How do you treat Achilles tendon irritation?

Therapy for Achilles tendon irritation primarily consists of a strict ban on sports and a significant reduction in physical stress.
Especially people who do physically strenuous work should be on sick leave for a few weeks.

Exercise should be avoided for at least two to three weeks.
During this time, pain relievers and anti-inflammatory drugs can be taken.
The affected lower leg should be cooled and raised if possible.
In addition, relief, for example through a bandage or orthosis, can immobilize or additionally stabilize the ankle joint.
This way the Achilles tendon is not stressed too much.

Once the acute pain phase has subsided, small stabilization and stretching exercises can be performed.
However, this should only be done in consultation with doctors and physiotherapists, as otherwise there is a risk of overstressing the Achilles tendon.
After approval by the treating doctors and physiotherapists, the exercises can also be performed at home.

In addition, the blood circulation and the metabolism of the Achilles tendon can be stimulated by massage, electro, ultrasound or laser therapy.
As a result, the body is better able to defend itself against the irritation.

If these conservative measures do not lead to the desired healing, surgery on the Achilles tendon is indicated in rare cases.

What is meant by electrotherapy and how it works is explained in detail in our relevant article: This is how electrotherapy works

Bandage for irritation of the Achilles tendon

Various bandages are used to treat Achilles tendon irritation.
They all have in common that they support the ankle joint and thus relieve the Achilles tendon.
Most bandages are made of elastic material, which allows compression of the tissue around the Achilles tendon.
This prevents swelling and water retention.

In addition, the bandages usually have a pad that rests on the Achilles tendon.
Depending on the model, this can be firmer or softer, and some pads are studded.
The goal of the pads is that they exert a light massage on the Achilles tendon with every step.
This improves blood circulation and stimulates the metabolism, which allows the Achilles tendon to regenerate better.

In order to additionally relieve the Achilles tendon you get a heel wedge with most bandages.
This can either be inserted into the bandage or it comes directly into the shoe.
This wedge causes the foot to stand slightly on tiptoe with every step.
The Achilles tendon is stretched less, which means that it is more relieved.
When using the heel wedge, it is important to wear this wedge on both sides, as otherwise the leg length will vary with a correspondingly different load.

You can find a lot more information under our topic: Bandage for achilles tendonitis

Appointment with an expert in Achilles tendonitis?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by the Achilles tendonitis disease. In many cases, the cause of the Achilles tendonitis cannot be identified at first. Therefore, the treatment requires a lot of experience. I focus on Achilles tendonitis.

The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Can the affected Achilles tendon be taped instead of a bandage?

If the Achilles tendon is irritated, the ankle can also be tapped instead of a bandage.
At the beginning of the illness it makes sense to tape the ankle joint quite tightly so that sufficient stability is guaranteed.
The stable (mostly white) tape is used for this.

Later, when the ankle is sufficiently stable, flexible kinesiotape can be used.
This is applied to certain positions in such a way that it supports the Achilles tendon and the calf muscles as they move.
In this way, some strength can be removed from the Achilles tendon, even if the foot is already being used properly again in sports.

Duration of an Achilles tendon irritation

Acute Achilles tendon irritation usually lasts about two to three weeks.
After that, careful training can be started.
The symptoms usually disappear after about four to six weeks, so that physical activity can be started again.

However, it is not uncommon for Achilles tendon irritation to become chronic.
In such a case, a period of several months must be expected.
Above all, it is important to strictly observe the sports break so that the Achilles tendon can recover.

You can recognize irritation of the Achilles tendon by these symptoms

• Pain

  • under pressure

  • Starting pain

• Signs of inflammation

  • swelling

  • Redness

  • overheat

• thickening

Achilles tendon pain or starting pain

When the Achilles tendon is irritated, pain is particularly caused by minor inflammations.

By stimulating the Achilles tendon, the body sets its defense mechanism in motion and flushes many inflammatory cells into the Achilles tendon.
So-called start-up pain occurs especially in the initial stage of the Achilles tendon irritation.
This is noticeable at the beginning of the exercise and / or in the morning after getting up.
If the calf muscles are warmed up, the pain disappears again.

Only in later stages do they become noticeable, even under stress.

How to diagnose Achilles tendonitis is explained in our article: Diagnosing Achilles Tendonitis

Thickening / swelling of the Achilles tendon

The irritation of the Achilles tendon causes various inflammatory cells to flood in.
These always bring fluid with them and thus float the Achilles tendon.
The tendon and the surrounding tissue swell.

A thickening usually only occurs through prolonged irritation.
The body begins to strengthen the irritated area of ​​the Achilles tendon to prevent degeneration.
Occasionally there is calcification due to permanent small inflammation foci in the Achilles tendon.
These also make the Achilles tendon thicken and repeatedly trigger Achilles tendon irritation and inflammation.

