Understanding Achilles

Problems with the Achilles tendon is one of the most common injuries runners face – and one of the most frustrating.

What It Is

The Achilles tendon is the largest tendon in your body, connecting the calf muscle to the heel bone, and allowing you to rise up on your toes and push off when you run.

Achilles tendon injuries usually begin as inflammation of the lining though which the Achilles tendon glides; eventually involving the tendon fibers themselves. Chronic inflammation and deterioration in the tendon area can weaken these fibers over time, eventually leading to a rupture.

Achilles injuries are sometimes referred to as “tendonitis” (inflammation) or “tendinosis” (tiny tears in and around the tendon caused by overuse).

What Goes Wrong

When your calf muscles are tight, you tend to exert too much force on your Achilles tendon, which connects the calf muscles to the bones of the foot. Failure to warm up before a run, lots of speedwork, hill training, and sustained high mileage (overuse) and lack of proper arch support can all cause problems with your Achilles.

What It Feels Like

With an Achilles tendon injury you may experience swelling in the ankle and mild to severe pain. The area may be tender to the touch and you may even notice than when you move the area you experience a sensation similar to crunching snow. Pay attention! Like most overuse injuries, pain may come on gradually over time.

What to Do

At first signs of Achilles problems, immediately stop all hill training and speedwork. If the pain is especially severe, you may need to take several days off from running. Be sure to warm up gradually and cool down after each run. Ice, anti-inflammatory drugs, and even ultrasound treatments administered by a physical therapist will promote the healing process.

Massage can also be helpful because it can accelerate blood flow to the damaged area and break up adhesions caused by scar tissue.

Once healed, to stave off future injury, exercises focusing on the lower leg should be used. The idea here is to properly stretch your calves to maintain flexibility.

A good exercise for support of the Achilles is the wall lean:

Facing a wall, stand arm’s length away and place your hands flat on the wall. Step back with the injured leg and hold that leg straight while you lean into the way, bending the other leg slightly. Make sure that your pelvis maintains a perpendicular relationship to the wall. Keep your weight on the outside of your foot while doing this stretch.

Include this calf stretch in your regular pre and post run stretching routine.

Prevention

One of the most irritating things that can happen to a runner is to sustain an injury that takes us out of training for any length of time. Prevention is always the best medicine:

Follow the 10% rule: increase your weekly mileage by no more than 10% week over week.

Follow hard training days with easy days.

Change your running shoes every 300-500 miles.

Avoid excessive hills and speedwork.

Do not try to run through pain – it won’t go away and you may be setting yourself up for more downtime by pushing through injury.

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