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Achilles Tendon Disorders

The Achilles tendon connects the bones of your heel to your calf muscles and allows you to flex your foot and point your toes. It is the longest and largest tendon in the body. It is also one of the most commonly injured.

In the event of an Achilles tendon disorder, you may experience mild to severe pain above your heel or in the back of the leg. This pain may happen after running or other sports activity. You may experience stiffness or sensitivity in the morning, too.

At UC San Diego Health, our foot and ankle team provides the latest diagnostic tests and nonsurgical and surgical therapies to treat every condition. As an academic health system, we are constantly developing new, more effective methods of evaluating and treating our patients.

Foot and ankle conditions treated

Diagnosis and Treatment

We use magnetic resonance imaging (MRI) and ultrasounds to diagnose Achilles tendon disorders and determine the best treatment plan. X-rays may also be performed to rule out other conditions that can cause similar symptoms.

Recommended treatment depends on the type of disorder as well as the severity and persistency of pain.

Less severe Achilles tendon injuries are managed with nonsurgical techniques such as nonsteroidal anti-inflammatory drugs, bracing, stretching, orthotic devices and physical therapy. You will also be asked to avoid activities that aggravate your condition. 

Surgery may be advised if your tendon is torn. Surgery can remove damaged tissue. We may also use tendon transfer, a procedure that shifts the tendon from its original attachment to a new one. Tendon transfer surgery can restore function.

Types of Achilles Tendon Disorders

Our foot and ankle experts treat the following Achilles tendon disorders:

  • Achilles tendinosis, insertional and non-insertional
  • Achilles tendon rupture, chronic and acute
  • Achilles tendinitis or tendinopathy
  • Haglund’s disease

Learn more about these conditions below.

Achilles Tendinosis

Achilles tendinosis is characterized by micro-tears of the Achilles tendon; this ultimately leads to thickening and disease of the tendon.

Achilles Tendon Rupture

This injury usually occurs in a tendon that is worn out and has weakened over time and then suddenly tears when enough force is applied. It typically occurs during recreational sports that involve running, jumping and pivoting. Symptoms of Achilles tendon rupture include swelling and severe pain in the back of the heel, below the calf. The pain is usually severe enough that it is difficult or impossible to walk or take a step.

Achilles Tendinitis

Achilles tendinitis and tendinopathy is a common overuse injury, accounting for 11 percent of all running injuries. The Achilles tendon can get inflamed (tendinitis) or it can degenerate/wear out (tendinopathy) with repetitive, aggravating activities, such as running and/or jumping. Symptoms of Achilles tendinitis and tendinopathy include pain and tendon damage, as well as swelling and/or thickening of the tendon.

Haglund’s Disease

A Haglund’s deformity is a large bony bump that develops in the back of heel. It is believed to result from repetitive irritation of the Achilles tendon as it attaches to the back of the heel and/or irritation from shoes. The bony bump can range from small to very large in some cases. Sometimes there is no pain associated with the bump, whereas in other cases, it can be very painful and inflamed. Physical therapy and stretching are key to treating Haglund's disease; however, in cases of severe pain, the bony bump may need to be surgically removed and other reconstruction to the Achilles tendon itself.

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