Why is my heel sore?
Jason Lake, MD, an orthopedic surgeon at Banner Gateway Medical Center in Gilbert.
Question: My Achilles tendon is sore, but I don't remember injuring it. Should I be worried?
Answer: The most common conditions causing pain near the Achilles' tendon are Achilles' tendinitis/peritendinitis and Achilles' tendinosis.
Achilles' tendinitis is inflammation of the tissue surrounding the tendon, and thus is actually a peritendinitis. The tendon itself is not inflamed, despite the confusing name. This often occurs in people who have changed their training program (such as adding hills) or increased activity too rapidly after a break. It is related to overuse.
Achilles' tendinosis is caused by degenerative changes or injuries to the tendon. The tendon, or its insertion on the heel bone, may become thickened with abnormal tissue. It is usually seen in middle-age or older people and can be associated with obesity, high blood pressure and diabetes. Overuse may be present.
Symptoms may be similar for both conditions. These include pain along the tendon or on the back of the heel bone, swelling and sometimes a limp. Pain is often worse when first trying to walk after sitting or lying down. Tendinitis may have a more rapid onset of symptoms.
Treatment always should begin with a conservative program that may include rest, immobilization, stretching, ice, anti-inflammatory medications, shoe inserts and weight loss (if applicable). Second-line treatment may include splinting, orthotics to correct foot deformities or physical therapy. Surgery and other experimental treatments are only considered as a last resort.
Discuss your symptoms with your physician as several conditions may have a similar presentation.