In Greek mythology, Achilles was a hero of the Trojan War who, despite managing to slay arch rival Hector outside the gates of Troy, sadly became most famous for dying from an arrow shot into his heel. Rather ironically, had Achilles been shot anywhere else he would have probably survived – a momentary oversight by his mother who, when dipping her baby into the water of a magic river to give him super protective powers, forgot about the heel she was holding him by.
Any runner who has suffered from persistent pain in the Achilles tendon will doubtlessly agree that it is a fitting name. As the thickest and longest tendon in the human body (normally around 15cm), the Achilles tendon connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).
The good news is, if treated correctly, runners can recover from Achilles pain sooner than many have had to endure it. However, success does depend on accurately identifying the source of the issue and taking appropriate steps to ensure it goes away and stays away.
What Does The Achilles Tendon Do?
The Achilles tendon is designed to deal with the loads that your body absorbs and uses to move. When you walk, these loads are the equivalent of approximately four times your body weight; when you run they move up to eight times your body weight.
In the case of runners, pain in the Achilles may well involve a combination of tendinitis (inflammation) and tendinosis (structural decline), which is why most modern therapists use the word tendinopathy to refer to the injury.
Rehabilitation For Achilles Tendinopathy
Appropriate rehabilitation of Achilles tendinopathy depends on at what stage of tendinopathy the tendon is at. The number one rule is, don’t ignore symptoms or try and run through them. In the early stages (reactive tendinopathy), the structure of the tendon is minimally effected so a little activity modification and strengthening work may be all you need to recover and get your training back on track. However, if you choose to try and soldier on and continue to expose the tendon to excessive load, its structure will start declining (tendon disrepair) and loss of function will soon follow. Rehab will take longer. Keep ignoring it and not making the necessary changes and you will get to the stage where function is severely compromised (degenerative tendinopathy).
Conclusion: Get Professional Guidance
- Assess it
Get it assessed and get some guidance for your rehab plan and and activity modification.
Massage nearly always has a place in the road to recovery but again it will not help your tendon get any stronger.
It may feel good, but in many cases it is the last thing your tendon needs and can even slow down recovery (by increasing compression).
- Foam rolling
Can be useful instead of stretching but again it’s how you do it that counts (they are not supposed to be torture devices!).
- Don’t stop!
Stopping your rehab the moment you start to feel better is a common mistake too; rehab needs to be progressed gradually and consistently even after you start seeing benefits. In fact, in most cases the rehab becomes ‘prehab’, i.e. a conditioning program your body will need for ever if you really want to reduce the risk of running into problems again. The biggest indicator of injury risk is if you have been injured before, so the message is learn from your injuries and make changes.
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