The Achilles tendon attaches the calf muscle (called the gastrocnemius and soleus muscles) to the heel. Excessive stress or a tight or fatigued calf muscle can result in microtrauma, degeneration, and even inflammation of the tendon- a condition called Achilles Tendonitis/Tendinosis. Prolonged walking, overtraining (excessive running or jumping, or walking hills can cause this condition.

Recent research suggests that a gradual onset of pain and prolonged recovery might be due to a similar condition called Achilles tendinosis. Tendinosis is chronic degenerative condition and it differs from tendonitis in that there is no inflammation present. It is probably more common than tendinitis because often times tendon pain is not accompanied by the classic inflammatory signs of swelling, redness, and warmth.

Treatment usually consists of rest, non-steroidal anti-inflammatory drugs (NSAIDs), ice, stretching, strengthening and progressive return to function or sport.

Forceful contraction of the calf muscle may rupture (completely tear) the Achilles tendon. It occurs during jumping, running, and cutting and is often seen in basketball and baseball players. The patient often reports the sensation of having been hit or violently kicked in the lower calf. There is pain and a “divot” in the tendon above the heel.

Treatment- non-surgical rehabilitation and surgical repair are viable treatment options. Active people may experience more benefit from surgical repair. Rehabilitation may require six to twelve months of progressive care.