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Achilles inflammation; achilles tendinitus

What it is:

Achilles is the name of the long tendon which attaches the two big calf muscles – gastrocnemius and soleus – with the back side of the heel bone. The achilles er the strongest tendon in the body, and can take strong loads, up to 600-800 kilograms, without going apart. The achilles starts in the leg muscles (m. gastrocnemius og m. soleus) and is fastened on the backside of the heel  bone – calcaneus. During running the tendon is “double working”, because it stabilises the back part of the foot during landing, and also ensures a powerful kick when striding.

The most powerful stretch in the achilles tendon is during the landing phase. It is therefore important that the back part of the foot is stable when hitting the ground during landing.

Despite the big strength, it is unfortunately common with running related injuries in the achilles. The achilles may become overloaded by running, due to repeated and monotonous  load. By being overloaded the tendon becomes too tight and forced to work too hard, which may result in an inflammation. If this inflammation is allowed to keep on for longer time, even if the inflammation is weak, it may result in sore tissue into the tendon, which makes it less flexible and exposed to long term injury.

It is very important to react quickly if you start to feel pain in the achilles. If not the pain and the proble may become a long term issue, which will stop you from running for a long time.

Symptoms:

  • A soft or sharp pain anywhere in the achilles tendon, but most frequently located close to the point where the tendon is fixed to the heel bone.
  • Reduced flexibility in the ancle.
  • Red, swollen and hot area around the point of pain.
  • A small lump/”nugget” of sore tissue located on the tendon.
  • A creaking sound (sore tissue towards the tendon), when moving/twisting the ancle.
  • The pain is worse when being cold. After warming up, the pain feels relieved, however retruns when the ancle gets cold again.

Caused by:

  • Tight or tired calf muscles transferring too much of the running load to the achilles tendon. This may happen if the legs are not stretched correctly, if the distance is increased too quick, or if overloading with too much training in general.
  • Uphill or high speed running loads the achilles more than other types of running. If the load is too high it may cause inflammation.
  • Runners who overpronate (the feet rotates to much inwards after hitting the ground) can easily obtain  inflammation in the achilles due to the overload caused by this.

Treatment and recovery:

  • Reduce the load – think alternative training; bicycling, running in water, swimming.
  • Stretching is important to keep muscles long and dynamic.
  • Do not start running again before you can do heel raise without any pain. Also, try burpees and rope jumping, before starting with slow and not too long runs.
  • Buy new shoes if the old ones are worn out.
  • f you feel pain during running and the tendon feels stiff and sore in the morning after a running session, stay away from running at least a week.
  • If the pain is not gone after a week,  consult a professional, who can give you tailor made advice to reduce the further development of the inflammation or stop it, before it settles. It is important to do this as early as possible. An early consultation is usually much cheaper than many treatments over a long time period for a chronic inflammation.

Prevention:

  • Stretch and strengthen the muscles in foot and leg.
  • Use shoes with movement control or adapted soles to prevent overpronation.
  • Do not run in worn out shoes.
  • Use a “light” running program to avoid overload.
  • Avoid hard uphill running.
  • Remember restitution for the muscles, they also need rest.

The following exercises are recommended, see videos below:




Anatomy of the achilles / lower leg

See detailed description of the anatomy of the achilles, being a part of the lower leg, at this page from TeachMeAnatomy.info:

3D picture:

See more about running injuries, preventive exercises and videos here:

Author: Hege Erichsen

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