The Achilles tendon is a strong rubbery piece of tissue that helps the muscles in the back of the lower leg move the foot up and down at the ankle. Without this tendon, you would not be able to walk as you could not keep the foot from extending upward once it struck the ground. It begins in the lower third of the lower leg and attaches to the back of the heel. The Achilles tendon receives a lot of wear and tear over a lifetime, and has to stay healthy, flexible, and strong to keep it working properly.
Over time, the tissue in the Achilles tendon can become damaged. This damage can be due to an injury that forces the foot upward at the ankle or something hitting the back of the heel. The damage can also be due to stress and strain from simple repetitive activities like pedal use or frequent ladder climbing, or in certain sports. The presence of spurs on the back of the heel bone can also irritate the tendon over time. Ultimately, the tendon damage leads to inflammation, possible partial tearing, and even degeneration of the tissue itself. The inflammation process is called tendonitis, and symptoms can include an aching or sharp/burning pain on the back of the heel or just above it. The upward motion of the ankle may worsen the pain, as can even the contact of the back of the shoe on the heel.
Achilles tendonitis needs to be treated promptly, as continued degeneration makes recovery more difficult, and the tendon can even rupture if weak enough. Treatment initially consists of ankle support with a brace, icing, anti-inflammatory medications, and regular stretching to keep the tendon limber. Later treatment may include physical therapy intervention or more rigid immobilization of the ankle. If these measures do not help, surgery may be needed to repair and reinforce the tendon, as well as remove any spurs on the heel bone that may be aggravating the condition.