Achilles Tendonitis

It’s estimated that Achilles tendonitis accounts for around 11% of all running injuries. The Achilles is the large tendon at the back of the ankle. It connects the big calf muscles (Gastrocnemius and Soleus) to the heel bone (Calcaneous) and provides the power every time you push off when walking and especially running.

Because of this, the Achilles bears a lot of weight (it basically supports your entire body weight as it propels you forward) and as such is prone to injury, especially in runners.

Tendonitis vs Tendinosis

Before we get into the details of this condition, it’s important to differentiate between two similar, but different injuries to the Achilles or any other tendon in the body.

Tendonitis - this is an acute (short-lived) injury to the tendon that is marked by inflammation. Inflammation is the body’s way of dealing with injury - the tendon is painful, red, feels hot and swollen. 

Tendinosis - this is what happens when inflammation has gone on for too long - too much inflammation will lead to a breakdown of the tissue. Tendinosis is a condition where the tissues of the tendon become degenerated. 

The approaches to tendonitis and tendinosis are different! The focus of this article is on tendonitis. Here’s a video that covers tendinosis.

Causes

Tendonitis is almost always caused by overuse. Meaning, too much work on the tendon. This can happen whenever a person overuses their body - it can be from walking, running, tennis, etc - it doesn’t matter the activity necessarily, it happens when the tendon is overworked.

Because the Achilles tendon bears most of our weight when we’re upright, it’s easy for it to become ‘overwhelmed’ by extra use. This is why it’s so important to gradually increase one’s activity over time, rather than going all out. Making sure the tendon and the muscles it attaches to (Soleus and Gastrocnemius) are strong is the best way to prevent tendonitis.

Symptoms

Achilles tendonitis often begins with the sensation of a ‘hot’ spot along the tendon. The location can vary; it may be where the tendon inserts into the heel, midway up, or closer to its origin at the bottom of the calf muscle. 

People often describe the pain as ‘burning’. In the morning, the tendon will feel stiff and painful when you start walking. The pain may resolve once the tendon warms up - this is what leads many people to continue exercising with tendonitis - it only hurts when they stop their activity!

A really inflamed tendon will develop thickened areas along its length - they are especially tender!

Relief

Ok, now for the important part - how do you get rid of it? Here are the steps we take with patients in the clinic. If you follow these exactly, as soon as you feel tendon pain, it will resolve relatively quickly. If you don’t, you risk developing Achilles tendinosis, which is a long term issue. Take the time now to heal your tendonitis, rather than dragging it out for months and months!

1. Give it a rest. Stop. Let your body heal. Tendons have a relatively poor blood supply and that makes it more of a challenge for them to heal, which means they need some time!
   
2. You can keep exercising, but do something that doesn’t stress the tendon. Think swimming, biking, yoga, strength training, etc. Anything other than running!
   
3. DON’T take ibuprofen or other NSAID (non-steroidal anti-inflammatory drugs)! These drugs have a nasty side effect and that is they actually inhibit repair of collagen (the protein tendons are made out of). Sure, they’ll relieve pain but they don’t enhance healing. Here's why we suggest avoiding these drugs.
   
4. Do negative calf raises. Here’s how:
   - Stand on a step with your toes on the edge, with your heels hanging off. 
   - Push up with both feet into a calf raise.
   - Take the unaffected foot off the step and then slowly lower the other calf until the heel drops below the step. 
   - Do 3 sets of 12-15 repetitions. 
   - Best done with shoes on.
   
5. We recommend three natural medicines to enhance healing of Achilles tendonitis:
   
   Ligament Restore provides the injured tendon with the nutrients it needs to heal and repair itself. It also contains pain-relieving botanical medicines.
   
   Inflammation Relief speeds healing by breaking down pain-generating chemicals and improves oxygen and nutrient delivery to injured tissues.
   
   Curcumin Relief - Made of a highly absorbable form of turmeric, Curcumin Relief is one of the strongest natural anti-inflammatories known!

Be diligent with your recovery, be sure to take a break from activities that stress or cause pain on the inflamed tendon, and follow the above suggestions. You should be completely healed in about 10-14 days. Be sure to start back very, very slowly to avoid aggravating the tendon again!

Want more info? Here's a more detailed video: