RUNNING INJURIES SERIES – ACHILLES PAIN
Running injuries are a pest and can be incredibly frustrating when they stop you from staying active and doing the thing you love to do. The first blog in this series talked about knee pain when running and explored Runners knee and IT band syndrome. The knee isn’t the only common area where running injuries and pains can occur. Another very common injury for runners is Achilles Tendinitis.
This injury involves inflammation to the tendon which connects your calf muscle to your heel. When it comes to tendon injuries you are almost always looking at load as your key contributing factor. Increases in run frequency, distance or intensity can start to cause this inflammatory response in the Achilles as it is unable to adapt to the increase in load being put through it. If left untreated you increase your risk of a full Achilles rupture so early management is key.
Achilles tendinitis is often characterised by dull pain in your lower leg above the heel, swelling, warmth and redness along your Achille and even some limitation in your range of motion when flexing your shin up to your shin. The first steps of the day or your first steps after being seated for a while are often uncomfortable and painful, and then you’ll feel it warm up as your start to get moving.
Your initial management for Achilles Tendinitis looks similar to other lower limb injuries with the RICE Protocol (rest, ice, compression, elevation) and also taking nonsteroidal anti-inflammatory drugs (NSAIDS) like Voltaren or Nurofen initially.
However, the most important component of recovery is LOAD MANAGEMENT. Your Achilles needs time initially to settle down and let the inflammation resolve by pulling back off the current load you’re are doing. Note that this doesn’t mean to stop activity entirely. You must slowly reintroduce load, capacity and build strength back up in the Calf and Achilles.
As a general rule of thumb, we take the approach of: if the pain or discomfort during or post activity is less than or equal to 4/10 than you are okay to continue. Your Achilles needs to be loaded to its tolerance level to create adaptation, so some discomfort is okay while the tissue adapts. The saying “If you don’t use it, you lose it” is perfectly applicable here.
Physio guided programming to ensure you progressively reload the Achilles is key in returning safely and effectivity after Achilles tendinitis. From there building up your maximum calf strength will ensure that you don’t get into the cycle of flare ups constantly.
If you’re suffering from pain when running and want to get thoroughly assessed and an individualised treatment plan made, then book in a full Running Assessment at Befit Physio’s: The Running Space in Randwick.