Take Care, Achilles
“We run, not because we think it is doing us good, but because we enjoy it and cannot help ourselves.” Sir Roger Bannister
Anybody in your running group out with achilles tendon problems? If not now, statistics would point toward the probability in the future as 8-10% of running related issues are achilles in nature. It’s the strongest tendon in the body connecting the heel bone (calcaneus) to the calf musculature.
Achilles tendon pain may occur in any athlete, particularly those who may be deconditioned for the chosen activity, runners who do excessive hill work or the old “too much too soon” seen so often in my office. It starts gradually, 4-6 cm above the heel, as pain only with exercise subsiding with rest. Jumping sports like volleyball can accelerate the process, or when making a significant change to one’s training plan. You do have a training plan, right? Even normal running can cause tiny tears in the tendon which heal spontaneously unless the runner over stresses the area with insufficient rest. Rest is KEY to the Rock Star athlete! Ultimately, this can lead to a chronic tendinitis picture with nodules in the tendon and in very rare cases, rupture of the tendon. I’ll bet that would change one’s training.
So, you think you might be getting it and want to know what to do. Well, before you call the doc, you’d try twice daily cold therapy-watch out for frostbite. Have a friend inspect your legs looking for redness or maybe a cracking feeling coming from the narrowest point of the tendon. It can be pretty dramatic. A heel lift from your local running shoe store can be beneficial – both sides if you’ve had limb length inequality issues. While there, ask them to look at your shoes and your gait. I have great respect for the local running shoe store owners and they can be an invaluable resource.
In summary:
1)back off your running volume/intensity
2)twice a day icing
3)careful stretching
4)short term heel lift (work shoes too)
5)see your local “running shoe guy” then Sports Med Specialist if not getting better reasonably quickly.
John Post, MD