What is Achilles Tendonitis and Why Does It Hurt?

Achilles tendonitis can happen in active people who walk or stand a lot. Or, in those who recently increased their activity levels.  It usually starts as a nagging pain in the back of the heel that persists. If you have this pain, you may have Achilles tendonitis.

What is the Achilles tendon?

The Achilles tendon may be the most famous tendon, thanks to Greek Mythology, but we digress already. 

The Achilles tendon is the largest tendon in your body. It connects the calf muscles (gastrocnemius and soleus) to your heel bone (calcaneus). The Achilles tendon is the primary tendon in ankle push off, which is what you do when you walk or run. 

What is Achilles tendonitis?

Achilles tendonitis is inflammation and degeneration of the Achilles tendon. The injured area can also swell. Sometimes pain is in the middle of the Achilles tendon. Also, pain can develop where the Achilles attaches to the heel bone, called insertional Achilles tendonitis. 

What causes Achilles tendonitis?

There are multiple risk factors for Achilles tendonitis. 

• Tight Achilles and calf muscles
• Repetitive activity
• Bone spur in the heel

Additionally, there is an area a few centimeters from the heel bone where the blood flow to the Achilles is limited. This is a common area for Achilles tendonitis and tears. 

What are the symptoms of Achilles tendonitis?

Pain is the primary symptom associated with Achilles tendonitis. The Achilles tendon can also become thicker on the injured side. A bone spur can form on the back of the heel. Direct pressure on the tendon or heel can make the pain worse. 

How do you diagnose Achilles tendonitis?

Dr. Stautberg and the orthopedic surgeons at Southwest Orthopedic Group can help diagnose Achilles tendonitis. 

First, a thorough history and exam can help with the diagnosis. A radiograph can show bone spurs or calcification of the Achilles tendon. Advanced imaging, such as an MRI, can evaluate the Achilles tendon for tears and degeneration. 

Will Achilles tendonitis heal on its own?

There are nonoperative and surgical treatments for Achilles tendonitis. In general, some level of treatment is required to help the pain resolve. 

How do you know if you tore your Achilles tendon instead? Read our blog post: What is an Achilles Tendon Tear?

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about Achilles tendonitis: FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD