Achilles Tendon

Achilles Tendon

The Achilles tendon is the largest tendon in your body. And when the Achilles gets injured, the runner has a big problem.

You don’t have to search for long before you find articles that say something frightening. “No More Running!”  is what most runners fear when the Achilles start to ache. But don’t let the alarmists scare you into a state of panic. There is always a solution. You just need the right solution for you, your running style and your running goals.

The trick with figuring out what you should do with your aching achilles is to first determine how bad the problem may be. Once you understand the extent of the problem, you can decide on the best way to calm it down, heal the Achilles and get back to running.

Achilles Paratendinitis

The prefix “para-” means around. The suffix “-itis” means inflammation. There is a very thin covering surrounding the Achilles tendon which is called the parent teen on. When you have paratendinitis, there’s inflammation surrounding the Achilles tendon between the tendon and the paratenon. This is the simplest Achilles tendon problem and easiest to treat and runners.

Achilles Tendinitis

True Achilles tendinitis means that there is an inflammatory process with in the Achilles tendon itself. Although Achilles tendinitis is more difficult to treat then Achilles paratendinitis, it can be reversed without any long term consequences to your ability to run. But it must be treated quickly in order to prevent irreversible damage.

Achilles Tendinosis

Tendinosis is a degenerative condition of the collagen fibers that make up the Achilles tendon. The collagen becomes weaker and disorganized. Some of the bundles of collagen and individual collagen fibers may actually rupture. There may be multiple areas of tiny little tears within the Achilles tendon itself. In many respects, tendinosis is irreversible damage. Achilles tendinosis often develops after a prolonged course of undiagnosed, minimally treated or untreated Achilles tendinitis in a runner.

Partially Torn Achilles Tendon

If you have Achilles tendinosis and just tune the pain out, ignore it, keep running and continue to train hard, the weakened collagen can rupture, or tear. Most of the time endurance runners suffer partially torn tendons. Basically, the area of week or damaged collagen starts to rip apart resulting in a significant injury within the Achilles tendon that leads to pain, swelling and can lead to further injury.

Completely Torn Achilles Tendon

A full rupture of the Achilles tendon, and injury in which the largest tendon in your body rips in half, is rare and endurance runners, but more common in activities with explosive movement. Completely torn Achilles tendons are much more common in men in their 30s and 40s who signed up for a recreational basketball leagues. Men with dubious fitness levels to take on the explosive movements associated with basketball when they are not physically prepared to do so, can put themselves at risk of a completely torn Achilles tendon. Although rare by comparison, full ruptures of the Achilles tendon in runners can happen during a fall, a severe misstep while running, or when a partially torn tendon that propagates and rips all the way across the rest of the tendon.

Running with Achilles tendon pain

One of the main questions I get from runners is whether not they can just continue to train and make it through their upcoming race without any problems. The answer is maybe. If you only have a minor issue it is possible that you can continue to run an attendant will not develop any permanent damage. However if you have a high pain tolerance, as most endurance athletes do, it is possible that you have some developing Achilles tendon injuries which could put you at risk of a partial or full rupture of the Achilles tendon.

It is critical to make sure that you don’t have an Achilles injury that is expensive enough that it could lead to irreparable damage if you continue to run.

In the earlier stages of Achilles tendon injury many runners continue to train if they simply ice the area aggressively, perform contrast bath treatment in the evenings, and put a slight heel lift under the insert in the running shoes. This combination may decrease the stress on the tendon and reduce the inflammation enough that the pain and swelling in the tendon will subside and they can continue to run.

If you think Achilles tendinosis is the problem you should do eccentric stretches.

add image/link to PDF on eccentric stretches.

If you think you have a partial or complete rupture (torn Achilles tendon) you shouldn’t do anything other than see a foot and ankle specialist…immediately.