Achilles tendinitis occurs when the Achilles tendon (which connects the calf muscles to the heel) becomes inflamed and/or irritated upon overuse. Symptoms can range from a mild ache to severe pain in the back of the lower leg, most commonly above the heel.

This problem most commonly occurs in runners, especially those who have increased either the speed or duration of their runs. It can also occur in people who are involved in sports, such as basketball and tennis.  The following strategies can help alleviate the symptoms associated with this problem:

• Use heel lifts in your shoes. Elevating the heel will help to relieve the strain on the tendon.
• Wear footwear with a small heel while also at home.
• Abnormal foot mechanics (e.g. flat feet) can place excessive strain on the Achilles tendon.  Custom foot orthotics can help correct for these abnormal mechanics of which, in turn, will often result in less pain.  Heel lifts should be added to the orthotics for this problem (as previously discussed).
• Wear proper footwear. Purchase shoes that provide shock absorption and medial arch support. In addition, choose shoes with a small heel.
• Replace older footwear. This will depend upon usage.  Many runners replace their footwear 2-3 times per year, depending upon the number of kilometres ran per year.
• Maintain a healthy weight. This will help minimize the strain on the Achilles tendon and lower limb joints in general.
• Avoid running on hills. Running on hills adds significant strain to the Achilles tendon.
• Increase your activity (e.g. speed, duration) in a gradual, progressive fashion.
• When symptoms become more intense, you might need to either completely avoid exercise for several days or switch up your workout routine. An option might be to choose an activity that doesn’t typically strain the Achilles tendon, such as swimming.  In general, structure your exercise routine by alternating between high-impact (e.g. running) and low-impact (e.g. swimming) activities.
• Apply an ice pack (wrapped in a paper towel or a t-shirt) to the back of the heel 3-4 times per day for 10 minutes each time. If pain increases, discontinue usage.
• Compressing the region (e.g. bandages, wraps) might also help in terms of reducing swelling.
• Elevating the affected leg above your heart (e.g. lying on your back with the affected leg propped up on several pillows) might also help to reduce swelling.
• Therapy is often helpful. Various passive treatments (e.g. electro-acupuncture, various soft tissue/muscle therapies, heated ultrasound, shock-wave therapy) and exercises (e.g. stretching, strengthening) targeting the calf muscles and/or Achilles tendon are often attempted. Work closely with a health practitioner/therapist (eg. physiotherapist, chiropractor, podiatrist, chiropodist) in order to see which specific exercises/treatments appear to be helpful.  Discontinue any exercise or treatment if it causes pain and/or exacerbates symptoms (at least for the meantime). One can always return to attempting this same exercise/treatment at a later stage in recovery if need be.
• If the above strategies do not yield the desired results, contact your family physician in order to discuss other potential options (e.g. medication, consultation with an orthopedic surgeon or podiatrist)