Whilst doing my usual scrolling through Facebook, I’ve noticed an increased number of posts asking about Achilles tendon pain. And it seems like once it strikes, it’s pretty tough to get rid of! But there is hope.
Here’s a typical anecdote from a runner suffering with achilles pain:
“About 5 weeks ago on a run my left Achilles started hurting. And since then it’s been a problem. Every morning I’m like an old woman getting out of bed (I’m 34!),
I hobble and can’t manage the stairs. Gradually within the hour it’s warmed up and eased. Prior to every run it takes about 1.5miles to warm up into it. Going uphill is painful.
Once it’s warmed up its not too bad…but ever so slightly tender when I press it. I rested it for 2 weeks (2weeks ago) hoping it would help, but it hasn’t.”Runner
And this is a pretty common story.
So I asked Modestas (our resident Sports Therapist) to share some insight with us on how to support and strengthen your Achilles to reduce your risk of injury and get you back on the road.
Where Is Your Achilles Tendon Located?
The Achilles tendon is the largest tendon in your body. It is located at the lower part of the calf and connects two major calf muscles – gastrocnemius and soleus- to the foot at the base of the heel .
These muscles allow you to move your foot up and down. Both muscles have a number of functions, however, the main ones are propulsion while you walk or run and shock absorption, particularly if you run on the balls of your foot or toes.
Repetitive sports such as running and cycling place a significant strain on calves and Achilles tendon, hence, it is very important to look after them. Main Achilles injuries are strain, known as tear and tendinopathy.
What Is An Achilles Strain?
An achilles strain is a tear of the tendon or muscle. There are 3 grades of stain, Grade I – mild strain where 5% – 15% of fibres affected, Grade II – significant strain of 20% – 70% of fibres affected and Grade III is severe strain or complete tear affecting 70% – 100% of fibres.
Symptoms of Achilles Strain
Symptoms of an achilles strain usually consist of a sudden sharp pain in the affected area that can stop you from continuing the activity. Depending on the severity of the strain you can observe bruising at the affected area, redness and the area may feel hot.
You might also feel a dent if the strain is significant. Your ability to move the ankle up and down might also be compromised, but that too depends on the severity of the strain.
Causes of Achilles Strain
Achilles strains are typically caused by a very forceful contraction of the muscle, landing followed by an attempted immediate acceleration or a slip or trip which suddenly changes the length of the muscles resulting in over-stretching.
How To Prevent An Achilles Strain
You can reduce your risk of straining the achilles through regular stretching, foam rolling and strengthening exercises.
More Common Injuries:
- Foot Pain When Running Caused By Plantar Fasciitis?
- Dealing With Shin Splints – Symptoms & Treatment
- Ankle Strengthening For Runners
- Managing Knee Pain When Running & Cycling
- 3 Effective Exercises For Glute Activation
Achilles Tendonitis / Achilles Tendinopathy
Achilles tendinopathy predominantly refers to the degeneration of the achilles tendon but can also cover a range of issues such as micro-tears, traumas or scar tissue formation.
Achilles Tendinopathy vs Tendonitis
Achilles tendonitis refers to inflammation of the Achilles tendon. Tendonitis is commonly diagnosed on the presentation of Achilles pain, however, it is thought that tendinopathy is in-fact the most common cause.
Tendinopathy – is an overuse or repetitive strain injury. It happens when the area is being used very often for long periods of time without proper maintenance.
Symptoms of Achilles Tendinopathy
Pain at the Achilles tendon in the morning or after long periods of being static is one symptom of achilles tendinopathy.
Also, pain at the beginning of the activity which reduces and may subside completely as the activity goes on. However, this depends on the severity as in severe cases pain would increase with activity and you would have to stop.
“It’s sore in the morning and when I get up after sitting for a period of time. Its noticeable when I start running but then eases off. It’s been painful to touch…”runner
If you’re wondering what the difference between plantar fasciitis and achilles tendinitis is, well, the symptoms of plantar fasciitis are pain in the heel, usually at the bottom of the heel, present after inactivity.
Achilles tendinopathy is typically caused by chronic overuse without appropriate maintenance such as stretching, foam rolling, or strengthening exercises (eccentric loading in particular). These are all key in minimising the development of Achilles tendinopathy.
How LONG To Recover From Achilles Tendinopathy
Recovery time varies depending on the severity and chronicity of the injury. The sooner you are diagnosed and crack on with the rehab, the faster your recovery will be.
There are many variables when it comes to recovery, hence, it is extremely difficult to suggest a timeframe of recovery suitable for all, however, it is estimated that it might take from few weeks up to several months.
Running With Achilles Tendinopathy
Should you run if you’ve been diagnosed with Achilles tendinopathy? The short answer is if you are in pain, rest and avoid running.
If you run when injured, you’re likely to make it worse which means you’ll down and out for far longer than you’d like.
Exercises To Support Your Achilles
Below are several achilles tendonitis exercises and stretches to help you to reduce your chances of developing these injuries, so you can keep running injury free for longer.
Stand tall and slowly raise your heels off the floor. Once you’ve reached your toes, pause and return to your start position.
- Sets: 2
- Reps: 12
Single Leg Eccentric Loading
Stand on a step or any platform with half of your foot on the platform and heel free. Use your hands for balance against a wall or other solid object.
Raise yourself up on your toes, then shift all your bodyweight on one ankle and very slowly (5-7 seconds) lower yourself down on one ankle within your comfort zone.
Ideally your heel should end up lower than your toes. Then place the second foot on the platform to help yourself up again and repeat.
- Sets: 2
- Reps: 8 per calf
Lower Leg Foam Rolling
Put your calf on a foam roller and roll back and forth.
- Sets: 1
- Reps: 1
- Time: 1 minute per calf.
Calf Stretch (Gastrocnemius)
Option 1 Above: Stand with your hands against a wall. Take a step back with the stretched leg. Keep the other leg in front.
Ensure that your toes are directed forward and that your heel is in contact with the floor. Then push your hips forward to increase the stretch maintaining your toes facing forward and heel on the floor.
- Sets: 1
- Reps: 1
- Time: 30 seconds per calf
Calf Stretch (Soleus)
Option 3 Above: Stand next to a wall. Have your hands on the wall and place the foot of the stretched calf in front of a wall. Have your other foot behind you.
Then keeping the heel of the forward foot on the floor bend the knee and try to reach for the wall.
- Sets: 1
- Reps: 1
- Time: 30 seconds
Check out this Post Run Stretch & Recovery Guide to help you reduce your risk of injury as a runner.
More On Treatment For Achilles Tendinopathy
As well as working on stretching, foam rolling and strengthening the area in question, there are a few others things you can consider to help treat achilles tendinopathy.
- Try not to increase your mileage dramatically
- look into getting better suited footwear / running shoes
- or update your running shoes if they are worn out.
The causes and treatments are all pretty similar to other lower leg injuries such as shin splints or plantar fasciitis so it’s important that if you haven’t had a diagnosis from a professional yet, you do seek one.
I can highly recommend seeing a Sports Therapist, Osteopath, Podiatrist or Physiotherapist… and if they’re also a runner, even better!