Achilles tendonitis is inflammation of the Achilles tendon, the thick cord of tissue that connects your calf muscles to your heel bone and powers walking, running, and jumping. It typically develops from repeated overuse rather than a single injury, and it responds well to conservative treatment — especially when addressed early, before a nagging ache becomes a more serious tear.
Because the Achilles tendon absorbs so much force with every stride, it is also one of the most commonly overused structures in the body. Our podiatrists in Farmington and South Ogden see this condition often, in weekend athletes and lifelong runners alike. Below, we break down what causes it, how to recognize it, and the treatment options that work.
What is Achilles tendonitis?
The Achilles tendon is the largest tendon in the body, running from the calf muscles down to the heel bone. It is essential for nearly every lower-body movement — walking, running, jumping, and even standing on your toes. Achilles tendonitis occurs when repeated stress causes the tendon's fibers to become irritated and inflamed, often alongside small-scale degeneration in chronic cases.
Left untreated, ongoing irritation can weaken the tendon over time and increase the risk of a partial or complete tear, so it's worth taking early symptoms seriously.
What are the symptoms of Achilles tendonitis?
Most people notice stiffness and discomfort in the back of the heel and lower calf, especially first thing in the morning or after a period of rest. Common signs include:
- Stiffness or aching along the back of the heel, worse in the morning
- Pain that intensifies with uphill walking, running, or climbing stairs
- Swelling around the tendon that may build throughout the day
- A thickened, "cord-like" feel to the tendon
- Tenderness to the touch just above the heel bone
If you notice a sudden, sharp pain accompanied by a popping sensation, that can signal a tendon tear rather than tendonitis — seek evaluation right away.
What causes Achilles tendonitis, and who is at risk?
Achilles tendonitis is most often caused by overuse and repetitive stress, which is why it is so common among runners and other athletes who ramp up training too quickly. Other contributing factors include:
- Sudden increases in running distance, intensity, or hill work
- Trauma or sudden, forceful movements that strain the tendon
- Chronic conditions such as arthritis and naturally tight calf muscles
- Biomechanical issues, including flat feet or high arches that change how load travels through the tendon
- Worn-out or unsupportive footwear
Because tight calves and poor arch support contribute to both conditions, Achilles tendonitis frequently overlaps with plantar fasciitis and general heel pain.
How is Achilles tendonitis diagnosed?
Diagnosis usually starts with a physical examination, where your podiatrist checks for tenderness, swelling, thickening, and range of motion in the ankle. Imaging — typically ultrasound or MRI — can confirm the degree of inflammation and rule out a partial tear or degeneration within the tendon fibers.
How is Achilles tendonitis treated?
The majority of cases improve with conservative care, so treatment typically starts there and escalates only if symptoms persist.
Nonsurgical treatment
- RICE method — rest, ice, compression, and elevation — to calm acute inflammation
- Activity modification to reduce the repetitive strain driving the irritation
- Anti-inflammatory medications to manage pain and swelling
- Supportive bracing or heel lifts to reduce tension on the tendon
- Physical therapy — the cornerstone of recovery, combining stretching, eccentric strengthening exercises, and balance training
- Custom orthotics to correct biomechanical issues contributing to the strain — see our custom orthotics options
Surgery
Surgery is reserved for severe cases that do not respond to an extended course of conservative treatment, or for tendons with significant tearing or degeneration. Procedures may involve removing damaged tissue or repairing a tear, depending on what imaging and examination reveal. Our physicians always exhaust nonsurgical options first.
Why early treatment matters
Achilles tendonitis tends to respond best when it is caught early, before repetitive strain leads to more significant tendon damage. Prevention also matters — supportive footwear, gradual training progressions, and custom orthotics for those with biomechanical risk factors can go a long way toward keeping the tendon healthy.
See a podiatrist if heel and calf stiffness lasts more than a week or two of rest and activity modification, keeps returning, or limits your normal activities. Seek care sooner if you experience sudden, sharp pain, a popping sensation, or an inability to bear weight, as these can indicate a tear. When you're ready, you can request an appointment at either of our Northern Utah offices.
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 article is for general education and is not a substitute for an in-person evaluation.