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Achilles Tendonitis: Causes, Symptoms, & Treatments

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Are you experiencing pain and discomfort in the back of your ankle? It could be a sign of Achilles tendonitis. This common condition, which affects the Achilles tendon, can cause pain, swelling, and limited mobility. In this article, we will explore the causes, symptoms, and treatments for Achilles tendonitis. The Achilles tendon is the largest tendon in your body, connecting your calf muscles to your heel bone. Overuse, repetitive stress, or sudden movements can strain the tendon and lead to inflammation. Factors such as age, repetitive use of high heels, and participation in sports that require jumping or running can increase your risk of developing Achilles tendonitis. The symptoms of Achilles tendonitis often include pain and stiffness in the back of the ankle, swelling, and difficulty walking or standing on tiptoes. If left untreated, this condition can lead to further complications, including tendinitis or a ruptured tendon. Fortunately, there are various treatments available for Achilles tendonitis, ranging from conservative measures such as rest, ice, and physical therapy to more advanced interventions like orthotics and surgery. If you suspect you may be suffering from Achilles tendonitis, it's important to seek medical attention promptly to ensure proper diagnosis and a tailored treatment plan.

Understanding The Anatomy Of The Achilles Tendon

The Achilles tendon, often referred to as the heel cord, is a vital component of your lower leg anatomy. It's the thickest tendon in the human body and plays a critical role in activities like walking, running, and jumping. Let's delve into its structure and function:

  • Connecting the Powerhouse: Imagine two powerful muscles – the gastrocnemius (calf muscle) and the soleus (deeper calf muscle) – working together. The Achilles tendon acts like a bridge, connecting these muscles to the heel bone (calcaneus). This connection allows these muscles to translate their force into movement, propelling you forward with each push-off.

  • Strength and Flexibility: The Achilles tendon is incredibly strong, able to withstand forces several times your body weight. This strength is crucial for activities that demand explosive power, like jumping or sprinting. However, the Achilles tendon also needs to be flexible enough to allow for proper ankle movement during walking and running. This balance between strength and flexibility is essential for optimal function and injury prevention.

Achilles Tendon

Causes Of Achilles Tendonitis

Here's a closer look at the common culprits behind this issue:

  • Tight Calf Muscles: Tightness in the calf muscles can put excessive stress on the Achilles tendon. This is because tight calves limit ankle dorsiflexion (the ability to lift your toes upwards). When this movement is restricted, the Achilles tendon has to work harder to compensate, increasing its risk of inflammation.

  • Improper Footwear: Worn-out shoes or shoes that lack proper arch support can contribute to Achilles tendonitis. This is because they don't provide optimal support and stability for your foot and ankle, leading to abnormal biomechanics and increased stress on the tendon.

  • Age-Related Degeneration: As we age, the Achilles tendon naturally loses some of its elasticity. This can make it more susceptible to tears and inflammation, especially with continued activity levels from younger years.

Risk Factors For Developing Achilles Tendonitis

Here's a breakdown of some key risk factors:

  • Biomechanical Abnormalities: Flat feet or overpronation (excessive inward rolling of the foot) can alter your foot and ankle mechanics. This puts undue stress on the Achilles tendon, making it more prone to inflammation and micro-tears.

  • Sudden Increases in Activity: If you're a weekend warrior or someone who suddenly ramps up your training intensity, your Achilles tendon may not be prepared for the increased workload. This rapid change can overwhelm the tendon, leading to inflammation and pain.

  • Improper Training Techniques: Running on uneven terrain, neglecting proper warm-up and cool-down routines, or using poor running form can all contribute to Achilles tendonitis.

  • Certain Medical Conditions: Rheumatoid arthritis, psoriasis, and some types of antibiotics (fluoroquinolones) have been linked to an increased risk of Achilles tendonitis. This is because these conditions or medications can affect tendon health and make them more susceptible to damage.

  • Previous Injuries: If you've had a prior Achilles tendon injury, you're more likely to experience another one in the future. This is because the tendon may be weakened or scar tissue may have formed, making it less resilient to stress.

