Achilles Tendonitis Treatment Oakland CA

What is Achilles Tendonitis (Tendinopathy)?

Achilles tendonitis (tendinopathy) is characterized by pain and stiffness in the Achilles tendon (the structure that connects your calf muscles to your heel) that increases after a resting period or as your activity increases throughout the day. There is often a bump or hardness present with Achilles tendonitis, which can be found along the base of the tendon at the back of your heel. There are two types of Achilles tendonitis, insertional, and non-insertional. Non-insertional tendonitis tends to occur with younger and more active people, whereas insertional tendonitis can occur in a person of any age or activity level.

Achilles tendonitis is also referred to as Achilles tendinopathy, which is a more general term for a problem with a tendon. The ending “-itis” technically means inflammation, and not all cases of Achilles tendinopathy involve inflammation.  An emerging term for non-inflammatory achilles tendinopathy is Achilles tendinosis.  The ending of the word, “-osis” doesn’t mean inflammation, it basically means a degenerative response. And that’s exactly what it is. If you would look under a microscope, you would see that the individual fibers of the Achilles tendon actually have become degenerated. With this degenerative response, adhesions are actually laid down within the tendon, and those adhesions are the cause of a lot of pain, and they actually restrict motion. The adhesions also impact your proprioception, your body’s sense of where you are in 3D space.  Your proprioceptive sense is thrown off if you have an injury to a tendon.

Symptoms of Achilles Tendonitis:

-Tenderness along the calf or back of the heel
-Thickening of the Achilles tendon
-Increasing pain with increasing activity
-Increased pain following a long rest period (overnight)
-Swelling of the Achilles tendon
-Calf stretching may increase the pain

Causes of Achilles Tendonitis:

Other than an acute injury, there are several other causes of Achilles tendonitis.
-Too much/too soon (increasing mileage)
-Tight calf muscles (gastrocnemius or soleus)
-Tight hamstring or glute muscles
-Weakness in hip or glute that affects biomechanics of the foot/ankle
-Bone spur*

*A bone spur is usually the result of Achilles tendonitis, rather than the cause. According to Wolff’s Law, a force exerted on a bone (by a muscle or tendon) causes that bone to remodel. When the calf muscles are overworking and pulling too hard on the calcaneus (heel bone), a bone spur may develop. Many people assume that the bone spur is the cause of pain, however it is usually more accurate to note that the bone spur is a result of the problem. Every once in a while, a bone spur forms for other reasons, and it can be a cause of pain in the Achilles tendon area.

Achilles Tendonitis Treatment:

So what needs to happen if there are adhesions in a muscle? Well, ice is not going to help, it’s not going to make an adhesion go away. Ice might give you a little bit of pain relief, but it’s not going to address the adhesion.  The same thing applies to stretching, you’re going to get some overall benefit from the stretching, but you’re not going to actually get rid of the adhesion. It’s analogous to having a knot in the middle of a rope… if it’s just a regular rope clear of knots and you pull on the two ends, you’re going to get some stretch out of it. But if there’s a knot in the middle of it, yes, you might get a little bit of overall stretch, but you’re just tightening up the knot in the middle, and that knot in the middle, that’s the adhesion. Other solutions like anti-inflammatories, again, those are not actually going to reduce the adhesion. Manual therapy and foot and ankle adjustments are the best way to restore normal tissue slide and glide!

Insertional vs. non-insertional Achilles tendonitis

Your page notes that there are two types. This table shows the main differences.

Who gets Achilles tendonitis?

• Runners, especially with a jump in mileage, hills, or speed work (see running injuries)
• Jumping and cutting sport athletes, including basketball, tennis, and pickleball players
• Hikers, particularly on long climbs and descents
• Weekend athletes between about 30 and 50 who jump back into sport after a break
• People who are less active, who can get the insertional type, as you note above
• People with tight calves, flat feet, or a change in footwear
• People who’ve taken certain medications, such as fluoroquinolone antibiotics (for example, ciprofloxacin or levofloxacin) or corticosteroids, which have been linked to tendon problems. Let us know if you take these.
• People with diabetes or inflammatory conditions

Is it Achilles tendonitis, or something else?

Pain at the back of the heel or lower calf has several possible sources. Besides Achilles tendonitis, they include a calf muscle strain (see calf strain), inflammation of the small fluid-filled sac in front of the tendon (retrocalcaneal bursitis), a bony bump at the back of the heel (Haglund’s deformity), a partial or complete Achilles tear, irritation of a nerve, and heel pain from the bottom of the foot (see plantar fasciitis). A hands-on exam is how we tell them apart, and it includes checking that the tendon is intact.

How we evaluate Achilles pain

Your first visit starts with a history of how the pain started, when it hurts most, what you’ve tried, and any medications or health conditions. We then examine the tendon: where it’s tender, whether it’s thickened, and how it feels when you press along it and move the ankle. We test calf strength and endurance (for example, how many single-leg heel raises you can do compared with the other side), check ankle and calf flexibility, and test that the tendon is intact. We also look at your foot posture, hip and glute strength, shoes, and training history. If we suspect a tear, a bone issue, or another problem we shouldn’t treat, we’ll recommend imaging or refer you to another provider.

