Early symptoms of Achilles tendinitis

The early symptoms of Achilles tendinitis include pain that starts as a mild ache in the back of the leg or above the heel after running or performing other sporting activities. More severe pain can be a result of prolonged running, stair-climbing, or sprinting. Tenderness and stiffness are also possible, in particular in the morning.

Achilles tendinitis symptoms include:

  • Sore Achilles tendon a few inches above where it meets the heel bone.
  • Stiff lower leg.
  • Slow and weak lower leg.
  • Slight pain in the back of the leg after running or exercising.
  • Pain in the Achilles tendon while running or a couple of hours afterward.
  • Greater pain when running fast for a long time.
  • Swollen and warm Achilles tendon.
  • Achilles tendon creaks when touched or moved.
  • Trouble standing up on one toe.

This condition occurs when the Achilles tendon – the band of tissue connecting the calf muscles to the heel bone, which is used when walking, running, jumping, or pushing up on one’s toes – is subjected to repetitive or intense strain.

Causes of Achilles tendinitis include the following:

  • Running with incorrect or worn out shoes.
  • Lack of warming up before exercise.
  • Increasing intensity of exercise too quickly.
  • Prematurely adding hill running or stair climbing to exercise routine.
  • Running on hard or uneven surfaces.
  • Calf muscle is injured or not flexible.
  • Sudden intense physical activity; e.g., sprinting for the finish line.
  • Jumping a lot.

Achilles tendinitis is common in walkers, runners, and other athletes. In addition to that,

  • Men experience Achilles tendinitis more often than women.
  • The structure of the tendon weakens with age.
  • A naturally flat arch in the foot can put more strain on the Achilles tendon, as do obesity and tight calf muscles.
  • People with psoriasis or high blood pressure have an increased risk of suffering from Achilles tendinitis.
  • Antibiotics known as fluoroquinolones have been linked to higher rates of Achilles tendinitis.

Tendinitis of the heel can lead to a degenerative condition called Achilles tendinosis, where the structure of the tendon becomes susceptible to an Achilles rupture or tear – a sharply painful injury that requires surgery. Fortunately, most treatment options for Achilles tendinitis do not involve a surgical procedure. And while tendinitis tends to respond well to self-care – such as applying a cold pack on the affected area for 15-20 minutes – it isn’t a bad idea at all to see a doctor about it. The doctor will press gently on the affected area during a physical exam to establish the location of pain, as well as tenderness or swelling. The physician will also assess flexibility, alignment, range-of-motion, and reflexes in the foot and ankle, and may order x-rays, ultrasound, or magnetic resonance imaging tests.

Achilles tendinitis treatments

Changes in activity

  • Decrease or stop activities that cause pain.
  • Run or walk on smoother and softer surfaces.
  • Switch to biking, swimming, or other activities that exert less stress on the Achilles tendon.
  • Alternate between high and low impact exercises


  • Specific stretching and strengthening exercises.
  • "Eccentric" strengthening

Changes in footwear

  • A brace, boot or cast to keep the heel and tendon still and allow the swelling to subside.
  • Placing heel lifts in the shoe under the heel.
  • Shoes that are softer in the areas over and under the heel cushion.
  • An orthotic device such as shoe inserts, wedges, and arch supports.

Nonsteroidal anti-inflammatory drugs (NSAIDs)


Related: 4 Common Ankle and Foot Injuries