Everything You Need to Know About Achilles Tendinitis

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Achilles tendinitis is an overuse injury of the Achilles tendon, the tendon that connects your calf muscles at the back of your lower leg to your heel bone. The Achilles tendon is the strongest tendon in your body. When you walk, run, or jump, you are using your Achilles tendon. 

Achilles tendinitis is a common condition that affects runners and other athletes when they increase the duration of their exercise or its intensity. It also occurs in middle aged people who play sports. As many as 30% of people experience Achilles tendinitis unrelated to sports injuries.


Achilles tendinitis usually occurs due to repetitive stress on the Achilles tendon. Things that may cause Achilles tendinitis include: 

  • Increasing exercise too fast (doing too much, too fast)
  • Tight muscles in your calf 
  • Weakness or deformity of the tendon or the attached muscles
  • Obesity or excess weight on the tendon
  • Certain medications, such as ciprofloxacin, levofloxacin, and steroids
  • Problems with balance or stability 
  • Unsupportive shoes 
  • Not stretching or warming up before a workout
Health Photo Composite - Achilles Tendinitis

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The most common symptoms of Achilles tendonitis are:

  • Pain in the heel or lower leg that may get worse with activity
  • Pain or stiffness in the tendon in the morning
  • Sensitivity to touch on and around the tendon
  • Rigidity or thickening in the tendon
  • Pain in the area the day after a workout
  • Bone spur development
  • Swelling that increases with activity
  • Pain in your heel when wearing shoes

Talk to your healthcare provider immediately if you feel a sudden pop in your heel or lower calf. You may have torn your Achilles tendon.


If you have pain in your heel and fear you may have Achilles tendinitis, talk to your healthcare provider. They will examine your heel and leg and ask questions about the pain, such as:

  • When do you have it?
  • What makes it worse?
  • What makes it better?
  • What activities or sports do you do?

Your provider may order imaging studies such as an X-ray, an MRI, or an ultrasound of your lower leg and heel.


If your healthcare provider diagnoses you with Achilles tendinitis, they may recommend these types of treatments to start:

  • Rest: Rest the heel and leg as much as possible to give it a chance to recover.
  • Ice packs: Apply ice packs to the area to reduce swelling and pain.
  • Physical therapy: Go to a physical therapist to learn exercises to help heal the tendon and prevent further injuries.
  • Wearing splints: These braces keep your feet in place and your toes pointing upward while you sleep. This position improves the flexibility in your calf, lowering the pull on your Achilles tendon.
  • Wearing supportive shoes: Supportive shoes or orthotics may help your pain when you are up and about, especially if participating in sports or other intense activities.


Your provider may also recommend certain medications to help ease the pain or Achilles tendinitis or help it heal.

  • Non-steroidal anti-Inflammatory drugs (NSAIDs), such as Aleve (naproxen) or Motrin (ibuprofen) can help mild pain.
  • Some healthcare providers may recommend using glyceryl trinitrate patches for Achilles tendinitis, an off-label use of nitric oxide. Nitric oxide may decrease pain or even improve healing in the area by encouraging the regrowth of connective tissue.
  • Injections directly into the heel area, such as steroids, platelet-rich plasma, or other therapies, may be beneficial.

Other Therapies and Exercises

If the Achilles tendinitis does not heal with these initial treatments, your healthcare provider may recommend moving on to other treatments, such as: 

