter anti-inflammatory pain medications. Self-care would include following the RICE method, which means to rest, ice, compress, and elevate the injured area. Other treatment options include:

  • Physical therapy. A physical therapist will help identify exercises designed for strengthening the Achilles tendon and surrounding areas, so that the Achilles tendon can handle more strain and pressure. One exercise that has proven to help the Achilles tendon is the slow letdown of a weight after raising it.
  • Surgery. After several months of failed conservative treatments, a doctor may suggest surgery to repair the Achilles tendon. 


There is no way to completely prevent Achilles tendonitis from developing. However, there are certainly many steps that can be taken to reduce the risks:

  • Take it easy. Avoid activities that add stress to your tendons.
  • Gradually increase intensity. If you exercise or run, try to slowly increase the intensity of each workout. 
  • Pick shoes carefully. Shop for shoes that are comfortable and have firm arch support to support the Achilles tendon during exercise.
  • Stretch daily.
  • Strengthen calf muscles. Stronger calf muscles allow more pressure to be added to the Achilles tendon without injuring it.
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