Better Me

That Pain at the Back of Your Foot Could Be Achilles Tendonitis

You probably learned about your Achilles tendon back in school. It’s the tendon on the back of your leg that connects your calf muscle to your heel bone. Thanks to Greek mythology, it may be the most well-known tendon in the body. Legend has it that Achilles’ mother held onto his body by that tendon and dipped him in the river Styx to protect him from injury. The only place he was vulnerable was that tendon where her fingers gripped. That’s why today, we refer to the Achilles heel as a point of weakness.

You may empathize with Achilles if you have Achilles tendonitis. That’s when pain strikes suddenly along the tendon or the point where it connects to the heel. It’s a condition with a name that can be a bit misleading. While “-itis” refers to inflammation, inflammation in the tendon might not be the reason you have pain. You may also hear people use the phrase “Achilles arthritis,” but that’s inaccurate. Arthritis refers to conditions that affect bones, not tendons.

Here’s what causes Achilles tendonitis

You might develop this condition if you start walking, running or jumping a lot more than you’re accustomed to. “Achilles tendonitis is often caused by a sudden change in activity, especially activities that require a lot of calf activation,” said Lela Stemple, a physical therapist at Banner Health. “For example, it is common after starting a new workout that involves jumping jacks if you haven’t done them since you were a kid or deciding that you are going to run five miles for the first time in 10 years.”

Here’s how to prevent Achilles tendonitis

Stemple said you can do two key things to prevent the condition:

  • Introduce new exercises slowly and gradually
  • Make sure your muscles are strong enough to handle any new activity you’re asking of them

Stretching is important too but stretching alone won’t prevent Achilles tendonitis. “If your muscles aren’t strong, it doesn’t matter how flexible they are. They won’t be able to support your body,” Stemple said.

Here are some symptoms you might notice

Along with tendon or heel bone pain, you might notice swelling or fluid buildup in the area. You’ll probably feel the pain when you bring your foot forward toward you, point your toes or do a heel raise, since these motions put tension on the Achilles tendon.

Here’s how it’s diagnosed

A physical therapist or orthopedic physician can diagnose Achilles tendonitis with a medical history and physical exam. X-rays don’t help, since X-rays show changes in your bones, not your soft tissues. “If you have X-rays or other imaging tests that show bone spurs, it doesn’t necessarily mean the bone spurs are what’s causing your pain,” Stemple said.

Here’s how you can treat it

A few different options can help you heal:

  • Gentle exercise. You’ll want to limit painful activity until your symptoms subside. But you don’t need to stop all activity — that will just reduce your strength without relieving the pain. “If running hurts but walking feels fine, go walking,” Stemple said. “Exercise is the best medicine. It’s important to stay strong.”
  • Physical therapy. Your therapist may prescribe easy range-of-motion, stretching and strengthening exercises.
  • Medication. Talk to your doctor about pain relief and anti-inflammatory medications that can help. Your doctor can help evaluate which are best, especially if you take other medications.

As your pain subsides, don’t overdo it. Return to your regular activity gradually and build in any increases in your workouts slowly.

Is Achilles tendinitis the same as Achilles tendinosis?

No, they are different medical conditions that affect the same area. Achilles tendinosis is chronic pain that’s not linked with swelling or inflammation. Pain that lasts more than 10 days may stem from Achilles tendinosis, and this condition can mean you have changes in the structure of your tendon.

The bottom line

Pain in your Achilles tendon, or the spot where it attaches to your heel, could be caused by Achilles tendonitis. Scaling back your activity, physical therapy exercises and medication can help you get back on your feet. To connect with a health care provider who can diagnose and treat your heel or foot pain, reach out to Banner Health. 

Other useful articles:

Orthopedics Sports Medicine