Achilles Tendon Injuries

Tendonosis, Tendonitis, and Achilles Tendon Rupture

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If you have pain and swelling in your heel and/or lower calf and have trouble running, jumping, or walking, you may have injured your Achilles tendon and should seek medical attention. Our foot and ankle specialists treat the full range of Achilles tendon injuries, including tendon tears, inflammation, chronic pain, bone spurs, and neglected older injuries. We work to identify and address the cause of your injury, eliminate your pain, and restore your mobility as quickly and safely as possible.

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Achilles Tendon Inflammation, Bone Spurs, and Chronic Pain

The Achilles tendon -- the strongest tendon in the body -- connects the calf muscle to the heel bone. A healthy Achilles tendon is critical for running, jumping, and walking. That's why any injury to this tendon can be debilitating and requires urgent evaluation.

Achilles Tendonitis

Tendonitis often starts suddenly and involves inflammation of the tendon itself or the surrounding tissues. Redness, warmth, pain, and swelling in your heel and lower calf are all signs of Achilles tendonitis. It is a common overuse injury but can occur for other reasons, including a sudden increase in activity or overly tight calf muscles. Without proper treatment, the problem can progress, making it difficult to walk and take part in your regular activities.

Achilles Tendonosis

Tendonosis is chronic degradation (breakdown) of the tendon. It usually starts gradually, and the pain can quite severe. In some cases, bone spurs may form on the back of the heel, which can irritate the Achilles tendon and cause more tendon damage and pain. If not treated properly, the tendon can weaken over time and even tear completely.

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Duke Health offers locations throughout the Triangle. Find one near you.

Achilles Tendon Rupture

If you hear a pop or snap, have severe, sudden pain on the back of your heel and lower calf, or experience weakness in your foot when pressing down, you may have ruptured (torn) your Achilles tendon. Although this injury often happens during intense activity, it can also occur from minor falls or missteps. It is important to seek prompt medical attention for a suspected rupture to maximize your treatment options and begin the healing process.

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Treatment for Achilles Tendon Injuries and Ruptures

Non-Surgical Treatments

Our foot and ankle specialists start with non-surgical treatment, when possible. For Achilles tendonitis or tendonosis, this may include:

  • Ice and anti-inflammatory medications or creams to help with inflammation
  • Boots and casts to immobilize the ankle and allow the tendon to rest
  • Physical therapy to help stretch or strengthen the tendon and improve mobility to prevent future problems

Conservative treatment for Achilles tendon ruptures requires a quick diagnosis after injury, careful monitoring by your doctor for weeks to months, and coordinated care with your physical therapist. Injections are rarely used to treat for Achilles tendon pain and injuries.

Surgical Treatments

If non-surgical treatments do not help or your condition becomes more painful, your doctor may recommend surgery. 

For Achilles tendonitis or tendonosis surgery, your surgeon will often remove the damaged part of the tendon and repair any tearing.They may also trim down or remove any bone spurs.

For Achilles tendon rupture surgery, your surgeon will reattached the torn ends of the tendon, often using minimally-invasive techniques. These techniques help limit scarring and safely reduce recovery time.

Achilles tendon surgeries are often outpatient procedures, meaning you will go home the same day. Depending on the type of surgery you have, you may begin a comprehensive physical therapy two to four weeks after the procedure to help promote healing and get you on the road to recovery. Our goal is to improve your pain, restore your strength, and get you back to the activities you enjoy.

Best Orthopaedic Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

A Team of Foot and Ankle Specialists

Our foot and ankle specialists are experienced in diagnosing and treating the full-range of Achilles tendon injuries. They are board-certified and fellowship-trained in foot and ankle surgery and perform hundreds of foot and ankle procedures each year. 

Minimally Invasive Techniques

If your injury requires surgery, we are experts in minimally-invasive surgical techniques. These small incisions translate to faster recovery and a quicker return to your daily activities.

Dedicated Physical Therapists

Our physical therapists focus exclusively on foot and ankle injuries and rehabilitation. They work with your surgeon both before and after surgery to devise a personalized rehabilitation plan specific to your injury and activity goals. 

This page was medically reviewed on 06/09/2021 by