Achilles Tendinitis for Runners



The Achilles is one of the lower leg's largest and most significant tendons. It's responsible for propelling you forward by plantar flexing the foot, creating the locomotive movement required for walking, running, and jumping. If you've experienced pain or discomfort in the Achilles, then you know how challenging running can be when pain symptoms are present.


The Achilles connects the gastrocnemius and soleus muscles of the calve to the heel (the calcaneus bone) at a 90-degree insertion point.


As the calve muscles contract, they pull on the Achilles tendon creating propulsion. Placing too much load on the Achilles, failing to warm up properly, or poor nutrition and hydration can leave the Achilles tendon susceptible to pain and injury, such as Achilles tendonitis.


How do I know if I should stop running if I have Achilles pain?


Pain in the Achilles tendon can range from mild to severe. If pain has begun to affect how you walk or run (notable limp or change in gait patterns), it's vital to decrease the training load or frequency while symptoms are present.


What is Achilles tendinitis?

The term tendinitis and tendinopathy can be used interchangeably as both denote inflammation.


While the mechanisms and causes can vary, generally, Achilles tendinitis is pain and inflammation along any portion of the Achilles. Runners often experience Achilles tendinitis in the lower portion of the Achilles, just above the heel. The pain will be notably worse with movement and may also be sensitive to touch (palpation).

The overuse and repetitive nature of running causes compression, and overload strain, leading to microtrauma and friction between the muscles of the calves, which translates to subsequent inflammation of the Achilles tendon.

The overuse and repetitive nature of running causes compression, and overload strain, leading to microtrauma and friction between the muscles of the calves, which translates to subsequent inflammation of the Achilles tendon. Once pain symptoms are present, continued activity can lead to degeneration (tendinosis) of the tendon over time. It's essential that symptoms are addressed due to the chronic nature of Achilles tendinitis.


Common causes of Achilles tendinitis for runners:

  • Limited mobility in the ankle or tight calve muscles

  • Failing to warm up and cool down from training

  • Increasing mileage or workout intensities too quickly

  • Overtraining

  • Hill training (especially uphill) as running uphill places the Achilles in a stretched position

  • Excessive pronation

  • Poorly fitted running shoes


How to treat Achilles tendinitis

*If bumps or nodules are present when you run your fingers along the Achilles, a specialist such as a physical therapist, chiropractor, or PCP with experience in endurance sports should be consulted as part of the treatment process.

  • Decrease training intensity and frequency while symptoms are present. If needed, opt for a stationary bike to continue training while reducing the impact force caused by running.

  • For runners that have begun to have symptoms of pain and inflammation, it's crucial to start icing while symptoms are present for 15 – 20 minutes, three to four times a day. If tolerated, over-the-counter medications such as ibuprofen can also help manage symptoms.

  • Self-massage with emphasis on the muscles of the calve. Due to limited blood flow to the Achilles tendon, massaging and using roller sticks directly to the Achilles tendon can limit and slow healing. *When massaging the calve, spend 1 – 2 minutes on each portion of the muscle belly with moderate, tolerated pressure.


Prevention

Strengthening the calve muscles is one of the best ways to reduce the risk of developing Achilles tendinitis. Completing exercises such as calve raises standing on the edge of a step or completing a banded exercise to develop lower leg strength, including ankle inversion and eversion, can help ensure proper alinement and foot placement when running.


Nutrition is a necessary component to overcome and prevent Achilles tendonitis. Support the lower leg muscles by staying adequately hydrated, and consume enough nutrients to support healing and training.






Refrences:

Wong M, Jardaly AH, Kiel J. Anatomy, Bony Pelvis and Lower Limb, Achilles Tendon. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499917/