Achilles Pain in the Runner

Given the recent unprecedented times of COVID-19, our podiatry and physiotherapy team have seen an outstanding amount of running injuries, particularly involving the Achilles tendon. We expect this to continue with the rapid return to the winter sporting season. There a few things to consider in attempting to prevent and treat this injury.

The biggest factor in developing Achilles tendinopathy is an individual’s training load being larger than the individual’s capacity. Regular gym fanatics who have focused on resistance training then decide to run 10 km, purely because that was their only option for exercise during isolation are a great example of this.

The Achilles, being the tendon that attaches our calf muscle to our heel bone is often placed under stress through running due to reduced tissue capacity of these calf muscles – tissue capacity involving weak and tight calves! The Achilles Tendon and our calf muscles are both important in being our main propulsive mechanism for walking or running, thus developing pain can be such a problem. Don’t be mistaken in thinking only elite runners and athletes are prone to this, as it doesn’t discriminate and be caused by simply moving upstairs or moving/landing abruptly.

Furthermore, having a podiatrist or physiotherapist assess and diagnose the severity of Achilles tendinopathy is often vital in getting back to activity sooner and to ensure the correct rehabilitation and treatment program is implemented. In order for tendons to repair, unfortunately reducing pain and inflammation is not enough. A gradual and thorough exercise program is required in regards to conservatively loading the tendon. Rest is catabolic for the Achilles tendon and leads to a reduction in tendon capacity.

Being assessed for biomechanical abnormalities in regards to walking or running patterns can also prove vital in relieving tendon stress. As podiatrist’s, addressing biomechanical stressors with orthotics is often an effective treatment modality long-term. This injury can prove to be a prolonged one, given the natural desire of runners of all levels to ‘push-through’, which ultimately makes things worse. Having the right advice and guidance in regards to Achilles injuries is imperative in making a strong return to running and sport.