Achilles Tendinopathy

Achilles Tendonitis / Tenosynovitis / Tendinopathy is severe swelling or inflammation of the Achilles tendon. A tendon is a thick flexible band of tissue that attaches bone to muscle. The Achilles tendon is the strongest and thickest tendon in the body and is found just behind and above the heel. It joins the calf muscles, the gastrocnemius and soleus, to the heel bone "calcaneum". The Achilles tendon helps to bend the foot downwards at the ankle. It is used for walking, running, jumping, standing on the toes, etc. Achilles Tendonitis is when the tendon that connects the back of the leg to the heel becomes swollen or inflamed, causing stiffness and weakness of the tendon and pain towards the bottom of the foot.

It is commonly present in runners and those participating in other running sports.

Causes or Possible Risk Factors

  • Repeated tiny injuries (known as micro trauma) to the Achilles tendon
  • Excessive mileage
  • Sudden increase in the amount or intensity of an activity
  • Decreased recovery time between hard workouts
  • Starting up too quickly after not exercising
  • Training or exercising wearing inappropriate footwear (e.g. shoes without proper support)
  • Training or exercising on hard or sloped surfaces (such as concrete, uphill terrain, stairs etc.)
  • Having insufficient or poor flexibility (for example, having tight or underdeveloped hamstrings (thigh) muscles)
  • Misalignment
  • Leg length discrepancy
  • Pes cavus (flat foot)
  • Lateral ankle instability
  • Wearing of high heels, which shorten the tendon and calf muscles
  • Muscle weakness
  • Muscle imbalance
  • Frequent running
  • Frequent jumping (such as when playing basketball)
  • Sudden movement of the feet turning in or out
  • Overpronation (rolling in) of feet when running
  • Age (>35 years old)
  • Increased body weight and height
  • People who are taking drugs from a group called fluoroquinolones for long periods also have an increased risk of developing Achilles tendinopathy


  • Pain, tenderness, weakness and/or stiffness around the affected Achilles tendon including the bottom of the calf
  • Pain and stiffness that tend to develop gradually and are usually worse when waking up in the morning
  • Pain after exercise
  • Pain when the area around or the middle of the Achilles tendon is touched
  • Swelling or tenderness of the tendon
  • Pain in the heel and along the tendon when walking or running
  • Trouble standing up on one toe

** If you get a sudden pain in your heel or calf and your heel becomes swollen bruised and painful, you may have completely torn your Achilles tendon. If this happens, you must seek urgent medical attention. **

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