Treating Achilles’ Tendonitis

Running from about mid-leg to your heel, on the back lower, leg is the Achilles tendon.  This tendon anchors both the gastrocnemius and the soleus muscles to the heel.  You’ll find the gastrocnemius muscle running from the lower part of the femur, while the soleus runs from just below the knee.  Although they’re very close in terms of location to one another, they work completely differently.  The gastrocnemius is most at work when the knee is extended (i.e. when walking), and the soleus goes to work when the knee is bent (i.e. when riding a bicycle).  Tendons work in tandem with one another as they join further down the leg to form the Achilles tendon.  This then attaches to the heel bone.

 

What seems to be the problem?

Because of where it’s located, it’s quite common for the Achilles tendon to get hurt.  It’s put under a great deal of strain a lot of the time as supports pretty much half your whole body weight.  Here are just some of the things that can go wrong:

  • Misalignment of the calcaneus (heel bone):  If you suffer from a flat foot or a high arch you constantly have to stretch and strain one side of your foot.  This creates a pull on the tendon that gradually gets worse.
  • Poor warm-up techniques: If you don’t carry out a proper warm-up before you exercise the chances of you pulling a muscle is quite high.  Your muscles will be stiff and hard to stretch and as a result, they’ll be unable to meet the sudden demand needed.
  • Lack of flexibility:  When you exercise a muscle it gets bigger and shorter, making it much more prone to injury as it’s constantly under tension.  Being constantly put under so much tension, eventually, the muscle will collapse or snap.
  • Muscle imbalance:  If your calves are a lot stronger than your anterior leg muscles, when you run your heel bone is kept plantarflexed when in the air.  When this happens, you end up overstretching the tendon with each step you take.  Eventually, this could lead to a rupture or tendonitis.
  • Pressure:  Direct pressure on the tendon from ankle braces, ankle taping, high top shoes, or any other poorly fitting shoe.
  • Hill training:  Training too much too soon is dangerous and if you’ve been out of action for a while it’s probably best not to start back with this.  Your calves are especially at risk of injury when hill training since they are constantly stretching and too much of this type of exercise without the proper warm-up or rest can weaken the muscle making it more prone to injury.
  • High heeled shoes:  They might look good, but they don’t do your feet or calves any favors.  As the foot is constantly in platarflexion your calves end up adapting to that position and shrink as a result.  Not only does this cause flexibility issues, but it creates a lot of unnecessary strain when wearing regular shoes as your calves become stretched again.

 

Treatment options

If you have managed to get an Achilles tendonitis you might want to stay away from running for a while to give yourself a chance to heal properly.  To do that, first, you need to locate the cause.  Once you know where the problem lies you can take the relevant steps to eliminate it, then you need to heal the damaged tendon.  First, you’ll need to allow around 3-4 weeks for the fibers to heal, so rest is vital.  For the first few days, you’ll also want to use lots of ice to reduce the swelling and accelerate the healing process.  Avoid walking if you’re in a great deal of pain.

When you can finally walk pain-free, you can start to heal those fibers.  Start by massaging the tendon gently to help rid any excessive scar tissue.  Then take some of the load off the calf by applying a deep massage to promote relaxation and good circulation.  As it begins to heal, you can start to stretch it but be careful not to overdo it as is still very weak at this point.  Once you are well enough to exercise again make sure you break yourself in gently, making sure that it still feels good.  Make sure you stretch too otherwise you may end up right back where you started in the road to recovery.  In the final part of treatment, try and use deep tissue massage.  To do this first warm up the muscle the massage it, stretch it and finally ice it.  Follow these steps and within a month or so you should back on your feet again, running pain-free.

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