Ankle + Foot

Achilles Tendon Pain

Overview

The Achilles tendon is the largest tendon in your body. It stretches from the bones of your heel to your calf muscles. It lets you point your toes toward the floor and raise up on your tiptoes. Symptoms of achilles tendon issues include:

  • Pain and stiffness along the tendon in the morning
  • Pain that worsens with activity
  • Severe pain the day after exercising
  • Swelling that is present all the time and gets worse throughout the day

Achilles Tendon Bursitis

Achilles tendon bursitis is caused by overuse of the ankle which results in inflammation of the bursa. The common causes include too much of walking, jumping, or running, and can occur in conjunction with Achilles tendinitis.

Learn more about Achilles tendon bursitis.

Achilles Tendinitis

Tendinitis is inflammation of a tendon that causes swelling, pain, or irritation. Achilles tendinitis is typically not related to a specific injury but results from repetitive stress to the tendon.

Learn more about Achilles tendinitis.

Achilles Tendon Tear

It's common for this tendon to get injured. If you have experienced a sudden "pop" in the back of your calf or heel, you may have torn the tendon. See your doctor immediately if you think you may have torn your tendon.

Learn more about Achilles tendon tear.

Diagnosis

The diagnoses can be made by a physical examination. Tests which may help your doctor confirm your diagnosis include X-rays and MRI.

Treatment Options

For overuse cases, nonsurgical treatment options will help provide pain relief, although it may take a few months for symptoms to completely subside. The first step is to stop the activities that make the pain worse, ice throughout the day, take anti-inflammatory medication, and start a physical therapy program. Cortisone injections, supportive shoes, and orthotics may also be recommended by your doctor.

Surgery may be considered to relieve the pain if it does not improve after six months of nonsurgical treatment. The specific type of surgery depends on the location of the tendinitis and the amount of damage to the tendon. Surgery will be required for an Achilles tendon rupture.

Gastrocnemius Recession

This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the Achilles tendon, this procedure is useful for patients who still have difficulty flexing their feet despite consistent stretching.

Debridement and Repair

The goal of this operation is to remove the damaged part of the Achilles tendon as well as any bone spurs. Once the unhealthy portion of the tendon has been removed, the remaining tendon is repaired with sutures, or stitches, to complete the repair.

Debridement with tendon transfer

In cases where more than 50% of the Achilles tendon is not healthy and requires removal, the remaining portion of the tendon is not strong enough to function alone. To prevent the remaining tendon from rupturing with activity, an Achilles tendon transfer is performed. The tendon that helps the big toe point down is moved to the heel bone to add strength to the damaged tendon. Although this sounds severe, the big toe will still be able to move, and most patients will not notice a change in the way they walk or run.

Physical Therapy

Your doctor may recommend physical therapy to help you regain strength in your ankle and to restore range of motion. Depending upon your procedure, you may need to wear a brace or supportive shoes for a time.