The Achilles is the largest, strongest tendon in the body, it’s notoriously vulnerable to running injuries, including Achilles tendonitis, which often hits us when we add hillwork or sprints to our training, or increase our mileage drastically.
When ancient Greek hero Achilles’ mother dipped him by his heel into the River Styx, she made his body invincible everywhere but on his heel, where she was holding on to him. This created the legendary weak spot that eventually led to his death - and a weak spot that many runners can identify with.
Many runners suffer from Achilles tendonitis, an injury that tends to occur in runners who drastically increase their mileage or speed, or add hill running or sprints to their programme.
Excessive pronation and tight calves, which can cause the heel to twist, tug, and overstretch the Achilles tendon, can also lead to tendinitis, says Rick Braver, a sports podiatrist and member of the Runner’s World Science Advisory Board. Multiply that torque over 1000 foot strikes per kilometre, and microtrauma develops over time, creating irritation and inflammation.
Telltale signs of Achilles tendinitis include:
- Pain that occurs when you push off or rise up on your toes
Pain typically strikes where the tendon inserts at the back of the heel; where it connects to the calf; or a spot just above the bottom of the heel bone.
Walking for a few minutes before you run can help fend off an Achilles attack – so can strong calves.
To strengthen calves, Braver recommends toe-raise exercises: rise up on the balls of your feet and take 10 seconds to lower your heels to the ground.
Should the running gods smite you with Achilles tendinitis, start treatment with an over-the-counter elastic brace, which provides support and applies constant compression to reduce swelling.
Participate in low-impact activities, apply ice, and elevate your foot to aid recovery. Massage therapy will improve blood supply and promote healing. Topical anti-inflammatories also work well. If you take ibuprofen, beware of masking pain and risking re-injury because you feel better than you are. Before you attempt to run, heat the Achilles tendon with a heating pad for 10 minutes to loosen it.
If you’re getting worse, see a sports podiatrist, who will check your shoe-wear pattern, make footwear recommendations, and customise an exercise programme to loosen and strengthen the calf muscles. A podiatrist may prescribe heel cups (or a full-length orthotic), night splints, slant boards or an immobilising boot, depending upon the severity of your problem.
Just refuse the offer of a cortisone injection, which, Braver says, increases the risk of a rupture.