What is Achilles Tendonitis
What is Achilles Tendonitis?
Achilles tendonitis is one of the most common overuse injuries in runners. The Achilles tendon is the large tendon at the back of the ankle joint which connects the calf muscles (gastrocnemius and soleus) to the back of the heel bone (calcaneus). If the tendon is placed under too much stress it can become tight and inflamed. This inflammation is known as Achilles tendonitis.
- Pain along the Achilles tendon which is usually worse on exercise. Some runners find they have pain at the beginning and end of a training session with a period of decreased pain in the middle.
- Swelling and redness over the Achilles tendon. A small lump of scar tissue may also be palpable.
- A creaking may be felt around the tendon on moving the foot or pressing the tendon. This is scar tissue rubbing against the tendon.
- Limited ankle flexibility / stiffness of the tendon especially in the morning.
- Inflexibility (tightness) of the calf muscles (gastrocnemius and soleus).
- Weakness or fatigue of the calf muscles.
- Over pronation (turning inwards of the foot on impact).
- Number of years running.
- Recent change in footwear or inappropriate running shoes.
- Recent increase in training activity (mileage, speed, intensity or an increase in hill work).
- Change of running surface / running on uneven ground.
- Limited movement at the ankle joint (dorsiflexion).
- Rest – avoiding painful aggravating activities.
- Use ice wrapped in a damp cloth and apply to the Achilles for 10 – 15mins. This is especially useful after exercise.
- Take non-steroidal anti-inflammatory drugs (eg. Ibuprofen.). Consult your pharmacist / General Practitioner for advise/ dosage.
- A heel raise can be used initially (in both shoes) to reduce the load on the tendon. This should only be used in the acute stages.
- Ensure correct shoes.
- Self massage – massage in small semi-circles away from the lump on the Achilles in all directions.
Stretching of the gastrocnemius and soleus muscles as below:
Stretch 1 – Gastrocnemius Muscle
Stand with one leg in front of the other and hands against a wall. Make sure that both feet are pointing forwards and that your heels remain on the floor. Lean in to the wall until you feel a gentle stretch down the back of your calf. Hold for 30 secs.. Repeat on both legs.
Stretch 2 – Soleus muscle
Stand with one foot in front of the other and the toes of the front foot against a wall. Bend your front knee until it touches the wall, hold for 30 seconds. If this is too easy and you do not feel a stretch make it more difficult by gradually moving the front foot away from the wall so you have to bend the knee further. This should increase the stretch.