Why strengthening matters for tendons

You already know ice, stretching, and anti-inflammatories often don’t solve the problem on their own. The other half of the picture is that a painful tendon doesn’t heal well by being rested completely. Tendons respond to gradual, controlled load. That’s why the best-supported part of Achilles tendon care is a progressive strengthening program for the calf, which starts gently (often with holding a heel raise) and builds to full, slow, weighted heel raises, and later to hopping and running. Hands-on treatment helps by reducing pain and restoring motion so you can do that work, but it works best alongside strengthening, not in place of it. Tendons are slow to change, so this takes weeks to months.

What else may be part of your plan

Your plan depends on your exam. It may include:

• Manual therapy for the calf, Achilles, foot, and ankle, as you note above
• Active Release Techniques and Graston Technique for the calf muscles and the tissue around the tendon
• Foot and ankle adjustments where joint motion is restricted
• Rehab exercises: a progressive loading program, starting with isometric holds, then heel raises with the knee straight and bent, then slower, heavier and eccentric work, then hopping and running, plus hip and foot strengthening
• A small heel lift or footwear changes in the early stage, especially for insertional pain, to reduce strain on the tendon
• Kinesio taping to support the area during activity 
• Myofascial decompression cupping for tight calf muscles 
• Training guidance, including how to adjust your mileage, hills, and speed work, and a gradual return to running

What to expect

Tendon problems are slow, and patience matters. Many rehab programs run about 12 weeks, though some people improve sooner and others need longer, especially if the problem is long-standing. Early visits focus on easing pain and starting gentle loading. Later visits build strength and capacity, then test the tendon with hopping and running. Pain that settles in a few days with a quick fix tends to return, which is why the strengthening is part of the plan. We’ll give you a realistic estimate after your exam. 

What you can do at home

• Don’t rest completely. Reduce the load that aggravates it (hills, speed work, long runs), but keep doing what doesn’t hurt, and keep walking.
• Try heel raise holds if they ease your pain. We’ll show you the right version for your type.
• Go easy on calf stretching, especially if the pain is at the heel. Deep stretches can irritate insertional pain, and it’s one of the symptoms on your list above.
• Use a small heel lift in your shoes if it feels better.
• Wear supportive shoes with a firm heel, and avoid flat, thin-soled shoes and going barefoot on hard floors.
• Build back gradually. Increase running or hiking in small steps, and avoid big jumps in hills or speed.
• Talk to your doctor before any injection in or near the Achilles tendon.

When to get medical care first

Get urgent medical care if you felt a sudden pop or snap in the back of your ankle, like being kicked in the calf, followed by trouble pushing off, rising onto your toes, or walking normally, or if you can feel a gap in the tendon. These can point to an Achilles tendon rupture. Go to an emergency room right away for calf pain with swelling, warmth, or redness, especially after a long trip or surgery, or with chest pain or shortness of breath, which can point to a blood clot. Get prompt care for a red, hot, swollen heel with fever, numbness, or sudden severe pain after starting a fluoroquinolone antibiotic. These need different care first.

Why Oakland runners and athletes choose Riverstone

• Local and easy to reach. We’re at 3409 Grand Ave #5 in the Grand Lake neighborhood, near Lake Merritt’s popular running loop. Patients also come from Adams Point, Rockridge, Temescal, Piedmont, and Montclair. 
• Hands-on, sports-focused care. Dr. Sandy Baird, DC works with runners, court sport athletes, and other active people, and looks at the foot, calf, hip, and glutes together.
• Experience with injuries that linger.
• Free consultation so you can ask questions first.

Achilles tendonitis FAQs

How long does Achilles tendonitis take to heal?

Tendons heal slowly. Many people need around 12 weeks of consistent rehab, and long-standing cases can take longer. Many improve noticeably within the first several weeks.

Should I rest an Achilles tendon that hurts?

A short break from the activity that aggravates it can help, but complete rest usually isn’t the answer. Gradual, controlled loading is what helps the tendon recover.

Should I stretch my Achilles?

Gently, if it doesn’t aggravate the pain. Deep calf stretches can irritate the tendon, especially at the heel, so we’ll show you what’s appropriate for your type.

Can I keep running with Achilles tendonitis?

Sometimes, with changes. Mild pain that settles quickly may allow shorter, flatter runs. If the pain is sharp, building, or lasting into the next day, cut back and get it checked.

Is Achilles tendonitis the same as tendinosis or tendinopathy?

They’re related terms. Tendinopathy is the general word for a painful tendon problem. Tendonitis means inflammation, and tendinosis means a degenerative change. Long-standing cases are usually more degenerative than inflammatory, as you note above.

Will a bone spur on my heel need surgery?

Not usually. As noted above, a spur is often the result of the tendon problem rather than the cause, and many people have spurs without pain. Most Achilles problems improve without surgery.

Should I get a cortisone injection?

Talk to your doctor first. Steroid injections in or near the Achilles tendon have been linked to a higher risk of tendon damage, so many clinicians avoid them in this area.

Do I need an ultrasound or MRI?

Not always. Most cases are diagnosed from your history and exam. 

How can I prevent it?

Build calf and hip strength, increase mileage and hills gradually, replace worn shoes, and don’t ignore lingering morning stiffness at the back of the heel.

Do I need a referral?

No. You can book directly. Insurance coverage varies by plan, and we can provide detailed receipts for reimbursement. 

If you are suffering with Achilles Tendonitis and would like to schedule a free consultation with an Oakland chiropractor, please call (510) 465-2342 or click the button below.