Exercises / stretching exercises

Exercises that are used in physiotherapy for an Achilles tendon irritation are aimed at maintaining stability in the ankle.
Many of the exercises therefore involve standing on a shaky or soft surface.
The idea behind this is to strengthen the remaining foot muscles so that the Achilles tendon is less stressed.

The Achilles tendon can later be strengthened again through targeted calf training.
Before that, however, stretching exercises are a more useful exercise variant.
For example, the forefoot is set up on a step or a similar edge, the heel is then lowered below the level of the step so that the Achilles tendon is stretched.

When you should and should not stretch your Achilles tendon, and you can read more about stretching exercises for the Achilles tendon in our article:
How to stretch your achilles tendon

The causes of achilles tendon irritation

The causes of irritation of the Achilles tendon are diverse.
Usually, however, the trigger is associated with overuse of the Achilles tendon.
For example, Achilles tendon irritation occurs more frequently in people who do a lot of standing or hard physical work because they use their Achilles tendons above average.
If the tendon is not fully adapted to the load, it can become irritated quickly.

Permanent overuse can lead to degenerative damage, which is also noticeable in the form of irritation of the Achilles tendon.
A similar high load is expected on your Achilles tendons if you constantly carry too much body weight with you.
Therefore, being overweight is also a risk factor for Achilles tendon irritation and inflammation.

You can find the best tips for losing weight efficiently in our article: Tips on how to best lose weight

Otherwise, more athletes, especially runners, are more likely to be affected by Achilles tendon irritation.
As a rule, your Achilles tendons are well trained to cope with the strain, which is why you should normally not experience any symptoms.
But especially when the load situation changes, irritation of the Achilles tendon often occurs.
For example, buying new running shoes can lead to a slightly different stress axis in the ankle.
New jogging routes with an unusually rough surface can also cause irritation of the Achilles tendon.

In addition, athletes who significantly increase their running quota in a short time are often affected by irritation of the Achilles tendon.

When can you start exercising again?

After an Achilles tendon irritation, sport may only be restarted once the symptoms have subsided.
Before doing this, the Achilles tendon should be strengthened with stretching exercises and physiotherapy exercises.

Only after approval by the responsible doctor or physiotherapist can light sporting activity be resumed.
In the case of acute Achilles tendonitis, one usually assumes a complete break in sports of two to three weeks.
A full load is possible again after about a month.

Chronic irritation can last for several months.

This is how the diagnosis of Achilles tendon irritation is made

The diagnosis of Achilles tendon irritation can usually be made on the basis of the medical history and physical examination.

The anamnesis asks about the pain and the triggering factors.
The examination can identify pressure pain, overheating and reddening of the Achilles tendon, as well as painful restrictions on movement.

An ultrasound of the Achilles tendon should then be performed.
In rare cases - especially in the case of particularly persistent Achilles tendon irritation or if serious tendon injuries are suspected - an MRI of the Achilles tendon should be performed.

The ultrasound examination of an Achilles tendon

A special ultrasound head is used for ultrasound of the Achilles tendon, which can display the structure of the tendon particularly well.
During the examination, the tendon is assessed from top to bottom and from left to right.

In the case of irritation, water retention and structural lightening or darkening can be found there.
If the Achilles tendon irritation is chronic, calcium deposits can also be detected in the tendon.
In the ultrasound, these appear as particularly bright (white) splashes.

When do I need an MRI of the Achilles tendon?

An MRI of the Achilles tendon is particularly indicated if a serious cause of the symptoms is suspected.
If, based on the medical history and the examination, there is a suspicion of a tear or partial tear of the Achilles tendon, this suspicion must be immediately confirmed with an MRI or, in the best case, eliminated.

An MRI can also be performed if the Achilles tendon irritation persists.
This may reveal sources of inflammation or identify other causes that explain why the Achilles tendon irritation persists for so long.

You can read about how a ruptured Achilles tendon should be treated correctly in our article: Therapy of a ruptured Achilles tendon

How high is the risk that an Achilles tendon will tear?

The risk of an Achilles tendon rupture is increased if the Achilles tendon is irritated.
In order not to worsen the condition of the Achilles tendon any further, straining the affected leg should be avoided.

In general, however, even if the Achilles tendon is irritated, a great deal of force is still required for the Achilles tendon to tear.
Those who suffer from chronic Achilles tendon irritation, on the other hand, often already have degenerative damage to the tendon and must expect the Achilles tendon to tear spontaneously at some point.

In general, there is little risk of rupture with simple Achilles tendon irritation.
The further the damage progresses, the more likely a crack becomes.