Achilles Tendinitis
Understanding Achilles Tendinitis
The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone. It plays a vital role in walking, running, jumping, and pushing off during each step.
Achilles tendinitis develops when repetitive stress causes irritation and inflammation of the tendon. If symptoms persist for an extended period, the condition may progress to Achilles tendinosis, in which the tendon begins to degenerate rather than simply become inflamed. Early treatment is important to prevent chronic pain and reduce the risk of tendon rupture.
What Causes Achilles Tendinitis?
Achilles tendinitis is most often an overuse injury, but several factors can contribute to its development.
Common causes include:
• Sudden increases in running or exercise
• Tight calf muscles or limited ankle flexibility
• Flat feet or high arches
• Poor foot mechanics
• Unsupportive or worn-out shoes
• Repetitive uphill running or jumping sports
• Standing or walking for prolonged periods
• Aging and decreased tendon flexibility
Identifying and correcting these contributing factors is an important part of successful treatment.
Conservative Treatment
Most patients improve with non-surgical treatment, especially when symptoms are addressed early.
Treatment options include:
• Rest and activity modification to allow the tendon to heal
• Calf stretching exercises to improve flexibility and reduce tendon stress
• Eccentric strengthening exercises, which have been shown to be one of the most effective treatments for chronic Achilles tendinopathy
• NSAIDs such as ibuprofen or naproxen to reduce pain and inflammation when appropriate
• Night splints to maintain a gentle stretch of the Achilles tendon during sleep
• Custom orthotics with heel lifts to improve foot mechanics and reduce tension on the tendon
• Physical therapy, including stretching, strengthening, gait retraining, manual therapy, and other therapeutic modalities
Most patients experience gradual improvement over several weeks to months with a consistent treatment program.
Advanced Treatment Options
For chronic Achilles tendinitis that has not responded to conservative care, advanced regenerative and minimally invasive procedures may be recommended.
Radial Shockwave Therapy (EPAT®)
Extracorporeal Pulse Activation Technology (EPAT®) uses acoustic pressure waves to stimulate the body's natural healing response. EPAT can improve blood flow, reduce chronic inflammation, promote tendon healing, and decrease pain—all without surgery or downtime.
PRP & Amniotic Tissue Injections
Platelet-Rich Plasma (PRP) uses concentrated platelets from your own blood to deliver growth factors directly to the injured tendon. Amniotic tissue injections contain naturally occurring biologic factors that may help reduce inflammation and support tissue repair. These regenerative treatments are often considered for chronic Achilles tendinopathy before surgery.
In select chronic cases, amniotic stem cell injections provide biologic growth factors and a scaffold to support tendon repair. These injections are reserved for patients who have not improved with standard conservative care.
TENEX®
TENEX® is a minimally invasive, ultrasound-guided procedure that uses ultrasonic energy to remove damaged tendon tissue while preserving healthy tendon fibers. It offers an excellent option for patients with chronic Achilles tendinopathy who have not improved with conservative treatment.
Surgical Treatment
Achilles Tendon Surgery
Surgery is reserved for patients whose symptoms continue despite exhausting conservative and advanced treatment options.
Depending on the severity of the tendon damage, surgery may involve removing diseased tendon tissue, repairing or reinforcing the tendon, removing painful bone spurs, or addressing structural problems contributing to the condition.
Although surgery is considered a last resort, it can provide excellent pain relief and restore function for appropriately selected patients with chronic Achilles tendinitis.
Get Back to Pain-Free Activity
Achilles tendinitis is a common overuse injury, but early treatment can prevent long-term tendon damage and help you return to the activities you enjoy. Whether your treatment includes stretching, custom orthotics, physical therapy, regenerative medicine, EPAT, TENEX, or surgery, we will develop a personalized treatment plan designed to relieve pain and restore your mobility.
If you're experiencing persistent pain along the back of your heel or Achilles tendon, schedule an evaluation with our office. We'll identify the cause of your symptoms and recommend the most effective treatment options to get you moving comfortably again.
Radial Shockwave (EPAT)
Conservative Care
A premium non-invasive alternative for chronic Achilles pain. EPAT uses acoustic waves to stimulate blood flow and trigger the body's natural repair mechanisms, effectively treating tissue that has failed to heal.