Achilles Tendinitis Home A-Z Health Information Health Library A-Z Achilles Tendinitis Overview The Achilles tendon, which is the largest and strongest tendon in the body, connects the calf muscles to the heel bone. It is essential for activities like walking, running, and dancing. Achilles tendinitis is the inflammation of the Achilles tendon, which occurs when it swells because of stress or improper training. Symptoms Pain in the heel with early morning stiffness and can radiate to the calf area.Pain worsens with activities, such as walking or exercising.Swelling around the back of the ankle. Risk factors Age above 30 years in males.Diseases, such as diabetes, rheumatoid, and thyroid disorders.Obesity, very tight or weak calf muscles, poor core stability, or joint stiffness.Calcification (calcium deposition) or bony spur formation (bony growth). Diagnosis Radiographs (X-rays): Recommended to assess bony spurs or calcification.Ultrasonography: Affordable, can be performed in the clinic, and helps detect calcification or spurs.Magnetic resonance imaging (MRI): Recommended for patients with long-standing heel pain to rule out tendinosis (degeneration of the tendon). Treatment Non-surgical treatmentNon-surgical treatment is effective during the initial stages of the disease. It includes:Rest and lifestyle modifications for avoiding strenuous activities and injury prevention.Ice pack application.Non-steroidal anti-inflammatory drugs (NSAIDs) to decrease the initial inflammation.Physical therapy, including calf muscle stretches and isometric strengthening (unilateral and bilateral heel drops).Use of night splints and orthotics with the foot pointing upwards (similar to calf stretches).Extracorporeal shock wave therapy whereby high-energy and low-energy shock waves are induced around the heel area to decrease inflammation and swelling.Surgical treatmentSurgical treatment is recommended when all non-surgical options fail. It includes:Removing the degenerated (damaged) tissue around the tendon (debridement) and addressing other pathologies like bony spurs or calcification.Gastrocnemius resection in patients with tight calf muscles in whom no improvement is observed with conservative management.Minimally invasive surgery using an endoscope. It is highly recommended because it brings minimally invasive pain relief and causes less tissue damage.