The Achilles tendon is a band of tissue that runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the heel cord, the Achilles tendon facilitates walking by helping to raise the heel off the ground.

Achilles tendonitis is an inflammation of the Achilles tendon. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

As "overuse" disorders, Achilles tendonitis and tendonosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon.

Athletes are at high risk for developing disorders of the Achilles tendon. Achilles tendonitis and tendonosis are also common in “weekend warriors”—those who are less conditioned and participate in athletics only on weekends or infrequently.

In addition, people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking.

In diagnosing Achilles tendonitis or tendonosis, the foot doctor will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.

If nonsurgical approaches fail to restore the tendon to its normal condition, surgery may be necessary. The foot and ankle doctor will select the best procedure to repair the tendon, based on the extent of the injury, the patient’s age and activity level, and other factors.

To learn more about foot and ankle conditions, visit the American College of Foot and Ankle Surgeons’ patient education website, FootHealthFacts.org.