Achilles tendinosis is a chronic condition in which tiny tears develop in the Achilles tendon. This tearing occurs gradually due to overuse or strain and typically affects individuals in their 30s and 40s. As tears form in the tissue, blood flow to the area is reduced, limiting the ability for the tendon to heal. The condition can be very painful and will become progressively worse without treatment.

Causes of Achilles tendinosis

Achilles tendinosis is typically caused by overuse of the tendon, making sudden movements that strain the Achilles tendon, or wearing improper footwear.

It is common for individuals who play sports that involve pivoting, jumping, running and pushing off from the toes (such as basketball or football), to develop Achilles tendinosis. These sudden movements place strain on the Achilles tendon and, over time, can cause the tendon to deteriorate, making it more likely for small tears to form in the tissue. Failing to stretch and warm-up before exercising, can also lead to Achilles tendinosis, as the tendon is more susceptible to injury when it is tight.

Wearing shoes with high-arches that stretch the Achilles tendon, or switching back and forth between heels and flats, can also strain the tendon and contribute to tendinosis.

Achilles tendinosis symptoms

Symptoms of Achilles tendinosis may include: 

• Development of scar tissue that may cause a noticeable thickening of the tendon. 
• Pain and soreness around the Achilles tendon, located between the heel and calf. 
• Reduced range of motion in the ankle. 
• Stiffness and creaking of the tendon, particularly in the morning. 
• Swelling around the Achilles tendon. 
• Weakness or pain when pushing off from the toes.

Treatment of Achilles tendinosis

Achilles tendonitis can be treated by resting the foot and reducing stress on the tendon, allowing it time to heal. Over-the-counter pain relievers, like aspirin and ibuprofen, can be taken during this time to reduce pain and inflammation.

A boot or brace may also be worn to keep the foot in place and help with healing. However, the foot shouldn’t be kept immobilized for too long at a time as this can cause the tendon to become weaker and prone to further injury. For this reason, physical therapy and stretching exercises are an equally important and necessary part of treatment.

It typically takes at least a few weeks for the tendon to heal. However, since blood flow is particularly important in the healing process, it may take longer if you have poor circulation. If the condition is severe and non-surgical treatments have not worked after several months, surgery can be performed to either remove scar tissue or transfer another tendon to help restore function. Contact your doctor to discuss your options and determine which treatment would be most appropriate for you.