Healthy Tahoe: Don’t let Achilles tendonitis keep you off the trail

Paul Ryan, MD
Paul Ryan

In our mountain oasis, we have access to world-class summits, rivers, and trails to enjoy. For any high-intensity activity, it’s important to ease in: increasing distance and speed incrementally as fitness improves. Before you head on your next long distance adventure or over challenging terrain, consider the mechanics of your body and understand common issues so you can minimize your risk for injury.

A common overuse injury is achilles tendonitis — inflammation of the largest tendon in the body which connects the muscles of the calf to the heel. This tendon provides a great deal of your forward propulsion when going uphill and helps to control your descent when going downhill; overusing it can result in inflammation and pain.

For new feelings of pain in this area, it is recommended to avoid the activity that caused the pain for a few weeks. Use ice to massage the area after exercise, evaluate your shoes for any areas of uneven wear that may have contributed, consider an over-the-counter heel lift or insert, gently stretch the tendon, and incorporate strengthening exercises, such as heel lifts.

Many people also benefit from physical therapy. A physical therapist can provide a variety of strengthening exercises and achilles lengthening stretches. Some therapists have the ability to perform tests such as gait analysis, which measures walking or running form, assessing the root of the problem and ensuring your form is not putting you at risk. Importantly, physical therapy can also help relieve pain and discomfort caused by inflammation.

If achilles tendonitis symptoms persist or become chronic, an evaluation with a foot and ankle specialist can be revealing. A specialist may perform a weight bearing radiograph or x-ray of the ankle to evaluate the cause of pain. Depending on the results, your provider may provide a referral for shoe inserts, braces, or injections with a physical medicine specialist. In some cases, surgical treatment may be required, ranging from minimally invasive to total reconstructive surgery. 

Whatever your pathway to addressing new ankle pain, the goal of quick intervention and treatment is to repair the affected areas and get you back to doing what you love as quickly as possible. Speak with your care team if you are experiencing pain, and get started on a treatment plan to keep you on your feet and active.

Dr. Paul Ryan is a board-certified orthopedic surgeon with Tahoe Orthopedics and Sports Medicine. He is a foot and ankle specialist treating patients from offices in Carson City, Zephyr Cove, and South Lake Tahoe. To learn more about foot and ankle services, call 530-543-5554 or visit

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