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(Achilles Tendonitis; Achilles Tendinosis)
by Carrie Myers Smith, BS
Tendons are tough fibers that connect muscle to bone. Tendinopathy is an injury to the tendon. It can cause pain and swelling and make it difficult to move. Tendinopathy may be tendonitis or tendinosis:
The achilles tendon connects the calf muscle at the heel bone. Achilles tendinopathy is pain in this tendon.
Tendinopathy is most often caused by overuse of a muscle and tendon. Over time, the strain on the tendon causes changes in the tendon. This change leads to pain.
Overuse of the Achilles tendon can happen in many ways. Some examples include:
Risk Factors TOP
Older adults have a higher risk due to the aging process. Other factors that may increase your risk of getting achilles tendinopathy include:
Symptoms of tendinopathy may include:
You will be asked about your symptoms and exercise habits. A physical exam will be done. The motion of your ankle will be checked. A diagnosis will be made based on the exam.
If the diagnosis is unclear, then the doctor may order imaging tests such as:
These tests may also be done if other damage may be present.
The tendon may take weeks or months to fully heal. Treatments include:
Rest and Support
The tendon will need a break from movements that are causing pain. However, full rest is not needed.
Other supportive steps may include:
A physical therapist will assess the tendon. Ultrasound and/or massage may be done to help relieve tension.
An exercise program will be created to strengthen and stretch the calf muscles. This can help with recovery and prevent future injuries.
To decrease your chances of getting achilles tendinopathy:
American College of Sports Medicine
OrthoInfo—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Achilles tendinopathy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated January 22, 2018. Accessed February 22, 2018.
Achilles tendinitis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
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Updated June 2010. Accessed February 22, 2018.
Common disorders of the achilles tendon. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at:
...(Click grey area to select URL)
Accessed February 22, 2018.
de Jonge S, van den Berg C, de Vos RJ, et al. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med. 2011;45(13):1026-1028.
Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDS for acute musculoskeletal pain in adults. Cochrane Database of Syst Rev. 2015;(6):CD007402.
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McCormack JR, Underwood FB, Slaven EJ. Eccentric exercise versus eccentric exercise and soft tissue treatment (Astym) in the management of insertional Achilles Tendinopathy: A Randomized Controlled Trial. Sports Health.2016;8(3):230-237.
Zwiers R, Wiegerinck JI, van Dijk CN. Treatment of midportion Achilles tendinopathy: an evidence-based overview. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2103-2111.
10/26/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
Last reviewed February 2018 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS
Last Updated: 7/13/2018
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