Question: I am starting to develop some pain at the back of my heel, I think its my achilles tendon. It feels quite stiff and aches, especially in the morning and at the start of runs, but it always improves within the first mile or so. What should I do to avoid it getting worse?
Answer: This is quite typical of an early case of achilles tendinopathy. It is important to catch it now, before it develops into a serious problem. Achilles tendinopathies (also called tendinitis, or tendonitis) cause stiffness and pain in the achilles tendon, usually on both contracting and stretching the muscle. Initially the condition eases as exercise continues and then stiffens up again afterwards. If ignored, it will become worse until pain is constant. This increases the risk of a rupture.Treatment should focus on the tendon and calf muscles themselves, as well as the cause of the injury:
Rest from any activities which aggravate it – this should be until all daily activities are pain-free. A gradual return can then begin.- Apply ice – after any activity or whenever it feels sore, for 10 minutes at a time.
- Stretch the calf muscles – make sure you stretch both the gastrocnemius and soleus muscles at least 3 times a day.
- Visit a sports injury specialist – who may perform treatments such as massage and ultrasound.
- Wear a small heel raise – lifting the heel temporarily can take the strain off the tendon and help it to heal (this should not be used long-term as it will shorten the calf muscles).
- Get gait analysis - to see if you overpronate or oversupinate both of these place extra strain on the tendon and you may require different running shoes!
- Reassess your training program – a sudden increase in mileage,speed or hill work could be to blame.
Once pain & stiffness decrease, start to strengthen the tendon and calf muscles using the heel drop exercise. Perform a heel raise on a step with both feet and then swap to the injured foot only to lower back down below the level of the step. Repeat 10-20 times.
It is really important to catch this injury as early as possible and don’t be tempted to carry on training! Resting now for a couple of weeks is far more preferable to ignoring it and ending up having to take 6 weeks or more off!
To find out more about achilles tendinopathy treatment please visit www.sportsinjuryclinic.net
