Achilles Tendonitis = Not Fun!

Achilles tendonitis is an inflammation of the tendon just above your heel. This tendon connects the calf muscles, the gastrocnemius and the soleus, to the calcaneus, or heel bone. It can present as a pain during or after activity, a thick nodule that you can feel on the tendon, or a popping feeling as you point and flex your ankle.  It is commonly found in runners, tennis players and “weekend warriors”.

What causes it?

It is typically caused by an increase in running frequency or duration, or adding in too much hill running at one time.  When you change your program like this, you do not give the Achilles tendon enough time to adapt to the increase in activity and it can get irritated and begin to wear down, like a rope which frays over time. Achilles tendonitis can also be caused by abnormal mechanics of your feet, especially over pronation, or flat feet.

How can I prevent it?

• 10% RULE
  Each week, runners can increase their training volume by 10%, and then take a down week on the 4th week, with reduced volume to allow your body to rest and repair.
• HILLS
  Build hills into your workout slowly to allow your body to adjust.
• SHOES
  Have a physical therapist or trained employee at a shoe store make sure you are in the proper shoe to fit your foot.
• STRETCH
  Stretch and strengthen the two muscles in your calf.

What should I do if I get it?

First, you need to rest the tendon. Take a break from the sports that are aggravating your tendon and use this time to cross train or strengthen other muscle groups.  Use ice several times a day for 10-15 minutes at a time to decrease the inflammation and pain.  You may speak to your doctor about anti-inflammatory medications to aid the healing process. Once the inflammation and pain has resolved and you can run short distances without pain, you may resume a running program. It is important that you start with low duration, frequency and intensity and obey the 10% rule.

Physical Therapy Treatments

If you are diagnosed with Achilles tendonitis and see a physical therapist, you can expect some typical treatments.  Your therapist will start you on a stretching and then strengthening program for your calf muscles. They will work on balance and sport-specific exercises.  Certain modalities may be used to decrease inflammation, increase blood flow and promote healing; these modalities include ultrasound, electrical stimulation, iontophoresis and ice.  Your PT may mobilize some bones in your foot and ankle to increase your motion, stretch your calf muscles or do cross friction massage to the tendon. Finally, your PT may recommend heel lifts, orthotics, or a new type of shoe to adapt to the shape and mechanics of your feet.

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