Heel pain and Achilles tendonitis - aftercare: MedlinePlus Medical Encyclopedia

P When you overuse the Achilles tendon, it can become swollen and painful near the bottom of the foot and cause heel pain. This is called Achilles tendonitis.

T More About Your Injury
P The Achilles tendon connects your calf muscles to your heel bone. Together, they help you push your heel off the ground when you stand up on your toes. You use these muscles and your Achilles tendon when you walk, run, and jump.
P Heel pain is most often due to overuse of the foot. It is rarely caused by an injury.
P Tendonitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes.
P Tendonitis from arthritis is more common in middle aged or older adults. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and causes pain and swelling.

T What To Expect
P You might feel pain in the heel along the length of the tendon when walking or running. Your pain and stiffness might increase in the morning. The tendon may be painful to touch. The area may be warm and swollen.
P You might also have trouble standing up on one toe and moving the foot up and down.
P Your health care provider will examine your foot. You may have an X-ray or an MRI to check for problems with your bones or with your Achilles tendon.

T Self-care at Home
P Follow these steps to relieve symptoms and help your injury heal:
- Apply ice over the Achilles tendon for 15 to 20 minutes, 2 to 3 times per day. Use an ice pack wrapped in a cloth. DO NOT apply ice directly to skin.
- Take painkillers, such as aspirin, ibuprofen (Advil or Motrin), or naproxen (Aleve, Naprosyn) to decrease inflammation and pain.
- Wear a walking boot or heel lifts if recommended by your provider.
P Talk with your provider before using pain medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past. DO NOT take more than the amount recommended on the bottle or by your provider.

T Activity
P To allow your tendon to heal, you should stop or decrease activities that cause pain, such as running or jumping.
- Do activities that do not strain the tendon, such as swimming or cycling.
- When walking or running, choose soft, smooth surfaces. Avoid hills.
- Gradually increase the amount of activity you do.
P Your provider may give you exercises to stretch and strengthen the muscles and tendon.
- Range of motion exercises will help you regain movement in all directions.
- Do exercises gently. DO NOT over-stretch, which can injure your Achilles tendon.
- Strengthening exercises will help prevent tendonitis from coming back.

T Follow up
P If your symptoms do not improve with self-care in 2 weeks, see your health care provider. If your injury does not heal with self-care, you may need to see a physical therapist.
P Having tendonitis puts you at risk for an Achilles tendon rupture. You can help prevent further problems by keeping up with stretching and strengthening exercises to keep your foot flexible and strong.

T When To Call the Doctor
P You should call your provider:
- If your symptoms do not improve or get worse
- You notice a sharp pain in your ankle
- You have trouble walking or standing on your foot

T References
P Grear BJ. Disorders of tendons and fascia and adolescent and adult pes planus. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 82.
P Jevremovic T, Asem K, Bonin M, et al. Overview of sport-specific injuries. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 12.
P Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 30.

T Review Date 8/26/2017
P Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

T Related MedlinePlus Health Topics
- Heel Injuries and Disorders
- Tendinitis