  • Extracorporeal shockwave therapy (ECST): ECST uses energy shockwaves to promote healing in the damaged tissue. It may increase functioning and reduce pain by as much as 60%.
  • Eccentric loading exercises (ECC): ECC therapies are the gold treatment standard for Achilles tendinitis. ECC is a type of exercise therapy that stretches the muscle under tension.
  • Acupuncture: Acupuncture may help relieve symptoms of Achilles tendinitis.
  • Augmented soft tissue mobilization (ASTM): A healthcare provider, such as a physical therapist or a chiropractor, will use special tools to stimulate your body to regenerate and heal without damaging other healthy tissue. ASTM may help your body heal the tendon. 
  • Photobiomodulation: Light or laser therapy, may help your body regenerate healthy tissue to replace damaged tissue.
  • Surgery to remove damaged tissue or bone spurs: A surgeon removes the damaged tissue or bone, reattaches the healthy tendon tissue to the bone, and supports it with plastic or metal supports and stitches to keep the tendon in place.
  • Surgery to lengthen the calf muscles: This type of surgery may help if flexing your feet is difficult, even with stretching exercises.


You may prevent Achilles tendinitis from recurring, or prevent it in the first place, by following a few suggestions:

  • Switch to a sport that does not require repetitive use of the Achilles tendon. Jogging or sports that require a lot of running can cause or aggravate the condition. Consider trying a new sport that uses it less strenuously, such as swimming or bike riding.
  • Eccentric exercise therapy can help treat Achilles tendinitis or prevent it from becoming chronic.
  • Wear good supportive running shoes with plenty of cushioning in the heel.
  • If you run, start slow and increase the speed and distance gradually. 
  • Cool down and stretch after exercising.

Supplements and Herbs

Some herbs and supplements have been found to help heal or help prevent certain diseases or illnesses. Use herbs with caution, however. Some herbs are not safe for everyone. 

In sports medicine:

  • Ginseng: It’s sometimes used to enhance performance and endurance. 
  • Alkaloids: Supplementing with alkaloids seems to improve intense exercises such as sprinting or cycling.
  • Green tea extract: It may help increase body mass in athletes.

Certain herbs, such as Astragalus and Rhodiola, may help relieve joint and muscle pain.

Some herbs and supplements may interact with your medication or cause other health conditions to worsen. Use herbs with extreme caution and talk to your healthcare provider before starting a new herb, supplement, or alternative therapy. 

Foods and Drinks

Many vitamins, minerals, and other nutrients are necessary for optimal tendon and muscle health. They work together to keep your body strong, fight off infection, and regenerate damaged tissue.

Certain nutrients may improve tendon healing and regeneration, especially when used together and with an overall healthy diet. These include plenty of proteins, amino acids, and especially phytochemicals, which come from plant-based foods like vegetables, fruits, and whole grains.

Specific vitamins and minerals may be especially helpful to treat and manage Achilles tendinitis, including:

  • Vitamin C
  • Vitamin D
  • Manganese
  • Copper
  • Zinc

A Quick Review

Achilles tendinitis, the inflammation of the tendon connecting the heel bone to your calf muscles in your lower leg, can be painful and disrupt your normal activities.

Fortunately, treatments are available that can help your tendon heal and prevent the condition from recurring. This may include treatments as simple as rest and ice or as complicated as surgery.

Talk to your healthcare provider about the best treatments and therapies for you.

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6 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Pavone V, Vescio A, Mobilia G, et al. Conservative treatment of chronic achilles tendinopathy: A systematic review. JFMK. 2019;4(3):46. doi:10.3390/jfmk4030046

  3. Medina Pabón MA, Naqvi U. Achilles tendonitis. In: StatPearls. StatPearls Publishing; 2022.

  4. Kaplan K, Olivencia O, Dreger M, Hanney WJ, Kolber MJ. Achilles tendinopathy: an evidence-based overview for the sports medicine professional. Strength & Conditioning Journal. 2019;41(5):24-40. doi:10.1519/SSC.0000000000000485

  5. Sellami M, Slimeni O, Pokrywka A, et al. Herbal medicine for sports: A review. Journal of the International Society of Sports Nutrition. 2018;15(1):14. doi:10.1186/s12970-018-0218-y

  6. Curtis L. Nutritional research may be useful in treating tendon injuries. Nutrition. 2016;32(6):617-619. doi:10.1016/j.nut.2015.12.039

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