Home » Sports Medicine » Achilles Tendonitis
Achilles Tendonitis Treatment in Houston, TX
Medically reviewed by Mufaddal M. Gombera, MD, Board-Certified Orthopedic Surgeon.
Dr. Mufaddal Gombera is board-certified in orthopedic surgery with subspecialty certification in sports medicine and treats Achilles tendonitis in runners, court-sport athletes, and active adults across Houston. Nearly all of it resolves without surgery, but not with rest alone. This page explains what actually fixes it.
Schedule An Appointment
What Achilles Tendonitis Feels Like
Achilles tendonitis causes pain and stiffness in the tendon behind your ankle, usually worst with the first steps of the morning and at the start of a run. The Achilles is the strong cord connecting your calf muscles to your heel bone, and it loads with every stride. Typical symptoms:
- Morning stiffness that eases once you get moving
- Pain that warms up during activity at first, then returns worse afterward
- A tender or thickened spot you can pinch on the cord itself
- Trouble with hills, sprinting, or rising on your toes
Doctors increasingly call this Achilles tendinopathy: the tissue is worn and disorganized more than inflamed. That detail explains why the most common treatment fails.
Insertional vs Midportion: Location Changes the Plan
There are two types of Achilles tendonitis, named for where the tendon hurts, and they need different programs.
Midportion tendonitis hurts 2 to 6 centimeters above the heel bone, often with a spindle-shaped thickening you can roll between your fingers. It is the more common type and responds well to classic heel-drop loading.
Insertional tendonitis hurts lower, where the tendon anchors into the heel bone, sometimes with a bony bump that rubs on shoes. Aggressive stretching and heel drops off a step often make it angrier; loading only to floor level, plus a temporary heel lift, works better.
Sorting out which one you have is the first job of the evaluation.
Why Rest Alone Fails
Rest calms Achilles pain but does not fix it, because rest does not rebuild the tendon. Tendinopathy means the tendon’s capacity has dropped below what your activity demands. Pure rest lowers that capacity further, so the pain returns the first week back. The tendon regains capacity only when it is loaded, progressively and consistently. That is why “just stop running for a month” so often ends in relapse.
Eccentric Loading: The Core of the Fix
To diagnose Achilles tendonitis, Dr. Gombera, our Houston orthopedic specialist, will check your range of motion, tenderness, and swelling. In some cases, he may order imaging tests like ultrasound or MRI to confirm the diagnosis and rule out other problems.
Two ground rules. Mild pain during the exercises is acceptable, up to about 3 out of 10, if it settles by the next morning. And results build over weeks; the program has not failed until it has had 12 consistent weeks. Dr. Gombera pairs the loading work with physical therapy, training-load adjustments, and footwear guidance. Sensible load progression rules are in our injury prevention guide.
Does Achilles Tendonitis Ever Need Surgery?
Rarely. Most patients improve within three to six months of structured loading and never need an operation. Surgery becomes a conversation only after six months or more of genuinely completed treatment: removing degenerated tissue, and in insertional cases reshaping the heel bone prominence. Recovery takes months, which is why it sits at the end of the ladder; our [tendon repair](/tendon-repair.html) page explains tendon procedures.
When to See a Doctor
See a doctor for Achilles pain that is not clearly improving after six to eight weeks of sensible self-care, or sooner if any of the following apply:
- A sudden pop, snap, or the feeling of being kicked in the back of the ankle
- Sudden weakness pushing off, or inability to rise on your toes
- Pain at rest or at night
- Rapidly growing swelling or a new lump on the tendon
The first two deserve urgent attention: a chronically irritated tendon is weaker than normal and can rupture. Read about Achilles tendon tears and get seen promptly.
Frequently Asked Question
How long does Achilles tendonitis take to heal?
Most patients feel meaningful improvement within 12 weeks of a consistent loading program, and full recovery commonly takes three to six months. Tendons remodel slowly, so progress is measured in weeks, not days. Pain that has been present for over a year can still improve, but it usually takes longer.
Can I keep running with Achilles tendonitis?
Often yes, at a reduced level. A common rule: pain up to about 3 out of 10 during activity is acceptable if it settles by the next morning. If pain climbs beyond that, changes your stride, or worsens week over week, cut the load further. Complete rest rarely helps by itself.
What causes Achilles tendonitis?
A jump in training load is the most common trigger: more miles, more speed, more hills, or a fast return after time off. Calf weakness, age-related tendon changes, foot structure, and unsupportive shoes contribute. Certain antibiotics called fluoroquinolones, plus conditions such as diabetes, also raise tendon risk.
Do cortisone shots help Achilles tendonitis?
No, and they can make things worse. Corticosteroid injected into or around the Achilles weakens tendon tissue and is associated with rupture, which is why Dr. Gombera does not inject cortisone there. Short-term relief is not worth trading for a torn tendon; loading programs fix what cortisone cannot.
Will heel lifts or new shoes fix my Achilles pain?
They help; they do not fix. A small heel lift temporarily reduces strain on the tendon, and a cushioned shoe can ease symptoms, especially for insertional pain. The lasting fix is a loading program that rebuilds tendon capacity. Treat footwear changes as support for that work, not a substitute.
Schedule an Achilles Tendonitis Consultation in Houston
Dr. Gombera evaluates Achilles pain at Texas Orthopedic Hospital (7401 Main St), the Memorial office (8731 Katy Freeway, Suite 110), and the Baytown office (7718 Garth Rd). Same-week consultations are available.
Dr Gombera, MD