Medical Library: Foot & Ankle – Achilles Tendon

The two most common conditions related to the Achilles tendon are tears and tendonitis.

Achilles tendonitis is the irritation and inflammation of the large tendon in the back of the ankle and lower leg, and is a common condition among recreational athletes. When the Achilles tendon is overused or improperly used, inflammation leading to pain and swelling may result.

Achilles tendonitis usually stems from a lack of flexibility or overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often, long distance runners will have symptoms of Achilles tendonitis after changing their workout routine, such as increasing their mileage or increasing the amount of hill training they are doing.

In most cases, Achilles tendonitis leads to pain behind the heel. The pain is often most prominent just above where the tendon attaches to the heel. When patients are inactive for a period of time, for example in the morning just after waking up, the pain tends to be most significant. Patients may also experience pain while running or jumping, or other activities that put strain on the tendon. The pain associated with exercise is most significant when pushing off or jumping.

An Achilles tendon tear occurs when the Achilles tendon, which connects the calf muscle to the heel is completely torn. This is a relatively common injury, seen often in men ages 30-40 who are involved in weekend sports and simply push themselves too far. When an Achilles tendon tears or ruptures, sudden pain is felt behind the ankle, and many patients may hear a ‘pop’ or a ‘snap,’ and will almost always say they feel as though they have been kicked in the heel. They will experience swelling and bruising, difficulty pointing their toes downward, and may be unable to walk without severe pain.

Some patients who have Achilles tears have symptoms of Achilles tendonitis prior to experiencing the tear, but most have no history of prior Achilles tendon problems.