Muscle Pain in the Back of the Ankle due to Achilles Tendonitis

Muscle Pain in the Back of the Ankle due to Achilles Tendinitis

 What is it

Achilles tendinitis is the most common cause of muscle pain around the back of the ankle and it is focused primarily in the region 2-6 cm above the back of the heel bone where it inserts.

The Achilles tendon is the largest tendon in the body and it must be because it supports all of your body weight when it flexes; it must absorb all the stress of jumping and running, but it too can be overworked and fatigued.

Tendinitis refers to the inflammation of the tendon which is the body’s response to injury and it is an attempt to remodel itself. Unfortunately this process leads to swelling, pain and constant irritation of the tissue that is involved.


Achilles tendinitis is not due to any specific injury or disease, but simply the results of repetitive overworking of the tendon. Overworking can drastically be increased by poor biomechanics induced by previous injury or from a factor such as being overweight.


Factors that put you at risk:

-Put stress on your body that it is not used to: this is the weekend warrior or someone who exercises really hard after sitting on the couch for the last 4 months.
-Having very tight calf muscles: If you have trouble getting anywhere near your toes this may be you!
-Calcification of the the achilles tendon at the insertion: can you feel some unusually bone formation at the back of your heel?


Similar Injuries which are possible:

1) Achilles Tendon Rupture

If there is a palpable gap or swollen area in the back of your heel after a high impact injury such as a basketball fall or falling off a ladder, you should consider a partial rupture or a full rupture of the achilles tendon rather than just a fall.

2) Haglund’s Deformity or “Bone Bump” at the Back of the Heel

If the pain appears more quickly and you can physically feel a bump on the back of your foot then suspect that you have:

3) Plantar Fasciitis

It is also possible that you may have a condition known as plantar fasciitis if the pain is present more in your foot and underneath your heel rather than at the back of your heel.

4) Neurologic, Traumatic or Other Pain

These would need a podiatrist to evaluate them.


  • Long lasting pain
  • Pain that onsets gradually over weeks or months rather then immediately (otherwise consider one of the other conditions)
  • Pain at the back of your heel especially wearing shoes
  • No pain while wearing comfortable shoes at the back of her heel
  • Inflamed red hot and swollen area
  • Elevated boney eminence


  • Erosions or spurring at the achilles tendon insertion
  • Calcification within the tendon
  • Increase in soft tissue density around the achilles tendon insertion


Home Treatment

Stage 1: Home Treatment

Stage 2: Extensive Home Treatment

Stage 3: Surgical Evaluation