Achilles Tendonitis Treatment

Treatment for Achilles tendonitis, also sometimes called Achilles tendinitis, depends on the severity of the injury. If heel pain, tenderness, swelling, or discomfort in the back of the lower leg occurs, physical activity that produces the symptoms should be discontinued.

If the problem returns or persists, a medical professional should be consulted. If pain develops even with proper stretching and training techniques, the patient should consult a podiatrist to check for hyperpronation and adequate arch support. The addition of an orthotic may be enough to maintain good arch and foot alignment and eliminate pain.

If damage to the tendon is minor, the injury may respond to a simple course of treatment known as RICE (rest, ice, compression, elevation).

Patients are advised to:

  • rest the tendon by keeping off their feet as much as possible;
  • apply ice packs for 20 minutes at a time every hour for a day or two to reduce swelling;
  • compress the ankle and foot with a firmly (not tightly) wrapped elastic bandage; and
  • elevate the foot whenever possible to minimize swelling.

A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen may be used to reduce pain, swelling, and inflammation.

Additional treatment may be required if injury to the tendon is severe, if mild Achilles tendonitis does not respond to basic treatment, or if symptoms return with the resumption of physical activity.

A flexible cast may be used to immobilize the foot and reduce swelling, and crutches may be used to keep weight off the foot. This treatment may be necessary for up to 8 weeks.

If the injury responds to this treatment, the patient may then be advised to wear low-heeled shoes and perform rehabilitation exercises (e.g., physical therapy) to gradually stretch the tendon before full activity is resumed.

Severe Achilles tendonitis, tendon rupture, or tearing away from the heel bone may require surgery and lengthy rehabilitation. Surgery involves removing the tendon's inflamed outer covering and reattaching the torn tissues.

Following surgery, patients undergo passive range of motion physical therapy and progressive strengthening exercises for 2–3 weeks. Most activities can be resumed in 6–10 weeks and competitive sports usually can be resumed after 3–6 months.

Publication Review By: Hai-En Peng, D.P.M.

Published: 31 Dec 1999

Last Modified: 26 Aug 2015