Your Achilles tendon connects your calf muscle to your heel bone. It takes the strain every time you walk, run or jump. When it hurts, the cause is usually one of a few problems, and telling them apart is the first step toward the right treatment.
Most Achilles pain comes from overuse. It often starts when you increase activity too fast, or don't rest enough between workouts. Over time, the strain can weaken the tendon.
Not every pain at the back of the heel comes from the tendon itself. Our doctors often find that what people call "Achilles tendonitis" is really another problem, like insertional tendinosis, an inflamed bursa or Haglund's deformity.
Where you feel the pain is the biggest clue. Pain in the middle of the tendon, a few inches above the heel, is usually Achilles tendonitis, which is covered below. Pain at the heel itself, or a sudden injury, points to one of these:
Pain right where the tendon attaches to the heel bone, often with a bump that hurts against the back of your shoe. It develops slowly and can involve bone spurs.
Insertional Achilles Tendinosis
A partial or complete tear, usually during a sudden push-off or landing. It's more likely in a tendon weakened by long-term problems.
A detailed guide to pain at the back of the heel, from bursitis and Haglund's deformity to the surgery used to repair a damaged tendon.
Pain around the sides of the ankle instead? See Tendon & Ankle Pain for other causes.
A sudden pop or snap at the back of the ankle, a feeling like you were kicked in the back of the leg, or sudden trouble pushing off can mean a torn tendon. Stop the activity and get checked as soon as possible. Early treatment helps the tendon heal.
Most Achilles problems are treated without surgery. Your podiatrist may recommend rest, ice, stretching and strengthening exercises, physical therapy, supportive shoes, heel lifts or custom orthotics. More painful cases may need a walking boot for a short time.
For tendon pain that doesn't improve, Dr. Beau Willis offers the TenJet procedure. It removes damaged tendon tissue through a small incision.
Some problems do need surgery, such as removing bone spurs and reattaching the tendon to the heel. A complete tear can be treated with surgery or with a boot or cast, depending on the injury and how active you are.
It's usually wise to cut back. Running through the pain can make it worse and raise the risk of a tear. Swimming or cycling can keep you active while it heals.
A brace, heel lift or walking boot can take strain off the tendon while it heals. They help most when combined with rest and the exercises your podiatrist recommends.
Mild cases often improve in a few weeks. Long-lasting tendon problems can take several months.
If your Achilles pain lasts more than a few days, keeps coming back or started with a sudden injury, a podiatrist can find the cause.
