Try running on a softer surface or track

A recent study in the Journal of Orthopaedic & Sports Physical Therapy found that more stress is being placed on the Achilles Tendon when running on a treadmill compared to running overground. This is especially important for those with Achilles pain or injuries. At Progressive Physical Therapy and Rehabilitation we recommend to our patients that they run on a softer surface like a track or grass rather than on a hard surface like cement.

What is an Achilles Tendon injury?

An Achilles tendon injury (tendinopathy) is one of the most common causes of pain felt behind the heel and up the back of the ankle when walking or running. While Achilles tendinopathy affects both active and inactive individuals, it is most common in active individuals; 24% of athletes develop the condition. Males experience 89% of all Achilles tendon injuries, and an estimated 50% of runners will experience Achilles pain in their running careers. In all individuals, Achilles tendinopathy can result in a limited ability to walk, climb stairs, or participate in recreational activities.

The Achilles tendon helps to balance forces in the leg and assists with movement of the leg and the ankle joint. Achilles tendinopathy results when the demand placed on the Achilles tendon is greater than its ability to function. This can occur after 1 episode (acute injury) or after repetitive irritation or “microtrauma” (chronic injury).

5 tips to treat an Achilles Tendon pain and injuries

1. Take Smaller Steps – By taking longer steps you place more stress/stretch on your Achilles tendon, which can increase symptoms, so taking smaller steps with walking can avoid this.

2. RICE & MEAT –Tried and true, RICE (Rest, Ice, Compress, and Elevate) will help decrease swelling/inflammation and should be used immediately after pain or an injury for at least the first 24 to 48 hours. Icing is also recommended to help alleviate pain and inflammation. Try using an ice massage. Fill up a Dixie cup with water and freeze the cup. Then, cut the top off the cup off so you can hold it on the bottom and massage for 5-10 minutes going up/down the Achilles tendonMEAT stands for Movement, Exercise, Analgesics, and Treatment.

3. Heel Lift – Sometimes a heel lift in a shoe can be beneficial. By putting the foot into a plantar flexion state (foot or toes flex downward toward the sole) it will decrease the stress/stretch being placed on the Achilles tendon with walking.

4. Gentle Stretching – Gentle stretching is better than over-aggressive stretching.  Eccentric strengthening (overall lengthening of a muscle as it develops tension and contracts to control motion) of the calf muscle is one of the most important things that can be done for Achilles tendon injuries. Focus also needs to be paid to your core, hips, hamstrings, and glutes, as this is where power is generated for your running stride.

5. Foot Wear – Wearing proper shoes with good support and possibly using orthotics is key to injury prevention and rehabilitation. Consider using an insole orthotic like Superfeet to add additional support depending on what sort of arch you have. They also help decrease stress being placed on the Achilles tendon.

Easy eccentric calf stretches to rehab and prevent Achilles Tendon injuries and pain

Sitting towel stretch

Sitting Towel Stretch: Gently draw your toes and foot up towards you, and pull through the towel to increase the flexion at your ankle until you feel a stretch in the back of your calf
Hold for 30 seconds, repeat 3 times

Stair Stretch

Calf Stretch Stair One Foot: Hold on to the rail. With heel on the ground, position the foot with toes up until you feel a stretch in your calf.
Repetition: Hold for 30 seconds and repeat 3 times

Calf Stretch Stair One Foot: Hold on to the rail. With heel on the ground, position the foot with toes up until you feel a stretch in your calf.
Repetition: Hold for 30 seconds and repeat 3 times

Standing Calf Stretch

Standing Calf Stretch: Stand facing a wall and step the leg to be stretched back behind you. Make sure your toes are pointing straight forwards.
Stand upright with your back knee straight, lunge forward onto your front leg until you feel a stretch in your calf muscle on the back leg.
Repetition: Hold for 30 seconds and repeat 3 times.

Standing Calf Stretch with Knee Bent for a Deeper Stretch: Stand facing a wall and step the leg to be stretched back behind you. Make sure your toes are pointing straight forwards
Standing Soleus calf stretches
Action: Bend the back knee slightly and, keeping up tall, lean into the wall until you feel a stretch in your calf muscle on the back leg.
Repetition: Hold for 30 seconds and repeat 3 times

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