Common Symptoms Of Achilles Tendonitis

Achilles tendonitis doesn't always announce its arrival with a bang. The symptoms often develop gradually, so it's important to be aware of the telltale signs:

  • Pain and Stiffness: The most common symptom is pain and stiffness in the back of your heel, especially in the morning or after periods of inactivity. This pain may worsen with activity, particularly activities that involve forceful pushing off, like running or jumping. You might also experience tenderness to the touch along the Achilles tendon.

  • Reduced Flexibility and Range of Motion: Achilles tendonitis can limit your ankle's range of motion. This can make it difficult to flex your foot upwards (dorsiflexion), which can affect your walking or running gait. In severe cases, there might even be a noticeable bump or thickening along the Achilles tendon itself.

Achilles Tendonitis

Treatment Options For Achilles Tendonitis

The good news is that Achilles tendonitis is often treatable with non-surgical methods. Here's an overview of the common treatment approaches:

  • RICE Therapy: Rest, Ice, Compression, and Elevation (RICE) is the cornerstone of initial treatment. Resting the inflamed tendon allows for healing, while icing helps reduce inflammation and pain. Compression with a bandage can further minimize swelling, and elevating your foot above your heart promotes drainage of fluids.

  • Physical Therapy: Physical therapists play a crucial role in Achilles tendonitis rehabilitation. They can design a personalized program that includes stretching exercises to improve flexibility, strengthening exercises to build calf muscle strength, and manual therapy techniques to improve soft tissue mobility and reduce pain.

  • Medication: Over-the-counter pain relievers like ibuprofen or naproxen can help manage pain and inflammation. In some cases, your doctor may prescribe stronger medications for more severe cases.

  • Supportive Footwear and Orthotics: Wearing shoes with good arch support and proper cushioning can help distribute stress more evenly across your foot and ankle, alleviating pressure on the Achilles tendon. Additionally, custom orthotics may be recommended to address any underlying biomechanical abnormalities that contribute to the problem.

Bilt Labs Custom Orthotics

Achilles tendonitis can sideline you from the activities you love. While rest, physical therapy, and proper footwear are crucial for healing, Bilt Labs custom orthotics can provide targeted support to promote recovery and prevent future flare-ups. Here's how:

  • Addressing Biomechanical Abnormalities: Flat feet, overpronation, or tight calf muscles can all contribute to Achilles tendonitis by placing undue stress on the tendon. Bilt Labs orthotics utilize 3D scanning technology to create personalized insoles that address these specific imbalances. Features like arch support and medial posting can help correct your foot and ankle alignment, reducing stress on the Achilles tendon and promoting a more natural stride.

  • Improved Shock Absorption and Support: Bilt Labs orthotics are crafted from high-quality, shock-absorbing materials. This not only enhances comfort but also provides crucial support for your Achilles tendon throughout the day. By absorbing impact during activities like walking, running, or jumping, these orthotics can lessen the strain on the tendon, promoting healing and reducing pain.

  • Enhanced Proprioception and Stability: Proprioception, your body's awareness of its position in space, is crucial for balance and coordination. Bilt Labs orthotics provide a more stable platform for your foot, which can enhance proprioception. This improved stability takes pressure off your Achilles tendon, allowing it to function more efficiently and reducing the risk of overuse injuries.

Beyond these core benefits, Bilt Labs offers a convenient remote scanning process and a focus on quality materials for long-lasting comfort and support. If you're struggling with Achilles tendonitis and suspect it might be linked to foot mechanics, consider exploring how Bilt Labs custom orthotics can be a valuable addition to your recovery plan. Their commitment to personalized correction and support can help you get back to your active lifestyle, pain-free.

Bilt Labs Custom Orthotics


Achilles tendonitis, while painful, is a treatable condition. By recognizing the symptoms early, implementing RICE therapy, and seeking professional guidance, you can effectively manage the inflammation and get back to enjoying your activities. Remember, prevention is key! Stretching your calves regularly, maintaining proper footwear, and gradually increasing activity levels can all go a long way in keeping your Achilles tendon healthy and your feet happy. Take our free quiz today to find out which orthotic type is best for your feet.