Achilles Tendon Injuries

The Achilles is the thick rope-like tendon that connects the calf muscles (gastrocnemius and soleus) to the heel bone. This is usually extremely strong, but can be prone to injury, especially in running athletes.

Runners who develop Achilles tendinitis notice a gradual onset of discomfort or stiffness on awakening in the mornings, and hours after a training run. If one ignores the symptoms, the discomfort becomes painful, and one experiences the pain during and immediately after running. The tendon may swell and become stiff.

Treatment includes:

• Reducing or taking a break from running until the pain settles
• Applying ice and anti-inflammatory gel to the swollen tendon
• Regular calf stretches
• Strengthening the tendon will help prevent further recurrences.

This process can take 6-8 weeks, so patience is a virtue here! Like most overuse injuries, the following factors can contribute:

1.    Sudden increase in running distance, speed, or hills

2.    Running more often reduces the recovery time between sessions

3.    Running on harder surfaces i.e., concrete

4.    Inadequate or inappropriate shoes.

5.    Excessive pronation places increased stress on the calf muscles

6.    Tight calf muscles

Squash and tennis players may experience sudden pain in the Achilles area. This can be a severe injury if there is a tear of the Achilles tendon. Full-thickness tears invariably need surgical repair if one wishes to return to sports. There are a number of different problems that can cause Achilles or heel pain, and it is best to have this checked out before diagnosing the problem yourself. Treatment will depend on the exact diagnosis, but a general rule is that it is best to do regular Achilles and calf stretches. I make it a routine to stretch while brushing my teeth, and after a shower, as well as after a run. If the problem does not settle after a few weeks of rest, then you may need to see further advice.

Dr Jonathan King

Sports Medicine