Treatment depends on how badly injured your tendon is. It may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief (such as, ibuprofen or naproxen)
- Specific exercises to strengthen your calf muscles
- Physical therapy
- A system of exercises that help strengthen your calf muscles to take pressure off your tendon (eccentric strength training).
- Low-impact exercise alternatives, such as swimming
- Heel lifts in shoes, orthotic shoes, cast, splint, or a walking boot
- Extracorporeal shockwave therapy: High-energy shockwave impulses help stimulate the healing process in damaged tendon tissue. This treatment isn’t often used, but your doctor may recommend it to see whether you can improve without surgery.
If these do not work, or if the injury is severe or complete, surgery may be considered. The type of surgery depends on the location and amount of damage to the tendon and other factors, such as the severity of the tendonitis. Some of the surgical procedures used include:
- Surgery to lengthen your calf muscles (this is called gastrocnemius recession)
- Debridement surgery to remove damaged tendon tissue or bone spurs and repair the tendon
- Surgery to remove your damaged tendon tissue, repair the remaining tendon, and give it extra strength by moving another tendon to the heel bone (the tendon moved there is the one that helps the big toe point down)