Achilles Tendinitis

If you ever experienced Achilles tendinitis, you are well aware of the intense pain that can accompany each step. Even thought the Achilles tendon is a large and strong tendon, the amount of force transferred through it while running can easily explain the frequency with which it is injured. The Achilles tendon is the combined tendon of the the two calf muscles, the more superficial gastrocnemius and the deeper soleus. Unlike most tendons, the Achilles actually twists and rotates 90 degrees between it’s junction with the calf muscles and it’s insertion on the calcaneus or heal bone (1). This allows the tendon to act like a rubber band, which allows for greater efficiency during running.

The Achilles is responsible for taking much of the forces of impact with the ground and transmitting them back into energy during the propulsive period and toe off. This subjects the Achilles tendon to forces up to seven times greater than the body weight of the individual (2)! So while the storage and return of energy inside the Achilles tendon improves running and stride efficiency, the extreme forces stored in the tendon increases the likelihood of injury.

The Achilles tendon disperses forces up to 7 times greater than your body weight!

Gradually building running mileage and intensity allows the tendon to adapt to the new stresses. Quickly increasing either mileage or intensity of workouts increases your likelihood of sustaining a tendon or muscle injury.

Symptoms

The symptoms of Achilles tendinitis, often called Achilles tendinosis or tendinopathy, are pretty simple. It is characterized by pain (aching, stiffness, soreness, or tenderness) in the tendon and tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. A “creaky” or “crackling” sensation may also be present with the first few steps after a period of inactivity or when rubbing your fingers along the sides of the tendon. If the condition progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.

Prevention & Self Treatment for Achilles Tendinitis

There are some simple things that can be done to help avoid Achilles tendinitis or treat it quickly at the first signs of symptoms. First, ease into exercise routines and be sure to warm up properly. In addition, regularly stretching and foam rolling the calf muscles after running or exercise will assist with muscle recovery after exercise. Next, wearing the appropriate shoes for your foot type is also very important in preventing running injuries. This is one of the reasons why we work closely with our local running stores to ensure that our patients are being fit for the proper shoes. Finally, periodic preventative treatments such as Graston Technique, Active Release Technique and Dry Needling also assist in preventing recurrence of this painful condition.

Traditional Treatment of Achilles Tendinitis

• Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon and promote healing (3).
• Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the condition.
• Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed (4).
• Night splints. Night splints help to maintain a stretch in the Achilles tendon during sleep.

 

Our Integrated Treatment Approach

We carefully analyze your running form and identify areas to correct, improve or strengthen to optimize your form and efficiency, keeping you injury free. Check out more about our Running and Performance Clinic. We also used advanced soft tissue and myofascial release techniques including Graston Technique, Active Release Technique (ART), and trigger point dry needling. We will also prescribe specific stretches and exercises, typically involving eccentric loading activities for the Achilles tendon (5).

Our sports chiropractors typically perform Graston, ART, and/or dry needling treatments to the Achilles tendon, calf muscles, hamstrings and possibly into the muscles of the low back.

This article is part of a series looking at common running injuries, how to prevent them, and how to treat them if they do occur. Read more about the following injuries as well:

• Plantar Fasciitis
• Achilles Tendinitis
• IT-Band Syndrome
• Shin Splints
• Runner’s Knee
• Piriformis Syndrome/Sciatica

Achilles Tendinitis Sources: