Wherever inflammation occurs, pain is soon to follow. Considering the importance of the Achilles tendon in nearly every upright activity, it’s no wonder a 2008 study revealed achilles tendinitis to be the most common injury in runners.
Symptoms include pain in the back of the heel, which may or may not be associated with swelling and tightness, especially first thing in the morning, or after standing up after long periods of rest.
“Sports that typically incur this injury are ballistic sports, so quick starts and stops, like tennis or uphill inclined activities,” says Michael Gentile, a Fellow of the American College of Foot and Ankle Surgeons.
If you’re experiencing discomfort or pain in the region, the first course of action is to discontinue any aggravating activity, use ice compression, and take oral anti-inflammatories. If after two weeks of solid rest and recovery the pain doesn’t subside, visit a doctor.
“The key thing is to differentiate between tendinitis (inflammation) and tendonosis, which is really a chronic overuse injury characterized by disease in the joint that leads to tiny tears and scar tissue,” says Gentile. “Really a majority of patients have tendonosis.”
Injury to the tendon ranges in severity, from mild cases that can get better within two weeks, to more severe cases which may require immobilization using a fracture boot, and physical therapy; and, at the most extreme end, surgical repair.
Physical therapy is generally aimed at, “functional, sports-specific assessment, deep tissue instrumented work, and both eccentric and concentric conditioning,” says Gentile. "Rest is the hardest thing. A lot of people that come in don't want to rest."
By adequately stretching, warming up and cooling down the calves and hamstrings, Gentile says people can greatly reduce their chances of injuring their Achilles tendon. Preventative exercises like heel raises—increasing in intensity gradually—are especially worth it, when you consider that recovery can take as long as 12 weeks following surgical intervention.