Achilles Tendinosis - Causes, symptoms, Treatement


Achilles tendinosis, like plantar fasciitis, is a frequently occurring foot injury. Especially amongst runners it is a problem, and responsible for 6-17% of all sports injuries! It used to be known as achilles tendinitis in the past.

The injury is an inflammation of the tendon running from calf to heel. It is a so-called sterile inflammation, not caused by micro-organisms.

In serious cases the achilles tendon is not only inflamed, but can even result in an achilles rupture, either fully or partially. Finally there can even be a bursitis of the achilles tendon, which is an inflammation of the bursa in the tendon.

Achilles tendinosis causes

The cause of achilles tendinosis is often identical to that of plantar fasciitis:

Over use or one-sided movement and wrong shoes (no cushioning or bad footbed) are responsible for 80% of cases. Other causes can be:

  • Age
  • Differnces in length of both legs
  • Overweight
  • Instability in the ankle joints
  • Foot abnormalities like flat feet or hollow feet

Often the real cause is not an actual inflammation, but degeneration of the tissue in the tendon (mini-tears).


Typical symptoms of achilles tendinosis are the following:

Initially there are only minor complaints right after sporting or heavy use of the legs that disappear after a few hours. The pain in the achilles tendon usually concentrates a few centimeters above the heel. If these complaints are being ignored the pain in the the achilles tendon can worsen, and sustain. Sometimes in a warming up xercise the pain goes away a bit, but returns after training.

Especially after resting or in the morning the area around the achilles tendon can feel stiff and painful, and finally the tendon can get swollen.

In the case of an achilles rupture there is a very sharp pain, and walking becomes hardly impossible. The rupture can be even visible to the eye.


In the early stages of achilles tendinosis the injury can be treated most effectively. In more chronic cases this becomes more and more difficult:

  • Warming up: Make sure to build up strain gradually. Start quietly, and perform stretching exercises. Also cool down after heavy exercise.Perform stretching exercises, especially for the calf muscles. A number of exercises mentioned on the page for plantar fasciitis stretching are very usefull for achilles tendinosis as well.
  • Perform exercises that strengthen the leg muscles. An example is to stand on a stairway with the heels down and to bring up the body slowly. Repeat a few times in 3 sets. This can even be done with one leg at a time, though make sure not to damage any muscles and tendons.Massaging the calf muscles can be beneficial for healing and preventing achilles tendinosis, especially when performed by a skilled massage therapist.
  • Wear good shoes, especially when running, but also for daily use. Go to a profesional footstore and gain advise. Especially take care of a good footbed and sufficient cushioning.
  • Next to good shoes, inlay soles can assist in maintaining a good footbed. If needed, visit a podo-therapist for custom soles, especially if you suffer from flat feet or hollow feet.
  • Heel cushions: They can both assist to cushion the heels, but also a raised position of 1-2 cm can help to reduce strain on the achilles tendon.
  • Sometimes a night splint ot Strassburg Sock can be beneficial.
  • Bandages, zoals bv de Achillotrain

Achilles tendinosis can be very persistent, so most measures need to be endured for longer periods to gain effect. Especially be carefull to start full exercise and wear after intially the injury seems healed, as otherwise the complaints may come back.