5 Tips on Achilles Tendon Pain Treatment
At Podiatry on Yonge at King, I care about your foot health and would like to take the time to chat about some key factors in footwear that can impact your foot health. Being a runner, I constantly subject myself to repetitive impact and movements. This leads to the susceptibility of overuse injuries or imbalances. Achilles injuries are one of the injuries commonly found in runners and the walking population. Achilles injuries are commonly caused by overuse, fatigue and biomechanical imbalances. Here are some key points to help manage or prevent these injuries and debunk some myths in the footwear and foot health field.
1. Footwear, this has a huge impact on our predisposition to these injuries. The amount of load placed on the tendon can be influenced by our footwear. At a point I recall there was a trend in wearing runners of a lower drop. What does a lower drop mean? It means the difference from the rear foot to the forefoot. That difference in height between the rearfoot and forefoot can make a big impact on the connective tissue around your ankles. Have a little higher heel than the forefoot can help reduce strain on the tendon. Doing high impact repetitive activities in a lower drop causes more elongated and more contraction to happen around the lower limb and ankle. This can lead to plantar fasciitis or Achilles tendinitis, especially if there is any overuse or weakness. It is best to stick to a consistent heel height among your footwear. I put an example of a hoe I recommend at the start of this blog. I am a big fan of 10mm drops. I tried to go into a lower drop, proper transition and I still was not a fan of how it sparked an injury in myself!
2. Strength : Walking movement and running requires us to raise our heels off the ground as we move forward. It requires muscular strength in both of the calf muscles. However, overuse can lead to fatigue and weakness in these muscles. In the beginning of strengthening, heel raises may put too much unwanted strain on the achilles. That is why I advise doing a progression in strengthening for the achilles. I typically start out with isometric holds then move to added difficulty with either increasing weight or eccentric heel drops. I am also a big fan of also adding exercises for glutes and core, as weakness in these areas can lead to compensation by excessive overuse on the calf complex. If the calf is not strong enough the achilles will get angry!
3. Flexibility helps connective tissue to stretch within a range of motion. It is important to stretch the calf muscles and achilles especially since we contract them so many times when we walk or run. Those who do wear high heels should try to incorporate more stretching into their day to day regimen.
4. Pronation or flat feet can also cause this injury. Pronation is when the feet collapse inwards toward the middle of the body. This can create excessive strain on the tendon . It is important to also strengthen the ankle with this injury. This can be corrected with exercises and supportive shoes. Someone who has a flat foot should not be in flimsy shoes.
5. Slowly increasing your mileage or intensity. It is not wise to move up more than 10% of weekly mileage in a given week. Ease back into training if you are injured and trying to get back to running from this injury. I recommend easing back to activity by starting out wearing heel lifts or orthotics with posts in their non flat running shoe. It is not fun being injured, but you can maintain some level of fitness by cross training then progressing to the treadmill. The reason I like the treadmill is because it is lower impact and it isn’t as difficult as outdoor running. Once you are strong and flexible enough, I remove that lift, while moving you through a progression in difficulty of load and exercises.
Like any injury, it does take time and patience. So do not be too hard on yourself. All we can do is focus on the positive aspects, such as our exercises and rehab in order to get over our injury.