Achilles Tendinitis – Diagnosis and Treatment
Diagnosis
Doctors usually turn to imaging tools when you show up with pain in the back of your ankle. They want to figure out if you’re dealing with inflammation, overuse, or actual damage to the Achilles tendon.
Physical Exam
Your doctor will:
- Feel along the tendon for tenderness, swelling, or thickening
- Check your ankle flexibility and strength
- Ask you to do movements like heel raises or walk on your toes
- Look for signs of insertional Achilles tendonitis, where pain occurs right at the tendon’s attachment to the heel bone
Imaging Tests
If needed, your doctor may order imaging tests to confirm the diagnosis or rule out other conditions like tendon tears or bursitis.
You’ll probably hear about these imaging methods:
| Imaging Method | What It Can Show |
|---|---|
| X-ray | Spots bone spurs or changes to the heel bone (calcaneus). It can’t show tendons but helps rule out other causes. |
| Ultrasound | Uses sound waves to check tendon structure. Shows swelling, tears, or extra blood flow that comes with inflammation. It even lets them see the tendon as your foot moves. |
| MRI | Gives a detailed look at soft tissue. It reveals how much tendon damage, inflammation, or calcification you might have, especially in tricky cases. |
Doctors put together what they find on imaging with your physical exam results. This helps them confirm whether it’s Achilles tendonitis, identify if it’s the insertional type near the heel, and plan the best treatment.
Treatment
You can do a few simple things to ease discomfort and help healing along. Rest matters—taking breaks from running or tennis puts less strain on your Achilles tendon.
Try low-impact activities like swimming or gentle walks. If you use ice on the area for about 15 minutes after activity or when it hurts, you can bring down swelling.
Wrap an elastic bandage around your ankle for compression. That limits swelling and keeps the tendon from moving too much. Elevate your foot above your heart—even when you sleep—to help further.
Wearing comfortable shoes or using heel lifts can support your foot. Gentle stretches and calf exercises improve flexibility, too.
Here’s a quick look at helpful steps:
| Self-Care Step | Benefit |
|---|---|
| Rest | Reduces strain |
| Ice | Lowers swelling |
| Compression | Supports tendon |
| Elevation | Limits inflammation |
Over-the-counter meds like ibuprofen or naproxen can ease pain and bring down swelling. These belong to the group called non-steroidal anti-inflammatory drugs (NSAIDs).
Physical therapists focus on stretching and strengthening exercises to help your tendon recover. Eccentric exercises—where your muscle lengthens while working—often work best. Therapists might recommend heel lifts or shoe inserts to reduce stress on your tendon. Wearing good shoes adds support.
When symptoms stick around for months, doctors might talk to you about surgery. Here are the main options:
| Surgery Option | Purpose |
|---|---|
| Debridement and repair | Removes damaged tissue |
| Tendon transfer | Adds healthy tissue if needed |
| Gastrocnemius recession | Lengthens the calf muscle to reduce strain |
Most people get better with conservative treatment. Severe injuries might require surgery, and recovery can take longer.
Getting Ready for Your Visit
It’s worth getting things organized before your appointment. Jot down when your pain or swelling started, and whether it came on suddenly or gradually.
Make a note if you feel tenderness, irritation, or thickening of the tendon, especially if it gets worse at certain times or after activities like exercise.
List out all the medicines and supplements you’re taking. Think about which shoes you use for physical activity, especially if your heel or Achilles tendon feels sore.
Questions the Healthcare Provider Might Ask
Your healthcare provider will probably ask where it hurts and how bad the pain feels. They’ll want to know if resting makes the discomfort fade, or if you ever feel sharp pain or spot any warning signs of degeneration.
They might ask if you’ve changed up your routine lately—maybe you started a new sport, switched your workouts, or tried out new shoes. Let them know what you’ve done to help with the pain or swelling, like icing or just taking it easy.
| Symptom | Notes to Track |
|---|---|
| Pain | When it started |
| Swelling | How it changes |
| Bone spurs | If present |
| Muscle tightness | When noticed |
Don’t forget to mention if you’ve hurt your Achilles tendon before. If you’ve noticed bone spurs or the tendon seems thicker than usual, bring that up too.
