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The Achilles Tendon

Yesterday Mario and I watched the documentary “Running to the Limits.”  The film chronicles a sedentary drinker and smoker who decides to learn what it takes to train for a marathon like the elites.  His goal is to run the London Marathon in 2008 with hopes of running a sub 2:20 time. Impressive to say the least.  Spoiler alert: if you want to watch the movie and find out how he did, stop reading here.

Unfortunately his two year effort comes to a disappointing end when his achilles tendon prevents him from running the race.  And in fact, it took him 10 months to fully recover from this nagging injury.  But on a side note (in case you want to know how his other races went), he did run a 1:13 half and was on course to run a 2:45 marathon when heat stroke took over.  It’s amazing what one can accomplish in just two years time…

Seeing how hard he worked and how it all came to an abrupt end because of one silly tendon got me thinking:

What exactly is the achilles tendon and achilles tendonitis? How does it get injured? And as runners, how can we prevent and/or recover from these injuries?

The achilles tendon is the largest, thickest, and strongest tendon in the body.  Its purpose is to connect the calf muscles (the gastrocnemius and soleus) to the heel bone and is used when we walk, jump, and of course run.  Depending on what we are doing, the achilles tendon may be subject to 3 – 12 times a person’s body weight.  In comparing the achilles tendon with other tendons throughout the body, it has a relatively poor blood supply, which studies have shown can prevent adequate tissue repair which in turn leads to further weakening of the tendon.  No wonder so many people suffer from achilles tendonitis…

Regardless of the fact that that achilles tendon is the strongest tendon in the body, it gets injured, a lot.  I know I personally have suffered from achilles tendonitis, as well as my husband and many of my other friends.  It is a plaguing injury, but fortunately, if we learn to recognize the symptoms early enough and take preventive measures, it can be avoided.  Achilles tendonitis is basically irritation and inflammation of the achilles tendon.  Of course of the obvious cause of injury is too much too soon.  A quick increase in mileage doesn’t allow your body time to repair itself, and since the tendon already has a poor blood supply, this can do much more harm than good.  Your body needs to adapt so no need to up the mileage so soon.  Other causes of injuries can include lack of flexibility, explosive movements (jumps), tight calf muscles, over/under pronation, improper footwear (high heels, too much/too little support, worn out shoes), or simply not stretching before exercise.

Okay, so say you upped your mileage from 40 to 60  miles/week, skipped stretching, and wore high heels all day at work.  Your tendon is inflamed and you are suffering from achilles tendonitis.  Now what do you do? Well, other than eating the anti-inflammatory foods that we talked about yesterday, there are quite a few things that can be done to help with the injury.  First, and this is the one we never want to hear, stop doing the thing that caused the injury.  If that means giving up running for a week, go find a bike and learn to love it.  It will save your tendons and your body from further damage. Next, you need to stretch the calf muscles.  We often times think of the achilles tendon being just at the heel bone, but it begins at your calf so it’s important to stretch that muscle.  Here are some great calf stretches and strength training exercises to get back out the door a little sooner. I think it’s also worth noting the importance of the foam roller.  The foam roller  can help to loosen the calf muscles and break down scar tissue. Yes, it will probably hurt, but it’s all worth it.  Check out this video for some foam rolling exercises to help work out any muscle and tendon tightness:


Some other treatments of achilles tendonitis are inserting a heel insert into your shoe to relieve pressure off the tendon.  Physical therapy is also another option to work on strengthening the tendon as well as the calf muscle.  Perhaps one that we often overlook (or at least I know I do), is ice.  Ice immediately following exercise can help stop the swelling and help the rebuilding process begin.

Update: Also check out this video from Runner’s World for some feet and ankle strengthening exercises along with a good stretch for the achilles tendon.

There are five different grades of achilles tendon injuries and if you ignore the early symptoms,  you could be out for quite some time.  In fact, if you find yourself with a Grade 5 injury, your tendon can actually become deformed!  Grades 1-3 do not really affect your ability to exercise as much as grades 4-5 do.  And once you get to grade 4 or 5, your day to day activities become quite painful and limited.

I enjoyed looking into this topic today.  Yesterday after Mario’s run he was talking about how his achilles tendon was hurting.  Now I feel a little more competent to help him get better sooner =)

Happy Trails, Happy Running, and more importantly, Happy Memorial Day!

Tracie

And on a side note, if anyone would like me to research anything, please email me.  I’m happy to do it! I’ve got a running list of ideas but it is nowhere near the 300+ that I need.  Thanks in advance!

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2 Comments Post a comment
  1. Tracie, I forgot to mention this in my comment on your Google+ post yesterday, but I wrote a post a few months back on the basics of self-treatment for Achilles tendinopathy (i.e., any pain in the Achilles which may include tendinitis) – http://wp.me/pVkjc-rw. I didn’t get a chance to watch the video you included – does it include the Alfredson heel-drop protocol? Since I’m writing about studies now, that seems to be one approach that has been studied pretty thoroughly (and, near as I can tell, with good method) and it shows positive long-term results.

    May 29, 2012
    • Hi Greg! I’m going to make a point to go back and read what your wrote about Achilles tendinopathy. The video does not include the heel drop exercise but I did find a video on Runner’s World that included this stretch. The video was geared more towards foot and ankle strengthening so I didn’t put a link to it. However, based on what I read and just liked you mentioned, there is quite a bit about the effectiveness of this stretch so I’m going to go back and add the video. Thanks for the input!!

      May 29, 2012

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