Achilles’ tendinitis: 

History: Guess what, for runners this is another overuse injury.  Your Achilles hurts on the push-off phase of running.  Especially when running uphill or doing splints.

However, a common cause of Achilles tendon problems is the classic case of the former high school or college athlete.  He lays off sports for 10-15 years and then goes back for a class reunion and tries to play volleyball or basketball with his old buddies and blows out his Achilles. 

Self-Exam:  Here are some things you can look for in yourself. 

1)      Sometimes there is a small ‘bump’ in your Achilles, just above the heel bone. PH 

2)      Stand with the balls your feet on a small book or other object.  Try to complete a heel raise.  First, to this on both feet.  Then try the same maneuver with just one foot. VID If your calf hurts like begebbers or almost gives away, this is a pretty good hint you have Achilles tendinitis. 

Treatment:

1)      Manage the pain:

a.      NSAIDS will help.  Kinesiology taping to support your Achilles.  LIN

b.      For some runners, an over-the-counter ankle support brace may help.  But, I usually do not recommend trying one of these unless nothing else is helping.

c.       Ice or heat can relieve your pain.

                                                              i.      Ice right after you get done running

                                                            ii.      Heat on non-running days

d.      Continue running but avoid aggressive speed work and hill repeats, especially uphill running.

2)      Restore full motion:

a.      Most runners with Achilles’ tendon problems have tight heel cords.  The lower extremity Sequential short-term stretching will address this problem.  VID 

b.      Make sure you include stretching all your muscles as part of your training program.

                                                              i.      Stretching does not have to be part of your warm-up or cool-down.  But it HAS to be part of your training program. LIN

3)      Begin with non-weightbearing  exercises to restore strength without all the pressure on the joints

a.      Exercises to strengthen the calf muscles.

                                                              i.      Begin with double leg exercises with your heels elevated.

1.      If these hurt, hold on to something to help with your balance and reduce the work on the muscles.  VID

                                                            ii.      Progress to single leg exercises and then to single leg exercises with the book under your toes to make the muscles work harder.  VID

b.      You will not be at this level very long; we just need to increase your strength while minimizing stress on your ankle.

4)      Begin body weight exercises with emphasis on control versus strength and power.

a.      Apply the kinesiology tape to your Achilles before you start your weight-bearing exercises.

b.      These are done slowly, with a short range of motion, and STOP BEFORE IT HURTS.

c.       Static lunges, dynamic lunges, lateral step-ups, etc.  LIN

5)       Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.