Anatomy involved with the Achilles tendon
For nearly all runners Achilles tendinopathy is an overuse injury, the result of adding excessive mileage or speed to a training regimen. Tendinopathy is common because many runners are often pushing the limits of what their Achilles can handle. For professional runners this may mean increasing from 80 to 100 miles a week at six minute mile pace. For recreational runners tendinopathy could occur by adding an extra running day to a weekly regimen or adding three miles to a normal run.
With rest or limiting mileage some runners can get over Achilles pain with days or a few weeks. For others Achilles tendinopathy can become chronic and last for months. As many runners know when this occurs it can be very frustrating. There are recommended treatments to try when this does happen.
Tendon loading through progressive strengthening exercise is typically the treatment to try because it is effective and can be done easily at home. This type of strengthening may be done with slow calf raises while standing on one or two legs, or by eccentrically loading the calf. Setting up a strengthening plan may be best accomplished with assistance from a physical therapist to determine the intensity and duration of exercise. Other treatments that may be recommended for a stubborn Achilles tedinopathy may include extracorporeal shockwave therapy, certain types of injections, or placement of nitroglycerin patches over the tendon; these treatments are typically done by physicians.
If you are a runner who has struggled with Achilles pain know that you are not alone! In a lifetime of running most people will experience some sort of Achilles pain. Luckily Achilles tendinopathy is treatable and most people return to pain-free running within several months.
Bob Cranny, PT