The Achilles tendon connects the two major, more superficial calf muscles (gastrocnemius), as well as the deeper Soleus muscle to the back of the heel via the Achilles tendon. The Achilles tendon itself might tighten and become irritated (tendinitis) OR sometimes the junction between the muscle and the tendon becomes sore.
If the tendon becomes sore very often, you will be able to feel an area of swelling and soreness in the tendon. A feeling as if you have been kicked in the back of the leg is indicative of a tear in the area, where the muscle blends with the tendon
Who's at Risk?
Runners who dramatically increase training (especially hills and speedwork) or who are just starting back to running after a long layoff. Also, those runners with naturally tight calves or stiff ankles are vulnerable.
For children around the age of puberty, take particular care as they can develop a heel pain known as Sever's disease. In this condition, the Achilles tendon is pulling at the point of insertion into the heel bone and it is important to completely rest from activities that involve running and jumping.
Can You Run Through it?
This is not an injury to run through. If you catch a minor strain early, a few days off might be sufficient healing time. If you keep running as usual, you could develop a serious case that may take six months to go away.
If your Achilles is quite acute (sore), cycling is the only other safe exercise to begin with. Take advice from a therapist about options such as taping with kinesiotherapy tape, ice massage and potentially a little heel raise to take the stress off the tendon.
Once you can walk comfortably with no pain, try going to a swimming pool. The deeper you are in the water the more it will take the load off the tendon and calf muscles. Begin with your feet together hopping in the pool backwards and sideways. Going backwards and sideways puts less strain on the tendon. Only when you have no pain in these directions should you try hopping forwards. Once you can do this with no pain, then try single leg hops once more moving backwards and sideways first before trying to go forwards.
The next step is to start dry land exercises, doing double hops side to side then forwards and backwards while holding onto the back of a high chair. Move on to double hops backwards in a zig zag pattern and with a twist, sideways double hops and then forward double hops. Move on to running drills at walking pace, such as baby skips, walking on your toes and heels with toes in toes out etc. The final piece in the puzzle for full rehab would be single leg hops, again beginning with going backwards, then sideways and finally forwards.
How to Proceed
- Stop running completely: Severe pain and swelling above your heel, even when not running. Standing up on your toes causes pain.
- Run with caution: Dull pain around your heel at the end of your run that lingers afterward but goes away when iced.
- OK to run: No pain when you pinch the tendon, starting at the heel and working your way up towards your calf. You can perform heel raises and, more importantly, you can hop forwards and backwards on a single leg.
Prevent a Relapse
Make sure you have a good warm up and cool down, particularly if you are doing a session with some speed work. If you are prone to Achilles or calf problems, this is especially important. You need to be physically warm before running. Turn up early to the session and do plenty of running drills moving in different directions so that the ankles, tendons of the calf and feet have plenty of time to adapt to what you are about to ask of them.
For more information on Achilles tendonitis and calf problems or to book an appointment in Bridgnorth or Shrewsbury, please call 01746 761050.