Has running led to a sore achilles tendon?

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It’s been a while but you’ve decided to start running again. You lace up your shoes and off you go! You’re keen so you decide to just get stuck in and run every day – trying to go a little further or faster each session. You notice a niggle develop at the back of your heel but seems to settle down again so you keep going. The niggle then becomes constant and a bit swollen and now it’s painful just to walk let alone run.

Sound familiar? Maybe it’s not running for you, perhaps its bushwalking or netball. The story is often similar when it comes to achilles tendon pain – there’s almost always a story of overload.

Too much too soon

A spike in loading (eg. doing nothing to running everyday or walking 2 x week to bushwalking 5 x week) is a key reason for developing tendon pain. It’s common in weekend warriors who are exercising but work schedules and busy lifestyles prohibit regular consistent training. The body is really good at adapting to loads as long as there is enough time to get used to it. Too much too soon increases the risk of tendon pain.

What is Achilles tendinopathy

Achilles tendinopathy is pain felt in the Achilles tendon (a big thick tendon connecting the calf muscle to the heel). Pain is felt in a localised spot (you could put your finger on it) and tends not to radiate any larger than a 20 cent piece. There are a few different stages of tendinopathy from the reactive stage (swollen painful tendon) to degenerative (where there is changes to the actual tendon structure).

How do you mange achilles tendinopathy

Here are the main things to know when successfully managing Achilles tendinopathy (but there’s never a one size fits all when it comes to treatment – everyone’s situation is unique) :

  1. Reduce or modify load (however, that rarely means stop everything!). This can look like a change in intensity, or how often you exercise, a change in running/walking style, trading out exercise that loads the legs for more arm dominant ones. The aim is to settle the pain down.
  2. Start slowly reloading the tendon. This means reintroducing activities that were previously sore to do in a slow fashion whilst monitoring the symptoms. A simple rule of thumb on pain with activity: no increase in pain allowed straight after the exercise or 24 hours later.
  3. Build strength! Settling down the pain by some form of rest doesn’t actually fix the problem – increasing strength around the tendon and capacity of the tendon itself does! This is where a physio can help you – selecting the best exercises to do and progress with is key.
  4. Maintain – monitor fluctuations in training or activity. Try and be consistent and avoid peaks and troughs of activity. If you know you’re having an extended break from something – start back again slowly.
  5. Sleep 8 hours a night (easier said than done for some!) Sleep plays a vital role in recovery – more goes on from a body system point of view when you sleep than you may realise.
  6. Know that your body is robust and can get stronger – your not broken you can get stronger, more robust and resilient with the right training, sleep and exercise.

Your body loves to adapt to new demands

Our tendons aren’t like ropes that once frayed will never be as strong again. Tendons have an amazing ability to get stronger and more resilient to load. Permanently stopping exercise is never needed – you can get back to whatever it is you want to do. And the key to it all is loading it – start slow and slowly build.

Winston Hills | Physiotherapy | Clinical Pilates

Tim Cathers

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