Achilles Tendinitis: Symptoms, Treatment and Warning Signs

Oct 11, 2026 · Dr. Reza Mobarak

Achilles tendinitis is an overuse injury of the tendon at the back of the heel. It is common in runners and other active people, but it can affect anyone. Most people get better without surgery, though healing often takes a few months.

A sudden pop in the back of your heel or calf can mean the tendon has torn. The American Academy of Orthopaedic Surgeons (AAOS) advises seeing a doctor right away if this happens.

In the video above, Southwest Foot & Ankle Center, the Lewisville, Texas, practice of podiatrist Dr. Reza Mobarak, introduces Achilles tendinitis. The details below come from the medical organizations listed under Sources.

What the Achilles tendon does

The Achilles tendon, the body’s largest tendon, connects your calf muscles to your heel bone. You use it to push off when you walk, run, climb stairs, jump or stand on tiptoe.

In tendinitis, the tendon becomes irritated, swollen and painful, usually from repeated strain rather than one injury. There are two main types:

  • Noninsertional tendinitis affects the middle of the tendon. It’s more common in younger, active people.
  • Insertional tendinitis affects the spot where the tendon attaches to the heel bone. It can happen at any activity level, and bone spurs often form there.

Causes and risk factors

Tendinitis usually comes from overloading the tendon. Risk factors include:

  • suddenly exercising more, or harder
  • tight or weak calf muscles
  • running (especially on hard surfaces), jumping, dancing, or sports with quick stops and starts
  • exercising only now and then, as a “weekend warrior,” or a job that’s hard on the feet
  • unsupportive shoes, flat feet, or feet that roll inward
  • a bone spur at the back of the heel
  • arthritis, a more common cause in middle-aged and older adults

Symptoms

  • pain and stiffness along the tendon in the morning
  • pain that gets worse with activity, the day after exercise, or on stairs and hills
  • tenderness, swelling or warmth, sometimes with a thickened tendon
  • trouble standing on your toes

How it’s diagnosed

A doctor will ask about your symptoms, examine the tendon and check how well your ankle moves. Often the exam is enough. X-rays can show bone spurs, and ultrasound or MRI can show how much of the tendon is damaged.

Home care and treatment

MedlinePlus says the pain can take two to three months or longer to clear. First steps include:

  • Rest and change activities. Cut back on running, jumping and anything that hurts; try swimming or cycling instead.
  • Ice, covered with a cloth, never bare on the skin.
  • Over-the-counter anti-inflammatory pain relievers such as ibuprofen. Ask your doctor before using them if you have heart or kidney disease, high blood pressure or stomach ulcers, or for more than a month.
  • Shoe changes, such as supportive shoes, heel lifts or custom orthotics.
  • A night splint to keep the tendon gently stretched while you sleep.
  • A brace, walking boot or cast for a short time when pain is severe.

Stretching and physical therapy

Physical therapy is central to recovery. It may include:

  • Gentle calf stretches. Overstretching can injure the tendon.
  • Eccentric strengthening, in which you slowly lower your heel, usually started with a physical therapist. AAOS says these heel drops are mainly for noninsertional tendinitis and shouldn’t be done for the insertional type.
  • Other therapy, such as strengthening, soft-tissue massage, and retraining how you walk or run.

If symptoms continue, shockwave therapy, which uses sound waves, is another option. AAOS does not recommend steroid (cortisone) shots into the Achilles, because they can weaken it and make a tear more likely.

When surgery is considered

AAOS and Cleveland Clinic say surgery is usually considered only if pain continues after about six months of nonsurgical care. Depending on where and how badly the tendon is damaged, a surgeon may lengthen a tight calf muscle, remove damaged tendon tissue and bone spurs, or move a tendon from the big toe to reinforce the Achilles when more than half of it must be removed.

Most people do well, but rehabilitation can take up to a year, and lasting pain or wound infection can occur.

Warning signs of a torn Achilles tendon

Tendinitis can raise the risk of an Achilles tendon rupture, a partial or complete tear. Tears often happen with forceful jumping, pivoting or a sudden burst of speed. Steroids and fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, can also weaken the tendon; MedlinePlus advises calling your doctor right away about tendon pain while taking one.

Signs of a tear include:

  • sudden pain in the back of the ankle or calf, often compared to a kick or a stab
  • a pop or snap at the moment of injury
  • swelling between the heel and calf
  • trouble walking, or not being able to rise up on your toes

Get medical care right away if you notice these signs. Until you’re seen, the American College of Foot and Ankle Surgeons advises staying off the leg, using a covered ice pack, wrapping it with an elastic bandage and keeping it raised. AAOS notes that surgical repair, when needed, works best soon after the injury.

When to see a doctor

See a podiatrist or other doctor if rest and ice don’t help. The American Podiatric Medical Association suggests going if pain lasts more than a week, and MedlinePlus if symptoms worsen or two weeks of self-care hasn’t helped. Lingering tendinitis is harder to treat.

Prevention

  • Keep your calves strong and flexible, and stretch them gently after warming up.
  • Build up workouts gradually, and mix up your activities.
  • Wear supportive shoes that suit your feet and your activity.
  • Stop and rest at the first sign of Achilles pain.

Questions to ask your doctor

  • Is this tendinitis, or could my tendon be torn?
  • Is it insertional or noninsertional, and does that change my treatment?
  • Which activities should I avoid, and how can I stay active while it heals?
  • Should I see a physical therapist, and which exercises are safe for me?
  • Could any of my medicines affect my tendons?
  • When would surgery be an option, and how long would recovery take?

Dr. Mobarak is a podiatrist and foot and ankle surgeon at Southwest Foot & Ankle Center in Lewisville, Texas. See Dr. Mobarak’s Best Docs Network profile for more about the practice.

Sources

This article is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.

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