Achilles Tendinopathy Treatment in Fairfax, VA
Pain and stiffness in the Achilles tendon from overuse, treated with targeted loading, offloading, injections, and surgery when needed.
Overview
The Achilles is the largest tendon in the body, connecting the calf muscles to the heel bone. Achilles tendinopathy happens when repeated strain outpaces the tendon's ability to repair itself, leaving it painful, thickened, and weaker. It can affect the middle of the tendon or where it attaches to the heel (insertional tendinopathy).
Symptoms
- Pain and stiffness along the back of the heel, worst in the morning
- Pain that eases with warm-up, then returns after activity
- A tender or thickened area in the tendon
- A bump at the back of the heel (common with insertional cases)
Causes and risk factors
- Sudden increases in running mileage, hills, or speed work
- Tight calf muscles
- Flat feet or other alignment issues
- Age over 30, when tendons become less resilient
- Certain medications, including fluoroquinolone antibiotics
Diagnosis
We examine the tendon, check calf flexibility and foot alignment, and take X-rays to look for heel spurs or calcification. Ultrasound or MRI shows tendon thickening and any partial tearing.
Treatment
- Conservative: activity modification, a structured eccentric or heavy-slow loading program, heel lifts, and custom orthotics
- Offloading: a walking boot for short-term rest during flare-ups
- Advanced: PRP injections for chronic cases that haven't responded
- Surgical: debridement, spur removal, or tendon repair or transfer for persistent or severe cases (Reconstructive Surgery & Trauma)
We avoid cortisone injections into the Achilles because they can weaken the tendon and raise rupture risk.
When to see us
If Achilles pain lasts more than two weeks or limits your activity, book a visit at our Fairfax office. If you felt a pop or a kick to the back of the leg and can't push off, call us the same day: it may be a rupture.
Our approach
Both of our board-certified doctors treat sports-related injuries, and they start by identifying why the tendon became overloaded: training changes, calf tightness, or foot mechanics. Treating that cause is what keeps tendinopathy from coming back.
Frequently asked questions
Can I keep running with Achilles tendinopathy?
Often, at reduced volume and pain levels. We'll set limits that let the tendon recover without losing all your fitness.
How long does it take to heal?
Most cases improve in three to six months with a consistent loading program. Insertional cases can take longer.
Is it the same as an Achilles rupture?
No. Tendinopathy is degeneration and irritation. A rupture is a complete tear and needs urgent evaluation.