Sports Medicine: Achilles Tendonitis

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Achilles tendonitis is an injury of the Achilles tendon (back of ankle). This tendon, sometimes called the ‘heel cord’, attaches the calf muscle to the heel. It is important for standing on your toes or for push-off during walking, running or jumping.

Signs and Symptoms

  • pain, tenderness, and sometimes swelling over the back of the ankle
  • pain when pushing off or pushing down with toes
  • pain when standing on the ball of the foot or toes
  • a cracking sound when the tendon is moved or touched

Increased Risk

  • sports that require sudden and tense calf muscle contractions (jumping, acceleration or kicking)
  • poor physical conditioning (strength, flexibility and endurance)
  • poor warm-up before activity
  • obesity
  • previous injury to ankle, lower leg or back of ankle


  • Use of cold and heat
    • Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
    • Heat may be used before doing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
  • Medicine
    • Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
    • Other minor pain relivers, such as acetaminophen (Tylenol®), may be used.
  • Rest
    • Rest or decreased activity should help decrease pain and swelling.
  • Orthopedic aids
    • A cast or walking boot may be recommended in severe cases to limit activity and improve pain.
    • A heel lift or arch support (orthotic) may be used in some cases.
  • Rehab
    • Rehab with a physical therapist or athletic trainer can increase flexibility and strength, decrease pain and help the athlete return to activity.

How to Prevent

  • Do correct warm-up and stretching before practice or competition and use proper technique.
  • Taping or bracing may be recommended after healing completes.
  • Maintain suitable physical conditioning (flexibility, strength, endurance and cardiovascular fitness).

When to Call the Health Care Provider

Call your health care provider or the Sports Medicine team at 614-355-6000 if:

  • symptoms get worse or do not improve after 2 weeks despite treatment
  • new, unexplained systems develop 

Sports Medicine: Achilles Tendonitis (PDF)

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