What is Achilles Tendonitis?
Achilles tendonitis is an overuse injury affecting the Achilles tendon, the thick, fibrous cord that connects the muscles in the back of your calf to your heel bone. The condition is characterised by inflammation, pain, and stiffness in the area of the tendon, usually caused by repetitive stress or excessive loading. Achilles tendonitis is a common issue in athletes, particularly those involved in running or high-impact sports, but it can also occur in people who are not athletically active.
There are two types of Achilles tendonitis, based on which part of the tendon is inflamed.
Insertional Achilles Tendonitis
Affects the lower part of the tendon where it attaches to the heel bone. This type can occur even in people who are not active and is often associated with heel spurs.
Non-insertional Achilles Tendonitis
Affects the middle portion of the tendon, typically in younger, active people. In this type, the fibres in the middle of the tendon break down with tiny tears, swell, and thicken.
What Causes Achilles Tendonitis
- Overuse: Rapidly increasing the intensity, duration, or frequency of exercise.
- Biomechanical Issues: High arches, flat feet, or tight/weak calf muscles.
- Poor foot function: When the foot pronates (“rolls inwards”) excessively, it can create increased traction or over-stretching of the Achilles tendon. This results in increased shearing forces on the tendon which commonly leads to inflammation and pain. Often a lumpy build-up of scar tissue occurs.
- Footwear: Running in worn-out or unsupported shoes.
- Age and Health: More common with increasing age and associated with conditions like high blood pressure, high cholesterol, or diabetes.
- Medications: Certain antibiotics, such as fluoroquinolones
Symptoms of Achilles Tendonitis
- Pain and Stiffness: Pain is typically felt at the back of the heel or slightly higher (mid-portion) and is often most severe during the first steps in the morning or after rest.
- Swelling and Thickening: The tendon may appear swollen, warm, or develop a noticeable bump.
- Activity-Related Pain: Pain often improves after warming up, but worsens again after intense or long-duration activity.
- Reduced Function: Difficulty walking, running, or standing on
- Limited ankle flexibility and inflammation over the affected area are often present.
Achilles Tendonitis in Children
Achilles tendonitis is less commonly found in children than in adults, but it can occur, especially in young athletes or active kids (Sever’s Disease). Overuse or intense physical activity can put stress on the Achilles tendon and lead to inflammation and pain. Children who participate in sports like soccer, basketball, or track and field may be more susceptible to Achilles tendonitis.
Common Podiatry Treatments & Services for Achilles Tendonitis
Exercise Rehabilitation: Focusing on slow, and repetitive stretching & strengthening exercises (e.g., calf raises) is critical for tendon healing. Your podiatrist will advise you on appropriate exercises.
Activity Modification: Temporarily reducing high-impact activities like running and jumping, while resting or substituting with low-impact options like swimming.
Load Management: Utilising heel lifts in shoes or wearing shoes with a slight heel to reduce strain and compression on the tendon.
Orthotics: By preventing the feet from rolling inwards through the use of orthotics (custom-made shoe inserts), this reduces the over-stretching and traction on the Achilles tendon, therefore alleviating the problems.
Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain, though they do not heal the tendon structure.
Ice: Applying ice packs for 15 minutes to reduce pain and swelling, especially after activity.
Additional Therapies
- Shockwave Therapy (ESWT): A highly effective, non-invasive treatment that uses sound waves to stimulate healing, often combined with exercise.
- Manual Therapy: Massage and soft tissue work to reduce tension.
- Taping: Using strapping to provide support, reduce tension, and alleviate pain.
- Surgery: Only considered if symptoms do not improve after 3–6 months of conservative treatment
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Ready to fix your Achilles Pain?
For treatment of your Achilles pain consult Galleria Podiatry for a diagnosis and a tailored treatment plan. If you’re located in Morley and near Bayswater, Galleria Podiatry provides specialised care for foot and ankle issues for all patients in the City of Bayswater.
Your Achilles Tendonitis Questions Answered
What's the difference between insertional and non-insertional Achilles tendonitis?
Insertional Achilles tendonitis affects the lower portion of the tendon where it attaches to the heel bone and can occur even in people who aren’t physically active. It’s often associated with bone spurs and tends to be more common in older adults. Non-insertional Achilles tendonitis affects the middle section of the tendon and typically occurs in younger, more active individuals. This type involves small tears in the tendon fibres that cause swelling and thickening. At Galleria Podiatry, we can diagnose which type you have and develop an appropriate treatment plan.
How long does it take for Achilles tendonitis to heal?
Recovery time varies depending on the severity of your condition and how quickly you seek treatment. Mild cases may improve within a few weeks with rest and appropriate care, whilst moderate to severe cases can take several months to heal completely. Chronic Achilles tendonitis that has been left untreated may take six months or longer to resolve. The key to faster recovery is early intervention and following your podiatrist’s treatment plan consistently. At Galleria Podiatry, we’ll assess your specific situation and provide a realistic timeline for your recovery.
Can I continue running or exercising with Achilles tendonitis?
Continuing high-impact activities like running whilst you have Achilles tendonitis can worsen the condition and delay healing. It’s best to rest from activities that cause pain and switch to low-impact exercises such as swimming, cycling, or using an elliptical machine to maintain fitness. Once your symptoms improve, you can gradually return to running under guidance from your podiatrist at Galleria Podiatry. We’ll help you develop a safe progression plan that includes proper warm-up routines, appropriate footwear, and monitoring to prevent re-injury.
What are the warning signs that my Achilles tendonitis is getting worse?
Warning signs include increasing pain that doesn’t improve with rest, pain that occurs even during normal walking or at rest, significant swelling or a noticeable lump on the tendon, reduced ankle flexibility, or a creaking sensation when moving the ankle. If you notice the skin becoming warm or red, or if you hear a sudden pop or snap in the tendon area, seek immediate medical attention as this could indicate a partial or complete tear. At Galleria Podiatry, we recommend early assessment if you notice any of these symptoms to prevent progression to a more serious injury.
Will I need custom orthotics for my Achilles tendonitis?
Custom orthotics are often highly effective for treating Achilles tendonitis, especially when the condition is caused by excessive foot pronation (rolling inwards). Orthotics help control abnormal foot motion, reduce over-stretching of the Achilles tendon, and decrease traction forces on the tendon. During your assessment at Galleria Podiatry, we’ll evaluate your foot biomechanics and gait pattern to determine if custom orthotics are appropriate for your situation. Many patients experience significant pain relief and faster recovery when orthotics are part of their treatment plan.
