The occasional ache or pain is a normal part of life. Depending on how active your lifestyle is, you may be used to feeling sore and moving a little more gingerly the day after you’ve had an intense workout or spent a long time on your feet. But if you’re waking up with stiff feet every day or have heel pain that gets worse during physical activity, it’s worth finding out why it’s happening and what you can do about it.
There are a number of conditions that can cause heel pain. But consistent stiffness and pain that seems centered on the back of your ankles is often related to Achilles tendonitis – inflammation of the large tendon that connects your heel bone to your calf muscles. Learn all the key symptoms of this condition, what causes it and what you can do to start getting relief.
Achilles tendonitis pain and other symptoms can change throughout the day
Symptoms of Achilles tendonitis are generally most noticeable after extended rest and during extended activity. When you get up in the morning, for example, you may feel pain and stiffness in your Achilles tendon that decreases as you get up and go about your day. But during a day with a lot of activity, you may notice the pain start to get worse again. If your activity is particularly intense, such as running or playing sports, the pain may feel more severe the next day.
Alongside pain and stiffness, there may be constant swelling along your Achilles tendon that increases over the course of the day or with activity. This can result in tenderness when you touch or pinch the tendon. You may also have difficulty pointing your toes and putting weight on them.
Achilles tendonitis is caused by repetitive strain
Achilles tendonitis is what’s known as an overuse injury – putting more stress on the tendon than it can handle, and doing so too often for it to heal properly. It often results from suddenly increasing the amount of physical activity you do, or the intensity at which you do it.
Achilles tendonitis can also be caused by things that keep your feet from working the way they want to during normal use. Common examples include tight calf muscles and flattened arches.
Certain activities, health conditions and lifestyle factors can increase your risk
Your risk of developing Achilles tendonitis can be influenced by a variety of factors. For example, it’s common in both competitive athletes, who are consistently putting their Achilles tendons under intense stress, as well as in infrequent athletes, whose tendons are less conditioned. It also becomes more common with age.
Other risk factors for Achilles tendonitis include:
- Choice of activity – Activities that involve a lot of pivoting or jumping, such as tennis and basketball, put more strain on the Achilles tendon. Exercising in specific conditions, such as running up hills or in cold weather, can also contribute.
- Choice of footwear – Over time, wearing shoes that are worn out or unsupportive can have a similar effect on the Achilles tendon as physical issues like tight calves.
- Health conditions – Conditions like being overweight or having arthritis can contribute to strain or weakness in the Achilles tendon. High blood pressure is also associated with a greater risk of Achilles tendonitis.
- Medications – Certain medications, such as corticosteroids and quinolone antibiotics, are associated with a higher risk of Achilles issues, including both tendonitis and tendon ruptures.
A physical exam can usually diagnose Achilles tendonitis
A doctor can usually get enough information to diagnose Achilles tendonitis from a physical examination of your feet. During the physical exam, a doctor will look for swelling along the tendons and gently press them to assess the location and severity of your pain. They’ll also test the range of motion in your feet. In some cases, a doctor may order imaging tests, such as an X-ray or magnetic resonance imaging (MRI) scan, to look for physical issues in your bones, tendons or surrounding muscles.
There are a variety of ways to get relief from the pain caused by Achilles tendonitis. Some you can do right now at home, while others require the help of a doctor or other expert. An effective treatment plan may use a combination of both.
Self-care for pain relief
For short-term relief from Achilles tendonitis symptoms, it can help to take nonsteroidal anti-inflammatory medications (NSAIDs) like aspirin and ibuprofen, and to follow the RICE method (rest, ice, compression and elevation).
It’s also important to modify any activities that are putting excessive strain on your Achilles tendons. This may mean taking a break from certain sports or exercising less intensely than you have been. The goal is to give your tendons the opportunity to heal. It can also help to perform movements like calf raises to warm up your Achilles tendons before you exercise.
Physical therapy
Part of treating Achilles tendonitis is taking steps to help your feet work in a more balanced, efficient way. This can be done by stretching and strengthening your Achilles tendon and the surrounding muscles that support it. A physical therapist can make you a customized treatment plan and work with you to achieve these goals. They can also help you correct your gait (the way you walk) if your current gait distributes your weight unevenly.
Supportive footwear and other devices
Shoes that support your heels and provide cushion for the back of your feet can be very effective for reducing strain and irritation in your Achilles tendons. You can also buy orthotics (inserts) that add these features to shoes you already have. Orthotics are available over the counter, but you also have the option of getting prescription orthotics that are custom-made for your feet.
Night splints are another tool you can use to manage your symptoms. As the name suggests, night splints hold your Achilles tendon in a stretched position overnight, which can help with flexibility and reduce stiffness in the morning.
Surgical treatment
If other treatments aren’t effective or your doctor finds that there’s a lot of damage in your Achilles tendon, they may recommend surgical treatment to repair the tendon. This is followed by physical therapy to help restore strength and flexibility.
If you’re experiencing tendonitis symptoms, talk with an expert
It can be easy to ignore the occasional ache in your feet, but constant pain and stiffness isn’t something you should put up with. Getting a diagnosis is the first step in getting your body the care it needs. A foot and ankle specialist can help you figure out what’s causing your symptoms, make recommendations for both self-care and professional treatments, and get you back to moving comfortably.