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help please for achilles tendon pain

Question: help please for achilles tendon pain

I am a regular runner, in training for the SMH 1/2 Marathon in May. Unfortunately I have pulled up with a sore achilles tendon this morning after a 12k run with a group who set a pretty fast pace! I am due to take part in the Run 4 The Kids in Melbourne next weekend and am now a bit worried that I won't be able to do it. Any clues as to how I can ease the pain fairly quickly would be greatly appreciated!

Answer:

Hello,
Depending on the severity and duration of the injury,I would start with soft tissue treatment on the muscles above the achilles tendon. Tightness and restricted ankle mobility can lead to adhesions and tenderness in the muscles that act on the achilles tendon. The entire kinetic chain needs to be addressed but I would start with the gastrocs, soleus, posterior tibialis and see what happens from there. Continue to ice the areas of soreness to keep inflammation to a minimum. You may have to minimize running for now until you receive the treatment you need. You might want to try Active Release Technique (ART) for an option of treatment. Very powerful and effective technique. You can learn more about it and also find an ART provider in your area. Good luck with everything. Here is a link to learn more about ART and where to find a doc in your area. Take care.

BG

Answer:

I have had Achilles problems before and I am utterly convinced they are caused by heelstrike. Research I have seen in articles from SIB show that the cause may well be sudden compression of the tendon. Landing on the heal does not stress (put into tension) the calf muscle. The muscles on the front of the shin are used to control plantar flexion of the foot so that is does not slap into the pavement. When your heel lands, carrying many times your body weight, the wonderful suspension system that is yout foot and leg is in effect out of action. The energy has to be absorbed so the heal will twist, the thighs take a battering and the shock wave travells up to the hip and twists that as well.

At the moment of landing the Achilles is pushed into comrepssion and the theory goes hat his is the trigger that causes the injury. Tendonopathy is not an infalmmatory condiion so NSAIDs will not help, at leat not after the acute phase.

I suggest two things.

1. Do eccentric excercises twice a day. Stand on a step, lift yourself up in tip toe on the good leg and lower to below the step with the bad leg. Control the lowering. This is eccentric work where the muscle is lengthening while under tension. This causes collagen production which is essential to the healing process.

2. Change your style to midfoot landing but make very very sure that you put your foot down at or slightly behind for centre of gravity. NOT IN FRONT. Your calves will blow up! Increase stride rate to at least 180 per minute even when running slowly. You will not over stride when you do this. Start gently because your calves will be very weak and not used to doing what they should be done which is absorbing the energy of landing. You get it back. Imagine yourself running barefoot (as you did when a kid) and you will get the idea. Basically make landing on your heel out of bounds. You can put your heal down after landing on the midfoot. The additional side effect is that every step taken is a mini eccentric load.

Changing to mid-foot strike (avoid landing on your toes and this puts too much strain on your calves) has eliminated my tender Achilles completely. They are like new.