As the name suggests, Achilles Tendinitis is an overuse injury (reactive tendinopathy) or degeneration (tendon disarray) of the Achilles tendon.
No matter the cause, it’s important to know how to prevent or heal the injury on this tendon that connects the soleus and gastrocnemius calf muscles to your feet’s heel bones. In this post, I will discuss effective strategies for running with Achilles tendonitis.
Summary: Running Research for Achilles tendinopathy advises: – you take a rest from active running, increase your running gradually, ice the Achilles tendon area indirectly for 15 – 20 minutes (every 4-6 hours), roll out your calves using a foam roller, or strengthen your calf muscles through eccentric strength exercises. Consult an orthopedic surgeon if the symptoms persist.
Achilles tendinopathy Prevention Methods
Critical counsel first: As a runner, always give a second thought to the telltale signs your body is giving you. Otherwise, you might be in for massive surprising coming up along your athletic life. Further, Achilles Tendinitis promotes the formation of a less flexible and more rapture prone scar tissue covering the tendon. Below are we expound on some key tips for running with Achilles tendonitis
1. Gradual Running
Do you need to increase your intensity or distance of your running? Then, use the 10% rule to gradually improve your runs while protecting your Achilles tendon.
Het up your tendon using warm water before starting your run and cool it’s down with ice after running. Off-loading your tendon for a long time could be unhelpful but it’s important to initially limit the rate of increasing your running.
So, as noted above, listen to your body. For example, morning stiffness is a great sign that your tendon is barely coping with the load. Therefore, adopt slow strength training to allow the tendon to build its load tolerance. However, it’s important to also avoid overloading your tendon through other areas of training while cutting on running or strength training, outcomes from the gradual running will be negative.
From my marathon experience, I discovered that loading thrice in one week is excellent, but tendon re-molding takes time and thus you’ll have to be patient. However, it’s important to take a comprehensive gait analysis to realize where to concentrate your strength training initially.
Further, when going back to running, you’ll need to significantly reduce the length of your strides. If you’re a forefoot or midfoot striker, temporarily use the outer heel to strike the ground. Also, avoid speed workouts for a start until your Achilles reduces its sensitivity to touch.
2. Cross-training Exercises
Cross-training such as cycling is a great way to reducing the tightening on the Achilles.
However, avoid running or swimming for 2 weeks. During this time, you can use some ice packs to reduce inflammation of the Achilles or even use a night brace.
Running on a different surface can help strengthen various muscles in your feet and legs. Also, try exercises such as yoga or Pilates.
3: Get fitted for your right shoes
Orthotics and Shoe inserts like heel pads will reduce the elevation and stress on your calf, Achilles tendon, heel. Therefore, get yourself fitted with the right shoes and change them frequently. Learn more about best running shoes for Achilles Tendonitis. Further, heel cushions or cups raise the heel and hence shortening the Achilles tendon in addition to reducing pressure landing on it.
Conservative Treatment for Achilles tendinopathy
1. 1-2 days’ Rest from active exercise
Like in other soft tissue injuries, an active rest from running and weight-bearing loads can help reduce your pain or limping caused by Achilles tendonitis. Therefore, stop/ reduce running and avoid straining exercises such as swimming for 1-2 weeks. The resting phase will allow your Achilles enough time to heal.
In some cases, an athlete might require to use heel wedges, wedged Achilles walking boot, or crutches to temporarily reduce pressure on your Achilles tendon. But your physiotherapist can be advice on the appropriate device to use.
2: Icing to reduce swelling/ inflammation
Start the icing protocol when you notice symptoms such as pain or inflammation on your calf muscles and Achilles – until the swelling subsides.
Put some ice in a bag and wrap it in a clean cloth, and finally place it around the tendon area. Note: Ice for a maximum of 20 minutes per hour (repeat every 4-6 hours) – stop icing if you feel strange skin numbness.
Caution: If you have impaired sensation or poor blood circulation, consult your physician first before icing.
3: Careful Tendon Loading
Calf muscles tightness is a major culprit in Achilles tendonitis. Current tendinopathy research shows that you can use exercises aimed at the Calf muscles to promote Achilles tendon repair. The exercise must target to maximally re-mold the scar tissue and thus hinder further development of defective scar that might eventually tear.
Some of the helpful exercises include eccentric exercises such as Alfredson Protocol, concentric, and isometric exercises, massage, using neuro-dynamic mobilizations and foam rollers, or appropriate muscle stretches. However, when using a foam roller, ensure to the role the muscles and not your tendon area. Eccentric strength exercises will help you strengthen your calf muscles as they apply a load on the muscle when it’s lengthened.
Exercise until your limping subsides or when you can comfortably do Achilles tendon stretches without struggling. However, your physiotherapist can offer advice on individualized exercises and stretches to match your tendinopathy rehabilitation plan or running demands.
4: Foot Elevation
Next, raise the foot to a level above your chest or waist level. Therefore, this encourages the blood to return to the heart, which reduces the swelling and pain. You can achieve this putting a pillow under the affected foot while you are lying down on your back.
However, avoid anti-inflammatory creams or anti-inflammatory medications ibuprofen or Advil as they’ll slow the natural healing agents in your body.
If your injury is non-responsive to the above treatment options for more than 3 weeks, then consult your doctor or orthopedic surgeon. Notably, the physician may recommend a tendon rupture surgery such as open repair to scrape off the scar tissue from your Achilles tendon.