What is Achilles tendonitis and how can I prevent it?
Todd Shropshire, PT
Q: One of the most common running injuries that physical therapists see is Achilles tendonitis. What is it and how I can prevent it?
Your Achilles tendon is a thick tendon on the back of your heel and when people get into or jump back into running, they sometimes do too much too soon. That includes running at a higher frequency or running more miles than they are accustomed to. This can flair up the Achilles tendon and cause an inflammatory response (Tendonitis) and if left untreated, start to break down the tendon (Tendinopathy) so that anytime a runner pushes up on their toe, they tend to experience increased pain at the posterior heel / lower leg.
The treatment depends on the acuteness and severity, or the chronic nature of the injury. With a painful but new flair up, treatment is revolved around trying to appropriately load the Achilles tendon in a pain-free manner. This type of treatment approach promotes healing in the tendon but also re-trains the tendon to bear that load again. An example of this type of progressive therapy is to have patients lay on their stomach on a table or bed, with their feet off the table, and push their toes toward the ceiling. Once this is can be done pain-free, individuals can progress the loading of the Achilles tendon; sitting with feet off the table and pushing down into a resistive band, then standing heel raises on both feet and then single leg heel raises. The progression should be pain-free.To avoid Achilles tendinitis altogether, start small and start conservatively. Build up your distance and frequency over time and see how you feel.
Todd Shropshire is a physical therapist at OrthoCarolina Ballantyne Physical Therapy.