Achilles tendon complaints in runners.

Achilles tendon problems are unfortunately common in runners and others. The Achilles tendon is located between the large calf muscles (m. gastrocnemius & m. soleus) to the tip of the heel bone (os calcaneus). With a large amount of tensile forces on the Achilles tendon, this can lead to negative outcomes for the quality of our tendon tissue. An example is tendon damage (micro-trauma), reduced mobility and hypersensitivity of the Achilles tendon region with regard to everyday life. Thus, continuous overuse of the Achilles tendon can lead to an Achilles tendon rupture caused by an Achilles tendon injury. In this blog, we read how to prevent and possibly cure this (step by step).

The os subtalaris and the midtarsals are the two largest attachment points of the foot. Together with the ankle (talocruralis) they form the foot function through pronation/supination movements. Movements in the foot can be described in the following axes of movement; frontal, sagittal and transverse. In the subtalaris the following movements form; inversion, plantarflexion and adduction, the common name for these is supination. Another group of movements in the ankle, are eversion, dorsal flexion and abduction, this has its total name as pronation movement. 

Symptoms in Achilles tendon pain. 

Achilles tendon complaints often start by pain or stiffness, above the heel bone during start-up moments, this often disappears quickly. Sometimes the Achilles tendon may be somewhat red or thickened. Achilles tendon complaints can often result in sharp pain (usually closer to the heel). Other complaints, are decreased mobility (ROM), redness (sensation sensation) and possibly with thickening as an inflammatory reaction.

In many cases, the pain occurs during warm-up and after (e.g.) running. Sometimes this pain returns after an activity. Constant pain (nagging and or possibly stabbing), can sometimes lead during an activity and the first days after. As a final case of overuse, the pain is constant during everyday life.

Causes and risk target group. 

Reduced quality of footwear, training surface (paved/unpaved), body weight and inactivity are considered common causes. In addition, having tight calf muscles, can increase the chances of getting Achilles tendon problems. Easy causes, for avoiding Achilles tendon problems as a runner, is for example by doing stretching after a workout. This stimulates blood flow. In addition to the already mentioned factors, acceleration in training programs can also lead to more stress on the Achilles tendon, which can cause Achilles tendon problems among runners. 

In addition to overuse factors, our running pattern also has a major impact on the Achilles tendon. For example, runners, who overpronate more have an increased chance of hypersensitivity in the Achilles tendon region. Thus, it is stated that when pain is experienced in the Achilles tendon region, it is wise to reduce in intensity or (temporarily) altogether. 

Treat on time. 

If the irritated Achilles tendon is not treated in time, it can lead to Achilles tendinosis, which can become a chronic inflammation. Over time, this can lead in a deterioration of Achilles tendon tissue, which in turn can lead to tears in this tissue, which in turn can lead to a rupture (source: J.Metzl, M.D.). 

With Achilles tendon pain, it is advisable to have it examined/checked by a physical therapist and or family doctor. Some doctors like Mr. Metzl, suggest, that an ice bath 15-20 minutes a day can reduce swelling in the Achilles tendon region. Sometimes medication, such as ibuprofen or anti-inflammatory cream can have a relieving effect (temporarily). 

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