Here is our 3rd in our series of nagging running injuries. Again, I turn to my PT friend Jessica Garcia to help us with Achilles tendinitis…..
“Three blogs, three lower leg injuries, what’s up with that? While it may seem like overkill, those of us in the field of physical therapy have frequently heard the saying, “when the feet hit the ground”. The importance of this lies in the fact that as the first contact point to the ground, the feet and ankles help dictate lower extremity biomechanics. When searching for factors that may have contributed to any running injury a good starting point is the foot. Injuries march along what is referred to as the “kinetic chain”. Each runner is unique and thus the specific location for an overuse injury is determined by a multitude of factors (e.g., genetics, previous injuries, training factors, etc.) meaning that there is not an etched-in-stone-overuse-injury-sequence through which all runners’ progress. As such it is a good idea for runners to become aware of regions of the body that may become affected and learn a little about the specifics in each region. Knowledge and early warning are a runner’s best friends. So let’s look at one lower leg culprit……Achilles Tendonitis.
The Achilles is the large tendon connecting the two major calf muscles to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (tendonitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon, but other factors can make it more likely to develop tendinitis. These factors include tight or weak calf muscle, unsupportive footwear, too quick of an increase in volume /intensity/hills or a bone spur that has developed where the tendon attaches to the heel bone. Correction and prevention of this condition require addressing these factors.
The classic symptom is pain along the back of the tendon especially close to the heel but there may also be limited ankle flexibility, swelling that is present all the time and gets worse throughout the day with activity, redness over the painful area, a nodule (scar tissue) that can be felt on the tendon, or a cracking sound (scar tissue rubbing against the tendon) when the ankle moves. It is also typical to notice pain and stiffness when you first get up & when you first begin your run and severe pain the day after exercise. If you have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon.
As always it comes back to the million dollar question: To Run or Not To Run and unfortunately there is no easy answer. So again we will use a spectrum to help our decision making.
Red (stop): Severe pain/swelling above heel, pain standing up on your toes
Yellow (caution): Dull pain around heel at end of run, lingers after but goes away with ice
Green (go): No pain when you pinch the tendon
If symptoms persist you can begin self-treatment using RICE the well-known and frequently disliked mnemonic for Rest, Ice, Compression and Elevation. If injury doesn’t respond in two weeks it might be a good idea to see a physical therapist or orthopedic surgeon. In most cases, conservative treatment options will provide pain relief, although it may take a few months for symptoms to completely subside. Even with early treatment, the pain may last longer than 3 months so as difficult as it may be patience is a must.”
Thanks again! Jessica works at Ultimate Motion, located in the Gold’s Gym in Paramus, NJ. I am proud to have surrounded myself with professionals who have helped me with my running coaching and personal running. For more information, please go to my Facebook page: Click Here