What is Achilles Tendonitis and What Can you Do About it?
As the seasons change so do our running habits, maybe the footing isn’t as good if we are committed to outdoor running or maybe we like to move it indoors to a treadmill. Either way changes in our running habits can lead to injuries like Achilles tendon issues.
Your Achilles tendon is the strong fibrous band of tissue that connects your calf muscles to your heel. The tendon is named after "Achilles" who was a powerful, yet vulnerable warrior in Greek mythology. Likewise, our Achilles tendon, being the largest and strongest tendon in the body, is susceptible to injury from the high demands placed on it. (Running can generate forces over 12 times your body weight on the Achilles tendon.)
The tendon may be strained or even torn from excessive stretch or forceful contraction of the calf muscles. More commonly, the tendon is repeatedly overloaded and suffers tiny "micro-tears." Damage usually occurs either directly behind the heel or near the weakest area of the tendon- one to two inches above the heel.
Achilles tendon injuries affect between 250,000 and 1 million people per year. Most are middle-aged males, between the age of 30 and 50. Interestingly, Achilles tendon injuries occur more frequently on the left side. If you have suffered a prior Achilles tendon injury, you are at greater risk of injuring the opposite side. Two-thirds of all Achilles tendon injuries involve athletes. Runners are up to 10 times more likely to suffer Achilles tendon problems. You may be at increased risk if the arch of your foot is too high or too flat.
Symptoms may begin abruptly following a strain but more commonly develop slowly from repeated irritation. Morning pain and stiffness are common. Your symptoms will likely increase with activity, especially walking or running. You may notice pain when you rise on your toes. Walking downstairs stretches the tendon and usually increases symptoms. Some patients notice that the irritated area becomes firmly swollen. Ongoing irritation to the spot on your heel where the tendon inserts can cause a painfully elevated "pump bump."
Research has shown that conservative care, like the type provided in this office, can produce "excellent results" in over 85% of patients. Initially, you may need to limit or stop activities that cause pain. Runners may need to switch to swimming or cycling for a short period of time. Be sure to introduce new activities slowly and avoid increasing your activity by more than 10% per week. Runners should begin on a smooth, shock-absorbent surface and start at a low intensity – first increasing distance, then pace. Avoid training on hard or unlevel surfaces like hills. Make sure you warm up properly and avoid over-training. Avoid wearing compression socks, high heels, or shoes with an excessively rigid heel tab.
One of the most important and effective treatments for Achilles tendinopathy is performing "heel drop exercises". In-office treatments for acute Achilles injures are focused on decreasing pain and inflammation, restoring normal mechanics to the foot, ankle knee, hip and lower back and speeding healing.
In more chronic cases we use additional treatments like shockwave to help ‘kickstart’ the healing process, in both acute and chronic cases activity advice and home exercises are important management strategies.
