Achilles Tendinosis



The exact cause of achilles tendinopathy is not known. It is thought to be from overuse from:

  • Increasing speed or running long distances too quickly
  • Suddenly adding hills or stair climbing to an exercise routine
  • Stressing the calf muscles too soon after taking time away from exercising
  • Putting sudden stress on the calf muscles when they are not ready for stress

Risk Factors

Achilles tendinopathy is more common in men and older adults. Other things that may raise the risk are:

  • Certain lower leg problems, such as lack of flexibility, poor range of motion, or a foot that turns inward too much
  • Certain health problems, such as obesity and diabetes
  • A poor training program, such as activity on hard surfaces or hills
  • Wearing poor footwear
  • Certain medicines, such as corticosteroids



Symptoms of achilles tendinopathy may include:

  • Pain and stiffness above the heel bone
  • Problems that happen when bearing weight after rest, such as after sleeping
  • Swelling at the tendon
  • Problems wearing shoes
  • Decreased strength in the tendon


The doctor will ask about symptoms and past health. The person will be asked about the activities they do. A physical exam will be done. It will focus on the lower leg. This is often enough to diagnose achilles tendinopathy.

If the diagnosis is unclear, images may be taken. This can be done with:

  • X-rays
  • MRI scan
  • Ultrasound



Treatment depends on the tendon and how badly it is damaged. Options are:

  • Supportive care with rest and ice
  • Ankle taping to support the tendon
  • Shoe inserts
  • Medicines to ease pain and swelling
  • Physical therapy
  • Extracorporeal shockwave therapy (ESWT) to stimulate healing

Some people may need surgery when other methods do not help.


Achilles tendinopathy may be prevented by:

  • Wearing proper footwear
  • Slowly increasing activities
  • Stretching and strengthening the calf muscles

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.