Runners are susceptible to Achilles tendon and heel injuries because running is a high-impact activity that places significant stress on your Achilles tendon and heel. Worn shoes and tight calf muscles can also contribute to Achilles tendon and heel injuries. Injuries include plantar fasciitis, tendinitis and bone spurs. To alleviate pain, rest, ice and gently stretch your calf and foot muscles. If pain persists or worsens, avoid running and consult your physician.
Anatomy and Function
Your Achilles tendon is located on the back of your ankle and attaches your calf muscles to your heel-bone. Your plantar fascia is a band of thick tissue located on the bottom of your foot, extending from the base of your toes to your heel. This fascia helps support the arches of your feet.
Causes
Running on hard surfaces, such as sidewalks, wearing worn shoes and neglecting to stretch before running can lead to Achilles tendon and heel pain, or a bruised feeling. Plantar fasciitis and Achilles tendinitis are when your plantar fascia and Achilles tendon become inflamed, respectively. Plantar fasciitis or Achilles tendinitis, over time, may cause a bone spur, which is when a bony projection develops on your heel bone. Additional causes of Achilles tendon and heel pain include a heel bruise, stress fracture, sciatica and a torn Achilles tendon.
Risk Factors
Flat feet, high-arches and other foot abnormalities can increase your risk of developing heel pain due to altered foot mechanics during running. Additional risk factors include tight calf muscles, obesity and a previous foot or ankle injury. Over-training, weak leg muscles and poor running mechanics, such as over-striding, can make you susceptible to Achilles tendon and heel pain, too.
Symptoms
Your Achilles tendon and heel pain may be described as a bruised feeling, achy, sharp or stabbing, depending on the type of injury and severity. The American Academy of Orthopaedic Surgeons reports that heel pain associated with plantar fasciitis may be worse in the morning, subsiding as the day progresses. Additional symptoms of heel and Achilles tendon injuries include swelling, ankle stiffness and crepitus, or crackling, over the injured area. Weight-bearing activities, like running, will likely aggravate your symptoms.
Treatment
Ice your Achilles tendon and heel two to three times a day for 20-minute intervals until pain subsides. Wrap an elastic bandage around your foot and ankle, and elevate your foot above your heart to reduce swelling. Take over-the-counter pain medications, such as acetaminophen, to manage any residual pain. Stretch and massage your foot, ankle and calf to further alleviate symptoms associated with plantar fasciitis and Achilles tendinitis. For persistent pain, your physician may recommend wearing orthotics, a walking boot or night splint, which is a boot worn at night to keep your foot and ankle in extension. Additional treatments to discuss with your doctor include corticosteroid injections, physical therapy and surgery.
References
- “Clinical Evidence”; Plantar Heel Pain and Fasciitis; Karl B Landorf, et al.; January 2007
- “American Family Physician”; Tendinopathies of the Foot and Ankle; Michael R. Simpson, D.O., et al.; Nov.15, 2009
- "American Family Physician"; Plantar Fasciitis and Other Causes of Heel Pain; Stephen L. Barrett, D.P.M., et al.; April 15, 1999
- “Journal of the Royal Society of Medicine”; Achilles Tendinopathy: Aetiology and Management; Nicola Maffulli M.D., et al.; 2004
- American Academy of Orthopaedic Surgeons; Plantar Fasciitis and Bone Spurs; June 2010
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