Runners Injuries: Achilles Tendonitis
Symptoms, Treatment and Prevention of a Common Runner's Injury

by Dr. Andrea Johnson-Davis, DPT, MS

Achilles Tendonitis is yet another injury that plagues both novice and experienced runners. Achilles Tendonitis is an overuse injury that typically presents itself as pain in the heel, posterior ankle, calf, or Achilles tendon. Most often there are reports of pain with toe off (pushing off from your toes). As the injury progresses, you can begin to experience pain at heel strike as well. This pain occurs because as your heel strikes the ground, you are putting an aggressive stretch on the Achilles tendon. Because this tendon is already aggravated, the pain is exacerbated by aggressive movement. A STAR physical therapist can help with both the diagnosis of Tendonitis and the treatment to relieve the pain and get you back to your running routine. It is important to recognize the signs of Achilles Tendonitis early, as it can be a precursor to a full Achilles tendon rupture.

Treatment for an already aggravated Achilles tendon is fairly simple.

1. Limit painful activity: running, prolonged walking, excessive stair climbing, walking inclines or ramps, jumping, etc.

2. Begin a very gentle stretching program; Stretching should consist of both gastroc and soleus muscles. To accomplish this you should stretch the back of your leg with your knee straight and then do it with the knee bent.

3. Strengthen your muscles: You may begin strengthening only after you have been pain free for 7-10 days. Most often these exercises will be non-weight bearing to begin with so as to minimize the amount of force being translated through the still healing Achilles tendon. These may consist of theraband exercises, seated toe and heel raises, seated BAPS board, active range of motion exercises, and various forms of manual resistive exercise. A smart, steady progression of strengthening is required prior to full return to running.

4. Anti-inflammatories: As always, any use of medication should be done at the direction of your primary care physician. Anti-inflammatories are commonly used to help reduce the pain that comes from inflammation.

5. Modify your routine: There is a reason your Achilles is injured. Examine your workout routine and determine where, if any, it is deficient. Ask these questions: Am I stretching enough? Am I holding my stretches long enough? Do I need a longer warm up before I run? Am I ramping up my mileage too quickly? Should I be cross training? Do I have the proper footwear? Once you determine the answers to these questions, either on your own or with the assistance of a professional, you can make the necessary adjustments.

It is important to listen to your body, it is not always good to maintain the "no pain, no gain" mantra. Proper conditioning and good planning will make for a safe and productive workout.

Our professional physical therapists here, at STAR Physical Therapy, are experts in the field of runner's injuries and rehabilitation. Most are runners themselves! If you are having pain or soreness, please give us a call. We are happy to help!