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Achilles Tendonitis

Achilles Tendonitis

Achilles Tendonitis Treatment is essential with the onset of tenderness. Too often this condition can turn into a chronic achy never ending pain if not properly treated. The Achilles tendon connects the lower leg muscles to the heel. The tendons join the most powerful muscle group in the body, the two heads of the gastrocnemius and the soleus to the calcaneus.

From overuse and continued stress, the tendon is overworked and tightens. This reaction causes the inflammation, which is tendonitis. Scar tissue begins to cover the area, which is stiffer and less flexible than the tendon. If achilles tendonitis treatment is not received and the inflamed Achilles remains stressed, a rupture or tear can occur.


Achilles Tendonitis Symptoms

  • Dull or sharp pain along the tendon near the heel
  • Pain in the morning or after long period of rest with initial foot steps
  • Ankle flexibility stiff with redness and heat in the area
  • Grinding or cracking sound with ankle movement
  • Nodules or lumps of scar tissue can be felt


Causes of Achilles tendonitis

Aggressive Achilles tendonitis treatment is essential. The Achilles tendon is very susceptible to injury with the variety of forces during activity and the relatively poor blood supply. The limited blood supply can also contribute to the slow healing process. The number one contributor to chronic Achilles tendonitis is ignoring the onset of pain in the Achilles tendon. Some injuries allow a person to continue training, running through Achilles pain can lead to serious damage and long recovery. Initial soreness calls for immediate action.

Achilles Tenants Causes

  • Overtraining
  • Shoes
  • Tightness in the posterior leg muscles
  • Improper warm up and cool down

Overtraining does not necessarily mean an excessive amount of running, rather increasing miles, workouts and other activities too fast. As mileage should slowly increase, it is important to slowly incorporate new elements to the training regime as well. Do not add speed workouts and hill training on the same week. Add speed workouts one week and let your body adjust and hills can be included the next week.

An obvious but often overlooked factor is shoes. A stiff sole can increase tension in the calf muscle. The tendon is forced to work harder with the tension and can lead to injury. As support is sometimes needed, excessive heel cushioning strains the Achilles as the heel is suspended with the foot strike. Improper support can also contribute to the pain if overpronation is not controlled. Arches that roll in may make a person more susceptible.

As with some injuries, the pain can be a chain effect. Tight posterior muscles, the hamstrings and calf muscles can contribute to the tightness and prolong recovery.

Begriming exercises too intensely with cold muscles is dangerous. After sitting for hours and immediately transitioning into speed work without a light warm up increases the risk of injury. Following the run or activity, gentle stretching is encouraged.

Acute tendonitis is easily ignored as the pain seems minimal and decreases after the exercise. Yet if no action takes place, the condition will turn to chronic.


Acute Tendonitis

  • Gradual onset of pain within a few days
  • Pain at the beginning of exercise and fades
  • At rest the pain subsides

Chronic Tendonitis

  • Gradual onset of pain in the course of weeks or months
  • Constant pain throughout exercise
  • Tendon pain while walking and increased on hills or stairs
  • Pain and stiffness in the Achilles tendon especially in the morning or after rest.
  • Thickening or swelling around the Achilles tendon
  • Lumps or nodules in the tendon
  • Skin redness around the area
  • A cracking or grinding feeling with flexion in the Achilles


Achilles Tendonitis Treatment

Training modification is an essential first step for Achilles tendonitis treatment. Take a step down from the training regime, whether that is going from two a day workouts to one or from daily working out to every other day exercising. Include more recovery days during the week. Ensure proper stretching, but not excessive stretching as this can cause more damage. Loosen the hamstrings and calf muscles. The wall stretch is beneficial, but the stair or incline stretch could be too extreme for the tender area. Applying ice to the area for ten minutes with at least two hours in between can help reduce the inflammation. However after the icing be careful to not move too quickly or make sharp moves while the Achilles area is cold.

An initial heel lift can bring temporal relief but is only a short term solution. It may be time to replace old shoes or to get orthotics.

Achilles tendonitis treatment should begin immediately with an examination and recovery protocol to ensure proper recovery. The use of ultrasound and e-stem are very effective in breaking up scar tissue and hastening recovery. Proper massage and stretches are needed for long term success. The Running Doctor performs a thorough overview of the injury and will create a specific program, depending on the injury. Whether it is tight muscles or overuse, Dr. Thomas will design a recovery plan that is unique to your needs.

Cutting back on training is frustrating, however pool running / aqua jogging is a good alternative. Proper form and correct technique is essential to getting a quality workout. To maintain fitness, this is a good option. Cycling on a low gear, if there is no aggravation is another alternative.



As with most injury prevention methods, stretching and strength training are very helpful. Stretching the calf muscles and hamstring muscles after exercise helps relieve the tension when the muscles are not tight. Heel raises are beneficial in strengthening the calf muscles and squats strengthen the quads and hamstrings. However, with all muscles both the anterior and posterior need to be strengthened together to avoid muscle imbalances.

Gradual training is essential. Both mileage and intensity needs to be incorporated at a proper increase depending on a person’s abilities and base training. As hill workouts and speed are important in training, they too need to be added one at a time, one week at a time. Rest and recovery are also important. If something does not feel right, taking one day off can go a long way in preventing a chronic injury. Again with any injury, Achilles tendonitis treatment begins with prevention.

To begin Achilles tendonitis treatment and preventing further damage, call the Running Doctor at 678.705.2709.

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