Is your Achilles tendon your Achilles heel?
Achilles tendon injuries are a very common issue in track and field athletes, not exclusively but particularly with distance runners. The Achilles tendon is the main piece of tissue that attaches the calf muscle to the back of the heel and is vital in forward propulsion and efficient running. Tendon injuries can come in a number of forms. One type that is particular to the Achilles tendon is paratenonitis, and inflammation of the special sheath that surrounds the Achilles. This occurs with excessive friction of the sheath on the tendon, typical of extra compression that results from pressure on high backed shoes, tight compressive garments or taping techniques that cut across the back of the tendon sharply. This problem needs to be settled with rest and anit-inflammatory treatment such as ice and medication if needed. Problems in the substance of tendon itself present as either acute tendinopathy or chronic tendinopathy. Acute tendinopathy is a sudden onset of tendon pain as the result of an increase in stress to the tendon fibres, usually from repetitive landing stresses such as running and jumping activities. Subtle changes are sometimes enough to bring about the irritation, such as adding in more speed work or hill training, changing shoes, particularly flatter shoes with a lower heel, or changing the surface you are training on, like returning to the track sessions after winter. Usually these problems will settle down within 7 - 10 days of rest but a slow graduated return to activity is needed to prevent re-aggravation. Chronic tendinopathy is usually more of a long term, stubborn complaint that is the result of a gradual degeneration of the collagen fibres within the tendon. It is often very stiff in the mornings or at the beginning of a run but can sometimes warm up and tolerate some training. Tendons are often sore after activity or have an increased stiffness the following day. In both circumstances it is important to assess the severity of tendon damage to gauge how much and how soon activity can re-commence. It also important to assess the entire limb to identify any areas of weakness, tightness or biomechanical issues that may have contributed to increased stress on the tendon. In all cases it is important to undertake a carefully prescribed strengthening program to increase the capacity of the calf and Achilles to handle the load of running and jumping. Achilles injuries can be very tricky problems to resolve so make sure you get in touch with your closest Physiohealth clinic to ensure the correct diagnosis and management plan is devised for your Achilles troubles.