Achilles Tendinitis

The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone and transmitting the force of every step, run, and jump. Its strength makes it indispensable — and its vulnerability to overuse makes it one of the most commonly injured tendons in active adults.

Achilles tendinitis refers to inflammation of the tendon, typically from a sudden increase in activity, a change in training surface or footwear, or a biomechanical factor that places abnormal load on the tendon. It produces pain and stiffness at the back of the heel or lower leg — characteristically worse with the first steps of the morning and after exercise, and typically improving somewhat during activity as the tendon warms.

When tendinitis is not adequately treated and the inflammation becomes chronic, the tendon undergoes structural changes — a process called tendinosis. In tendinosis, the normal tendon collagen is replaced by disorganized, weaker fibers. This is not simply inflammation that has persisted — it is a degenerative process that requires a different treatment approach and carries a higher risk of tendon rupture if loading continues without appropriate management.

Achilles tendon rupture is a more serious injury — a partial or complete tearing of the tendon, typically occurring during a sudden explosive movement. Patients often describe hearing or feeling a pop, followed by immediate inability to push off the foot and significant pain and swelling. A rupture requires urgent evaluation to determine the extent of the injury and the appropriate management approach.

Dr. Gunter evaluates Achilles conditions clinically and with imaging when indicated, distinguishes between tendinitis, tendinosis, and rupture, and develops a treatment plan appropriate to the specific diagnosis — not a generic protocol for 'Achilles pain.'