Definition

Achilles tendonitis is an inflammation of the tendon that attaches the calf muscles to the heel. The tendon assists in what is called plantarflexion which is the action of rising up onto your toes. Inflammation of this tendon accounts for up to 18% of running injuries and can be exacerbated by the rapid shortening of the tendon fibers when your foot makes contact with the ground causing microtears in the tendon.

Symptoms

Typically you will see a gradual increase in pain, which may begin as tenderness when running and/or pain in the morning that will ease during the day. If untreated the pain may begin to last into normal day to day activities and the calf can feel stiff while sitting.

Causes

Causes include excessive stress on the tendon such as a change in running surfaces or an increase in training intensity. Other factors are poor foot biomechanics such as overpronation (excessive rolling in of the foot when running), inflexibility and/or weakness of the calf muscles, and improper footwear.

Treatment and Prevention

You want to strengthen surrounding muscles such as the ankle and knee, and stretch the hamstrings and calf muscles (gastroc-soleus). The use of orthotics may be indicated, as well as a running analysis to assess the biomechanics of your gait. Reducing inflammation is important as well as the use of arch supports and/or temporary heel cups. Activity modification is key such as cross training, progressing to plyometrics, when pain-free. Physical therapists can also provide cross-friction massage to the tendon, as well as ultrasound to promote healing and pain relief.

• Strengthening (ankle, heel raises progress to single leg stance, squats, lunges)
• Stretching (hamstrings, gastroc-soleus complex)
• Tennis ball rolls
• Frozen water bottle