This condition may be caused by:

• A sudden increase in exercise or activity, such as running.

• Doing the same exercises or activities, such as jumping, over and over.

• Not warming up calf muscles before exercising.

• Exercising in shoes that are worn out or not made for exercise.

• Having arthritis or a bone growth (spur) on the back of the heel bone. This can rub against the tendon and hurt it.

• Age-related wear and tear. Tendons become less flexible with age and are more likely to be injured.

Common symptoms of this condition include:

• Pain in the Achilles tendon or in the back of the leg, just above the heel. The pain usually gets worse with exercise.

• Stiffness or soreness in the back of the leg, especially in the morning.

• Swelling of the skin over the Achilles tendon.

• Thickening of the tendon.

• Trouble standing on tiptoe.

This condition is diagnosed based on your symptoms and a physical exam. You may have tests, including:

• X-rays.

• MRI.

The goal of treatment is to relieve symptoms and help your injury heal. Treatment may include:

• Decreasing or stopping activities that caused the tendinitis. This may mean switching to low-impact exercises like biking or swimming.

• Icing the injured area.

• Doing physical therapy, including strengthening and stretching exercises.

• Taking NSAIDs, such as ibuprofen, to help relieve pain and swelling.

• Using supportive shoes, wraps, heel lifts, or a walking boot (air cast).

• Having surgery. This may be done if your symptoms do not improve after other treatments.

• Using high-energy shock wave impulses to stimulate the healing process (extracorporeal shock wave therapy). This is rare.

• Having an injection of medicines that help relieve inflammation (corticosteroids). This is rare.

If you have an air cast:

• Wear the air cast as told by your health care provider. Remove it only as told by your health care provider.

• Loosen it if your toes tingle, become numb, or turn cold and blue.

• Keep it clean.

• If the air cast is not waterproof:

  • Do not let it get wet.

  • Cover it with a watertight covering when you take a bath or shower.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area. To do this:

  • If you have a removable air cast, remove it as told by your health care provider.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 20 minutes, 2–3 times a day.

• Move your toes often to reduce stiffness and swelling.

• Raise (elevate) your foot above the level of your heart while you are sitting or lying down.

Activity

• Gradually return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

• Do not do activities that cause pain.

• Consider doing low-impact exercises, like cycling or swimming.

• Ask your health care provider when it is safe to drive if you have an air cast on your foot.

• If physical therapy was prescribed, do exercises as told by your health care provider or physical therapist.

General instructions

• If directed, wrap your foot with an elastic bandage or other wrap. This can help to keep your tendon from moving too much while it heals. Your health care provider will show you how to wrap your foot correctly.

• Wear supportive shoes or heel lifts only as told by your health care provider.

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Keep all follow-up visits as told by your health care provider. This is important.