The Secret to Treating Achilles Tendonitis

By Spencer Richards

11% of marathoners reported having had Achilles Tendonitis at some point during their training. Read on to find out how to treat and prevent it.

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In my last post about common marathon injuries we looked at “Runners Knee” a condition that affects roughly 40% of runners training for a marathon. Today we look at another common injury – Achilles Tendonitis.

Runner’s World surveyed over 4500 marathoners and 11% reported having had Achilles Tendonitis at some point during their marathon training. My own St. George Marathon training this year was derailed in part by Achilles Tendonitis (and in part by deciding to remodel our home on our own—uggghhhh, tons of work, but very rewarding!). Toe runners, minimalists, and runners who do a lot of hill/speed work and rapidly increase their mileage are at most risk.

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Symptoms
Achilles Tendonitis presents itself as pain in the back of the heel or leg. A runner usually starts to feel this pain after a few miles and it rapidly gets worse. Achilles Tendonitis will get bad quickly, so don’t try to run through it! If caught and treated early, it may only require a couple weeks to heal, but if not, it could take 6 months or more of no running and the associated agony (and depression) that goes with such a long time off!

Treatment
Stop running! Cycling and swimming can be done if there is no pain during or after exercise. Five times daily, stretch and ice the area. Take ibuprofen or Aleve regularly (i.e. every day according to instructions), regardless of how much pain you have for 2 weeks. Do eccentric strengthening. Eccentric means that the tendon goes under tension while it is lengthened. This builds strength and improves the elasticity of the tendon while also preventing fibrosis (a troublesome condition where new, scar-like fibers form in the tendon, preventing normal function). To do this, stand on the balls of your feet on the back of a step. Rise up on both feet. Once up, shift your weight onto the injured leg and slowly drop your heel below the step. Repeat this process for 3 sets of 20 reps. Keep doing this every day through the marathon to help prevent relapse.

Prevention
Eccentric exercises are key. Some runners swear by compression socks or sleeves, although the medical evidence is sketchy. A running evaluation to look at your foot and running mechanics can be very helpful in assessing your risk of injury and for receiving tips on how to run better. Our Running Lab uses video analysis and state of the art technology to help runners prevent injuries and reach their goals. Finally, as always, core strengthening is recommended.