Achilles tendinitis 

Symptoms of Achilles tendinitis are pain and stiffness in heel and heel cord running from the calf muscle to the heel bone especially during the first few steps each morning.  Pinching the tendon causes pain.  In more severe cases a tender nodule can be felt in the belly of the tendon.

It is caused by overuse as in walking/running too many hills, or on uneven surfaces,  or by increasing mileage or speed too quickly.  It is aggravated by rigid-soled shoes.  Contributory hereditary factors include inflexible muscles and tendons, hypermobile foot or high-arched, inflexible foot.

This injury must be treated with respect since it can lead to life long pain and stiffness and incapacity if not handled properly.  In severe cases, the tendon can rupture and require emergency surgery.

Treatment involves correction of training errors including a reduction in mileage and speed.  More than minor pain during walk/runs mandates a significant cut back in volume and speed.  Cross training with cycling may be required in place of walks and runs. 

Consider new shoes.  If you have a hypermobile, overpronating foot, a motion control shoe will help.  If you have a high-arched, stiff foot, a cushioning shoe will  help.  A 1/4 inch heel pad should be inserted in the shoe.  Orthotics may be necessary in stubborn cases.

Symptomatic relief can be achieved with the application of ice packs for 10 to 15 minutes two to four times daily.  There is no agreement among experts as to whether longer periods are beneficial or harmful.  Aspirin and ibuprofen after work outs often help.  They should probably be avoided prior to work outs since they may mask the symptoms of a condition that is getting worse. 

Heel cord (Achilles tendon) stretching is an important part of treatment and prevention.  This can be done on by doing heel raises with the heels hanging over  a step and gently lowered to a full stretch then returned to the horizontal by contracting the calf muscles. At the beginning it  is important to do this slowly and to avoid bouncing.  Three sets of 10 repetitions daily are sufficient.  This can be done even while pain and stiffness is present. As the condition improves, the speed of the raise can be increased and weights added to your shoulders to increase the strength and length of the calf muscles and tendons. 

Avoid injections and surgery except in the hands of an experienced and skilled orthopedic surgeon.

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Copyright © 2001 by John Loeschhorn - Mail to:mtnrnr@pacbell.net February 11, 2001