Common Runners’ Injuries – Achilles Tendinitis and Strain

Achilles Tendon

Pain in the Achilles tendon area is a very common injury among runners and can’t be separated from problems in the calf muscles (gastrocnemius and soleus).

Achilles tendinitis, or inflammation of the Achilles tendon, is an injury of long-term overuse, running over steep hills or unusual surfaces, or increasing mileage or intensity of training too quickly. 

Pressure from a badly-fitting shoe can also cause tendinitis of the Achilles, as can a blow to the tendon. Symptoms are pain (often constant), with possible swelling and redness. Apart form these last two causes, Achilles tendinitis and most other Achilles injuries are associated with overtight calf muscles. Remember that the gastrocnemius and soleus muscles join at the lower end to form the Achilles tendon which then runs down to insert on to the calcaneus bone of the heel.

Treatment

The treatment of chronic or acute Achilles tendinitis will initially involve some period of rest; ice to the affected area (about 15 minutes three or four times a day to begin with); soft tissue manipulation to the calf muscles and Achilles; stretching of the tendon and the use of a heel raise in both shoes.

Prevention

Deep soft tissue massage to the calf/Achilles area, regular stretching and self-massage. Shoes should absorb shock well, and don’t suddenly dramatically increase the mileage intensity of your training.

Achilles strain

This can range from mild to complete rupture. Symptoms include swelling and tenderness, pain on plantarflexion of the foot/ankle, a crackling sensation in the tendon. There may be acute muscle spasm in the calf and loss of strength in these muscles. With a complete rupture, an audible snap may be heard.

Treatment for complete rupture

This often requires surgery and the use of a cast. Recovering from this can take many months. Once recovery is well under way deep soft tissue massage to the calf, stretching and an Achilles strengthening programme. Prevention is as before.

Achilles bursitis

The irritation/inflammation of two bursa in the Achilles region. Bursae are small fluid-filled sacs situated between a bone and a tendon. Their role is to reduce friction.

Treatment

Usually rest, the use of anti inflammatory medication, and often, the use of corticosteriod injection – only as the absolute last resort, as these are not good for the long term health of the tissue they are injected in to, especially if more than one injection is used. This injury often responds well to ice, and skilled soft tissue manipulation and stretching to the area.

Graeme Stroud ND, MRN, DO, ACOH is an osteopath, naturopath, certified zen body therapist and a qualified healer.