Prevention and Treatment of Achilles Tendonitis – Calf and Heel Pain i…

Achilles tendonitis can be a shared and frustrating cause of ankle and heel pain in runners and other athletes.

Anatomy of the Achilles tendon

The Achilles tendon is the terminal extension of the three posterior muscles in the lower leg: the soleus, gastrocnemius, and plantaris. The achilles tendon attaches (inserts) into the posterior calcaneus. Inflamation of the tendon can occur either at the insertion of the tendon at the preference for the bone or several inches above the bony attachment of the tendon.

Symptoms of Achilles tendonitis and tendinosis

Symptoms of Achilles tendinitis or tendinosis can include:

  • Pain, swelling, tenderness or stiffness at the Achilles tendon.
  • Heel pain during or after exercise
  • Heel pain worse with running and jumping
  • Pain worse with heel strike or pushing off from the ground
  • Formation of a “bump” on the back of the heel

Achilles Tendon burst

A burst of the Achilles tendon can occur during a forceful push-off. Typically there is a “pop” or ripping sensation in the back of the calf, followed by pain and decreased movement of the ankle. A suspected achilles tendon burst requires evaluation by a sports medicine physician and may require surgery with prolonged immobilization in a leg cast and then walking boot.

Causes of Achilles Tendonitis and Tendinosis

  • Overuse or overloading of the Achilles tendon, from either too much quantity or too high of an intensity of activity is a shared cause of Achilles tendonitis.
  • Other shared causes of chronic Achilles tendon include:
  • Tight calf muscle.
  • Recent increase in running mileage or running up hills.
  • Over-pronation (rolling in of the foot)
  • High foot arches (pes cavus) and flat feet (pes planus)

Prevention of Achilles Tendonitis and Tendinosis

Most Achilles tendon injuries occur as the consequence of “too much, too soon” or poor biomechanics and can be prevented with these simple tips and listening to your body. Achilles tendon injuries can be prevented by avoiding overtraining, allowing for adequate recovery and rest, following a regular stretching and strengthening program and selecting proper running shoes for your running style.

  • Begin the exercise standing on a stair facing up the stairs
  • The toes should be on the stairs and the heels off the stair.
  • Slowly lower your heel so that it drops below the step.
  • The eccentric movement is the dropping of the heel to lengthen the calf muscles.
  • You should feel a slight stretch in the calf.
  • Slowly return to the starting position.
  • Repeat 10 to 15 repetitions twice a day.

– John Martinez, M.D. Medical Director, Coastal Sports and Wellness Medical Center, San Diego, CA

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