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The following are parts of an article on achilles tendon injuries from Runners World:

Achilles Injury

By Brian Fullem, D.P.M.

The Achilles tendon is the largest tendon in the body and one of the more difficult injuries to treat in a runner. As a sports medicine podiatrist there are only a few injuries that lead me to advise runners that they have to take time off; Achilles tendinopathy is one of those diagnoses. The proper medical terminology no longer includes tendinitis when discussing injury of this tendon. A landmark paper in 1976 showed that under microscopic examination the injured Achilles tendon shows no inflammatory cells within the tendon but rather degeneration; therefore, tendinitis is not the proper term. This has led to a greater understanding in the treatment of this injury.
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The most common cause of Achilles tendinopathy is overuse. Tendons will typically not get injured until they are fatigued. Other causes include lack of flexibility, excessive overpronation, changes in training terrain, changing shoes, training in the morning, increases in training intensity, adding speed work or hill work. Two miscellaneous causes include prior use of oral steroids and the antibiotic class known as Quinolones, which includes the commonly prescribed drug Cipro (ciprofloxacin).
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The single most important aspect of treating this injury is early intervention and treatment. Rest is paramount for this injury to improve. As is the case in the beginning of most injuries, it will warm up initially at the start of a run and the run can be completed pain free. My rule of thumb is that if there is swelling, burning and/or pain, you should take some time off from running. When the injury starts to enter the chronic stage of longer than two to three weeks, strengthening exercises need to be added as part of the treatment plan.
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If you are a moderate to severe overpronator then a custom orthotic device may help correct the causative factors.* Working with a sports physical therapist has been critical to the successful treatment of my patients with this injury. Modalities such as electrical stimulation and ultrasound can help to improve this injury, combined with a therapist teaching proper technique for stretching and strengthening. There are several studies that support a hypothesis that therapeutic ultrasound can help repair injured tendons. When all the treatments fail and the injured tendon is preventing normal activity, then the use of a removable walking boot to completely immobilize the tendon should be considered. Remember that this must be followed by a rehabilitation of the muscles because atrophy will occur from immobilization.
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Extracorporeal Shock Wave Therapy (ESWT) has also shown to be somewhat effective in treating this injury. Shock wave therapy theoretically promotes the formation of new blood vessels in the treated area to promote healing of the tissue. The last resort is surgical intervention. Dr Amol Saxena, a top sports medicine podiatrist in Palo Alto, CA, has successfully operated on the Achilles of many Olympians. When is it time for runners to consider surgery? "When they have done all the non-surgical things, rested completely from running three to six months, when they have pain after every run or they are limping," says Dr. Saxena. The majority of Dr. Saxena's patients get back to prior activity levels within two to six months.
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Overall, 90 percent get better without surgery, but a recent study conducted by Dr. Nicola Maffulli, Professor of Trauma and Orthopaedic Surgery at Keele University School of Medicine in the United Kingdom, showed that rest, ESWT and eccentric exercise only reduced symptoms in about 30 percent, 60 percent and 60 percent of the patients studied, respectively.
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Dr. Brian Fullem is a podiatrist in Newtown, CT.