What is Achilles tendonitis?
Achilles tendonitis is inflammation of the Achilles tendon, the thick band of tissue that runs along the back of the lower leg and connects the calf muscle to the heel bone. This tendon is what allows you to rise up onto your toes and push off with each step, so it comes under significant load during walking, running, and jumping. When that load exceeds what the tendon can comfortably handle, the tissue becomes irritated and inflamed.
Achilles tendonitis and Achilles tendonosis are related but distinct conditions. Tendonitis refers to short-term inflammation, while tendonosis describes a more chronic, degenerative change in which the tendon loses its normal organized structure and is prone to developing microscopic tears. If inflammation is not addressed, it can progress toward this more chronic pattern over time, and in advanced or neglected cases the tendon is at greater risk of rupture. Because heel and ankle pain can stem from more than one structure, our heel pain guide can help you compare symptoms if you are not sure what you are dealing with.
What are the symptoms of Achilles tendonitis?
The most common symptom is pain or stiffness along the length of the Achilles tendon that is often worse after periods of rest and eases somewhat with gentle movement. Symptoms tend to build gradually rather than appear suddenly. Common signs include:
- Pain or stiffness along the back of the leg, above the heel
- Tenderness when squeezing the sides of the tendon
- Discomfort that is worse in the morning or after sitting for a while
- Aching or soreness after running, jumping, or other repetitive activity
- Swelling, thickening, or the development of small nodules along the tendon in more advanced cases
What causes Achilles tendonitis, and who is at risk?
Achilles tendonitis is generally an overuse injury, caused by a sudden increase in the amount or intensity of repetitive activity that stresses the tendon beyond what it is conditioned for. It is common among runners and other athletes, but also affects laborers and weekend athletes who ramp up activity too quickly. Factors that raise your risk include:
- A sudden increase in running mileage, hill work, or jumping activity
- Tight calf muscles that increase strain on the tendon
- Overpronation, or excessive flattening of the arch while walking or running
- Wearing worn-out or unsupportive footwear
- Physically demanding jobs that involve repetitive stress on the lower leg
- Returning to activity too quickly after a period of inactivity
Because overpronation and poor arch support are frequent contributors, flat feet and plantar fasciitis often occur alongside Achilles tendon problems.
How do we diagnose Achilles tendonitis?
We diagnose Achilles tendonitis with a hands-on examination of the foot and ankle, including an assessment of your range of motion and a review of your activity history and symptoms. Your podiatrist will check the tendon along its length for tenderness, thickening, or nodules that can indicate how advanced the condition is.
Imaging studies such as ultrasound or MRI may be used to determine the severity of the condition and to distinguish tendonitis from tendonosis or a partial tear. Establishing an accurate diagnosis helps guide how aggressively treatment needs to proceed.
How is Achilles tendonitis treated?
Most cases of Achilles tendonitis respond well to nonsurgical treatment, particularly when addressed early. We build a plan around calming inflammation first, then restoring strength and flexibility to prevent recurrence.
Nonsurgical treatment
- Immobilization with a cast or walking boot to rest the tendon in more significant cases
- Ice therapy to reduce pain and inflammation
- NSAIDs and other medications for pain management
- Custom orthotics to correct mechanics that overload the tendon — see our custom orthotics options
- Night splints to maintain a gentle stretch on the tendon
- Physical therapy focused on stretching and progressive strengthening of the calf and tendon
Surgery
Surgery is reserved for cases that do not respond to a thorough course of conservative treatment, or for more advanced tendonosis or tears. Our physicians will always exhaust nonsurgical options first and walk you through the risks and benefits before recommending an operative approach.
What is recovery from Achilles tendonitis like?
Recovery timelines vary depending on how long you have had symptoms and how advanced the tendon changes are, but consistent stretching, gradual return to activity, and supportive footwear are the biggest factors in a lasting recovery. Rushing back into high-impact activity before the tendon has fully calmed down is the most common reason symptoms return.
If immobilization or a structured physical therapy program is part of your plan, we will give you specific guidance on when and how to progress your activity so you can return to running, sports, or your normal routine with confidence.
When should you see a podiatrist for Achilles pain?
See a podiatrist if pain or stiffness along your Achilles tendon lasts more than a week or two, keeps returning after activity, or limits what you can do. Early treatment helps prevent a manageable case of tendonitis from progressing into chronic tendonosis or a more serious injury.
Seek care promptly if you experience sudden, severe pain at the back of the heel, an audible pop, or an inability to rise onto your toes — these can be signs of a tendon rupture and need urgent evaluation. When you are ready, you can request an appointment at either of our Northern Utah offices.
Wasatch Foot & Ankle Institute is a locally rooted podiatry practice serving Farmington, South Ogden, and the surrounding Davis and Weber County communities. Our board-certified, fellowship-trained physicians focus exclusively on the foot and ankle, from everyday tendon strain to complex reconstructive care.
That focus lets us offer the full range of Achilles tendonitis care under one roof — from custom orthotics and physical therapy to immobilization and, when needed, surgical repair — so your care can advance without a referral elsewhere. We treat patients from both of our clinics; learn more about our Farmington and South Ogden locations or call the office nearest you.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This page is for general education and is not a substitute for an in-person evaluation.
