Pain-Free Living

Achilles Tendon

by Robert S. Dinsmoor

The tendon that connects the two large muscles of the calf to the heel. Named after the warrior of Greek mythology, whose heel was his single vulnerable spot, the Achilles tendon, or heel cord, is the largest tendon in the body. It can withstand forces of 1,000 pounds or more.

Many people know of the Achilles tendon as a common site of inflammation, called Achilles tendinitis. Achilles tendinitis is most often due to overuse, as from running, walking, and sports such as basketball that involve jumping. It may also be associated with types of arthritis such as ankylosing spondylitis, psoriatic arthritis, reactive arthritis, or osteoarthritis in the ankle. The inflammation of Achilles tendinitis causes pain in the affected heel during walking or running. Often, the tendon is painful to the touch, and the skin over the tendon may be red and swollen.

Achilles tendinitis is usually treated first with nonsteroidal anti-inflammatory drugs (NSAIDs) in conjunction with physical therapy designed to stretch the muscle/tendon unit and strengthen the calf muscles. People with Achilles tendinitis are also advised to avoid activities that aggravate their symptoms and to apply ice as needed. Sometimes other measures are necessary, such as a walking cast to immobilize the heel, braces or boots to limit ankle motion, or orthotic devices such as heel pads or shoe inserts that support the muscle and relieve stress on the Achilles tendon. Surgery is usually a last resort, though if the tendon has torn completely surgery may be the best option.

If you are a runner, there are a number of measures you can take to lower your risk of developing Achilles tendinitis:

• Buy properly fitted running shoes, with sufficient cushioning in the heel.
• Walk and stretch to warm up before you run.
• Increase your running speed gradually and limit uphill running, especially if you’re not used to it.
• Cool down after a run by running more slowly, then walking, and finally doing stretching exercises.

Last Reviewed August 22, 2012

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Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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