The Achilles tendon is the strongest and largest tendon in the body. During running, forces on it can be 10 times the runner's body weight, says Dublin's Trinity College, with forces on the depending on running form as well as foot structure. Achilles tendon injuries can be debilitating to runners, and may require physical therapy or other medical interventions to aid in recovery.
Anatomy
The Achilles tendon can be felt as a thick cord in the back of the lower leg. It attaches the gastrocnemius muscle and the soleus muscles to the heel. Achilles tendonitis happens when there is a breakdown in remodeling: tissue is torn down faster than it is rebuilt. The result is disorganized collagen, small new blood vessels, swelling and degenerative changes. Achilles tendonits and tears occur slightly above the heel in an area of poor blood flow or at the insertion of the tendon into the heel.
Injuries
Achilles tendonitis initially causes pain and stiffness in the morning. Later, pain and swelling that worsens with activity occurs. As the condition progresses, the tendon may calcify or develop a bone spur at the insertion to the heel. The tendon can rupture, usually by landing with the knee extended. After an Achilles tendon tear it may be six months until running can resume, notes the American Academy of Orthopaedic Surgeons.
Treatment
Runners with Achilles tendon injuries should limit activities and ice the tendon. The American Academy of Orthopaedic Surgeons lists non-steroidal anti-inflammatory medications, physical therapy and stretching exercises as tendonitis treatments. After a health care practitioner has approved a runner to resume running, he should warm up before his running session and then ice the tendon when he is done.
Running Mileage and Mechanics
High weekly mileage increases the number of foot strikes which can lead to Achilles tendon injuries in runners with abnormal foot and body mechanics. Runners whose feet excessively roll inward or pronate may be helped by orthotics. In addition to finding shoes that work for their feet, runners should minimize running on hard surfaces or hilly terrains that irritate their tendons. After observing a runner's gait, coaches, athletic trainers and physical therapists may be able suggest running technique changes that can decrease Achilles tendon problems.
Prevention
The American Orthopaedic Society for Sports Medicine states that the best way a runner can prevent Achilles injuries is to correct strength and flexibility imbalances. The AOSSM suggests runners follow the 10 percent rule: increase training programs or activity by no more than 10 percent in a week. This rule applies to pace, mileage or weight in strength programs. Runners should alternate hard training days and easy training days. Cross-training by participating in other sports may decrease Achilles tendon problems.
References
- American Orthopaedic Society for Sports Medicine: Overuse Injuries -- Sports Tips
- "The Journal of Foot and Ankle Surgery"; A Retrospective Comparison of Endoscopic Plantar Fasciotomy to Open Plantar Fasciotomy with Heel Spur Resection for Chronic Plantar Fasciitis Heel Spur Syndrome; Rodney L. Tomczak,, Brent D. Haverstock; 1995
- American Academy of Orthopaedic Surgeons: PRP Shows Potential for Treating Achilles Tendinosis
- American Academy of Orthopaedic Surgeons: Achilles Tendonitis
- "Los Angeles Times": OK, Let's Take a Closer Look at That Stride
