Running Injury #5 Achilles Tendonitis / Tendinopathy

Running Injury #5 Achilles Tendonitis / Tendinopathy

   by Karen

Even the greatest warrior in the battle of Troy could not escape the pain and untimely demise of his Achilles tendon, so why should the almighty runner?

The Achilles tendon is a band of tissue that connects the calf muscles to the heel bone. Part way through the tendon there is an area that gets less blood flow. Because of this decreased blood flow the tendon is slow to heal after injury.

How do you know if you have it?

Achilles Tendonitis is pain felt at the back of the leg just above the heel. It is typically worse when you start walking or running, decreasing as you continue to exercise. The pain often worsens several hours after you stop exercising.

Within the first week or two of injury this is called a tendonitis (which means swelling in a tendon), when the condition becomes more chronic it is called a “tendinopathy” (which means a sick tendon).  The cause of tendonitis or tendinopathy is an increase in the amount of load or stress on the tendon and is therefore called a “load injury”. A load injury can be caused by doing too much speed work, up-hill running or plyometrics.

So how do you treat it?

To treat a tendon-itis you want to use the RICE formula of Rest, Ice, Compression and Elevation. You should avoid anti-inflammatories as these will decrease your body’s natural healing response.

To treat a tendon-opathy  the most effective treatment is one aimed at increasing your body’s ability to heal itself. Eccentric exercises including calf raises on the floor or a small step (with a focus on slowly lower during the down phase of movement) are most effective. A high number of repetitions of this exercise are required allowing a small amount of pain during the exercise, but not after, is recommended. Avoiding anti-inflammatories is essential.

Other treatment tips include stretching the muscles on the back of the leg and using a heel lift in your shoes for daily walking to temporarily unload the Achilles. Avoid anything that creates rubbing on the back of the heel.

Please ensure that you seek help from a qualified health care professional should your symptoms not resolve. Treatment options provided by a physiotherapist that can help decrease pain and speed healing include ultrasound or acupuncture, various taping techniques, manual therapy, and stretching and strengthening exercises in addition to those outlined above.

About the Author: Karen Gilbert is a physiotherapist at CBI Health Group in London, Ontario and a competitive distance runner.  Karen enjoys bringing together her love of running with her love of treating patients.