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achilles tendon pain

What to Do If You Have Achilles Tendinitis

Achilles tendinopathy (also known as tendinitis) starts with inflammation of the Achilles tendon due to overuse or injury. It is common in those persons those who play sports or work out during the weekends or at an irregular schedule. It normally develops after abrupt changes in activity, training on uneven surfaces and using worn or poorly fitted shoes. If left untreated, this could lead to degeneration and damage of the tendon.

The most common cause is overuse of the foot or excessive stress transmitted to the tendon by the calf muscles. Too much stress will lead to micro-injury of the tendon fibers and, if not given proper time to heal, the body is not able to repair the tendon before it is injured again.

Managing Achilles Tendinopathy with Conservative Managements

Mild cases of Achilles tendinopathy usually respond to over the counter pain medications, activity modification and relative rest.

On the other hand, if the pain becomes chronic, physical therapy is often used. A physical therapist will teach patient how to stretch the calf muscle and Achilles tendon to avoid injury. In addition, strengthening of the calf muscle as well as the ankle and foot is also necessary for stability of the lower leg. Additional strengthening exercise include heel lifts and eccentric strengthening. Eccentric strengthening involves increasing the tension on the muscle/tendon complex through a lengthening contraction to correct the abnormal forces that lead to injury.

Physical Therapy program is often combined with ultrasound therapy or injection treatments that are administered by a sports medicine physician. Platelet Rich Plasma injections in particular have shown significant benefit in allowing the tendon to heal, even when small tears are present. Sometimes topical Nitric Oxide patches can be used to increase blood flow to the tendon to promote healing.

It is also very important to assess the quality of footwear to ensure proper fit and does not have excessive wear. Runners should generally change shoes every 300-500 miles or one year, whichever is first.

Managing Achilles Tendinopathy with Surgery

Surgery is a rare treatment for Achilles tendinopathy and is only performed when the tendon is already ruptured. Surgical options can be discussed with the orthopaedic surgeon, to decide which procedure is right for you. The type of surgery to be performed depends on the location of injury and the amount of tendon damage.

The most important factor to expedite healing of the tendon is to seek the advice of a sports medicine or orthopedic specialist in order to start treatment prior to further deterioration of the tendon and possible tendon rupture.


At The Orthopaedic & Sports Medicine (OSM) Center we utilize the collective skills of our exceptional providers to deliver the most complete musculoskeletal care available. From your first appointment, you are cared for by a team specifically built based on the best treatment for your condition. If surgery is necessary, you will be paired with an OSM surgeon who has the expertise and experience in your specific condition. Our surgeons use the latest minimally invasive techniques where appropriate to ensure fast recovery.  Contact us today to schedule a consult.