4. Achilles Tendonitis
This one is near and dear to my heart. Having suffered achilles tendonitis my junior year in college, and battling it for the remainder of my college career, I feel in a very good place to discuss achilles tendonitis at length.
Let me tell you this, achilles tendonitis is almost always preventable. It is an overuse injury, but there are many warning signs that (I bullheadedly ran through), that tell you something’s amiss.
Achilles tendonitis is almost always caused by overuse. Whether it’s too many miles, too fast of workouts, bad shoes, poor quality running surfaces, it does not matter. Pure and simple, this is due to repetitive motion to a harmful degree.
The symptoms of achilles tendonitis are pain in the heel or just above the heel in the achilles tendon.
The tendon will be sore to the touch, and oftentimes, noticeably inflamed. It will usually hurt most when moving your foot up and down, but the worse pain will be at toe off when your tendon is shortened.
Recovery for achilles tendonitis can be tediously slow. Like all injuries, there are varying degrees of tendonitis. In most cases, if you catch it early and are on top of treatment, you should be back out there within a week or two.
If the injury is severe, it may take longer.
Recovering from achilles tendonitis is all about treatment. the R.I.C.E. (Rest, Ice, Compress, Elevate) protocol is key to recovery.
But also stretching and strengthening the ankle, calves, arches will also play a crucial role in how quick you bounce back, and in preventing a relapse.
Never stretch the achilles, calves when there is still pain in the area. This pain means there is inflammation and damaged tissue, it is not wise to stretch damaged tissue.
Don’t do any stretching/strength work until the achilles is pain free.
Oftentimes, athletes will be placed into a boot for the initial phase of recovery, to prevent engaging the damaged tendon.
The boot will come off when the inflammation has subsided, and at this time you can determine whether you’re ready to further your treatment with stretching and strength exercises.
Sometimes a healthcare provider will recommend a heel lift in your shoe to shorten your tendon and reduce the stress on it.
This is good for a short time during recovery, but can actually be a bad idea in the long run, as this will permanently shorten your achilles, and when you go for a run in shoes with a narrower heel-to-toe differential, this may cause quite a bit of stress being placed on the tendon. Increasing the chances of reoccurrence.
The same is true with your normal day-to-day casual shoes, if you wear shoes with a heel everyday, like dress shoes, this may be shortening your tendon with time and resulting in an increase chance of over-stressing the achilles when running in lighter weight shoes.
For this reason, and for some I will discuss in the next section on plantar fasciitis, I recommend anyone with heel, calf, or arch issues to wear Nike Frees when walking around to help the foot naturally flex and strengthen the foot muscles.
Make sure your tendonitis is gone before wearing Frees though, and ease into wearing them.
When can I run again?
I know you’re anxious to get back out there, but you have to take it slow with tendonitis.
Take your time, and ease back into your training gradually. Rushing back into full training load will only result in more damage or some other injury.
Supplement your running with other exercises to keep your fitness level up. Pool running is a good alternative, though you may need to tape your foot/ankle so that you don’t engaged the achilles when driving your leg up and down through the water.
Stationary bike can be another option, but this can potentially aggravate the area, so definitely play it by feel if you choose to test this as a secondary form of exercise.
As mentioned at the opening of this article, achilles tendonitis is usually preventable. The early warning signs are hard to miss if you know what to listen for.
Inflammation in the achilles develops over time, and can be preceded by calf tightness, especially in the gastrocnemius muscle that the achilles attaches to. You can usually run your finger from the back of your knee and follow soreness all the way down to the achilles tendon.
There are several causes of this tightness, it can be a hip misalignment, which over stress the hamstring, pulling on the calf. Or it can be from the ground up, tight, inflexible arches that pull on the tendon and over stress the calf.
Either way, there are ways to prevent this, alleviating pressure on the hamstring through stretching and rolling out on a foam roller.
In my experience, the injury was a result of an inflexible / tight arch due to the shoes I was running in. In this case, rolling the arch out on a golf ball and stretching the toes and arch, and in addition, strengthening the region through balancing exercises and calf raises, went a long way to preventing any future issues with tendonitis.
Listen for the signs, and stay on top of your strength and flexibility, and if you feel any sort of pull in the achilles region, make sure to ice, as that’s the beginning stages of inflammation.