Dundee Podiatry Clinic
Dundee Podiatry Clinic

Dundee Podiatry Clinic
62a Dundee Road, Broughty Ferry

Dundee DD5 1HY

Achilles tendon problems

 The Achilles tendon is the structure which attaches the calf muscles to the heel bone.  It is the thickest and strongest tendon in the body and is generally around 15cm long.  It is an area which is commonly injured by competitive dancers and during sport or exercise.  Many runners experience achilles problems at some stage.  The most common problem is an inflammatory condition known as Achilles tendinopathy.  Other conditions causing pain in this area include retrocalcaneal bursitis, calcaneal stress fracture and calf muscle tears.

 

Running Injuries

Achilles problems are common in runners because the Achilles resists loads of more than 8 times your body weight while running - that's over 1,200 Lbs or AN ENTIRE RUGBY TEAM SCRUM!!  Sometimes the injuries can be a result of over-training or poor foot mechanics.  Other issues may centre around the suitability of the footwear you train in and other times it's just plain bad luck.  Whatever the cause, Achilles injuries are a runners nightmare.

 

If you have recently injured your Achilles then run through this check list to see whether there are things you can alter to help yourself

  • Are your running shoes brand new or perhaps it's time they were replaced. If they are new then they may not be the ideal shoe for your particular foot mechanics and they may be causing or adding to your problem. Older shoes may have lost their shock absorbing qualities and are now allowing the impact of hitting the ground to travel up into the Achilles causing irritation and pain.
  • Do you stretch and warm-up/cool-down at either end of your training.  If you tend to skip these elements of your training then you may be asking for trouble.  Everybody is different, but some people need to thoroughly warm-up and cool-down in order to have their muscles perform comfortably.
  • Have you recently stepped up your training in preperation for an event.  Ober-training is a common cause of Achilles problems so be careful to stage any increase in your training carefully.
  • Are you trying to run through an injury?  Many runners find it hard to include rest days in their training regime and even hard to rest for prolonged periods during injury rehabilitation.  Try to remember that it is not in the active phase of your activity that the body gets stronger, but its actually in the rest and recovery phase.  So rest days are an absolutely vital part of your training and trying to run off an injury is rarely a good idea.

Your podiatrist will help you back to full fitness through a structured program of rest, support and exercise.  Depending on the specific nature of your injury, he may recommend strapping or special insoles known as functional foot orthoses.  These will help to address any mechanical imbalances that are affecting your Achilles.  He will also give you a stretching and mobilisation regime to follow before he helps you back into running and then ultimately back to competition if that is your aim.  One common misconception is that the RICE program (rest, ice, compression, elevation) is good for Achilles injuries.  This is generally not the case as this is designed to specifically target muscle injuries, NOT TENDONS. If you have a calf muscle tear then RICE and a slow return to reunning is best.  However, for tendon injuries you should follow the MEAT program instead;

 

TENDONS & LIGAMENTS

M - movement controlled movement of the injured limb can stimulate blood flow, reduce the formation of scar tissue, and speed up recovery. This is shown by Kerkhoffs et al. 2002 who demonstrated improved recovery in patients with ankle sprains treated with movement rather than immobilisation.  So keep it moving as much as possible.  

 

E - exercise this refers to  prescribed exercises given by your podiatrist, rather than just movement as described above or exercise in a more genral sense. Bleakley et al (2010) showed that the addition of ankle AROM, strength and sensorimotor exercises to standard treatments improved function and weight-bearing in patients following acute ankle sprain.

 

A - analgesics can be used for pain control but it is better NOT TO USE ANTI-INFLAMMATORIES. These can inhibit the normal healing process. 

 

T - treatment these injuries often require specialist intervention before returning to competition.  You should work closely with your podiatrist to ensure a full and timely recovery.  Follow your given exercise program closely and communicate any changes in your condition quickly.

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