• Achilles Injuries

Achilles Injuries

Achilles

Achilles, a Greek warrior, dies in battle with the Trojans by a single arrow to the heel. The pain runners often experience in the heel is probably similar to that of a Trojan arrow! Achilles’ mother, Thetis, tried to make Achilles invulnerable by dipping him in the river Styx. However, she forgot to dampen the heel that she was holding the infant by. For runners to be invulnerable they must either take a dip in the river Styx, or make use of this article.

You may find the river difficult to find as it runs between Earth and the Underworld (Hades), but keep a look out on your next long run!

As a result of his mother’s oversight Achilles is famous for his heel and not for being the most handsome and fastest of all the Greek heroes. As a handsome fast runner it is important that you take care of your Achilles heel so your running is more famous than your injury!

It is important that you do not ignore pain in your Achilles as over time it may become gradually weaker and therefore will be more likely to rupture (snap!)

Causes

Training – too much, too often.

The most frequent cause of pain in the Achilles is overtraining. Overtraining, coupled with a change in training is often related to Achilles problems. An increase in hill training and/or speed work places greater stress on the Achilles and should be avoided if you have soreness in this area.

Shoes

You should also consider your footwear; inappropriate footwear may place greater tension on the Achilles tendon.

Stiff shoes will limit forefoot movement and may cause pain. By looking at your old shoes it is often possible to tell if you pronate. Excessive pronation often places strain on the edge of the Achilles tendon.

It has been found that shoes with excessive heel cushioning are sometimes associated with a heavier or more pronounced heel strike. This means that the Achilles absorbs the shock and the Achilles is over stretched.

If you have recently bought new shoes (especially new spikes) this may place further tension on your Achilles, in the short term.

Wearing high-heeled shoes places you at an increased risk as your calf muscles will be significantly shortened and it is likely that the muscles in your foot will be weak.

If you have a very high or a very low arch this will also place greater strain on the Achilles.

Treatment

Initial treatment

RICE then MICE (see RICE article). Do not stretch the area initially, first check with a professional sports masseur that there is no likelihood of a rupture. If it is not a rupture then you will need to stretch the calf and hamstring. Wearing a pair of stiff boots will help to reduce the movement of the ankle, and help facilitate resting the Achilles tendon.

Reduce the cause of the pain

You will need to reconsider your training. Initially reduce the quantity of your training (while you recover) and then very gradually increase (to allow your body time to adjust). You may find that you will need to change the training if a particular surface or type of training aggravates the problem.

If it is your shoes that are causing the problem you may have to replace them. Shoes with a firm arch support are often a good option.

Treatment of the injury

As with most injuries the body is not very good at repairing itself. You will need to get a professional to help your body repair itself. Massage is a good option (see www.theisrm.com for a professional in your area). Your masseur will probably need to keep the ankle flexed when working on it . As a result self massage to the Achillies tendon is notoriously difficult and ineffective to do on yourself. Your masseur will be able to release the calf muscles and hamstrings which often place significant strain on the Achilles.

Worst-case scenario

Once you have tried all the above options you may need to consider surgery or a cortisone injection, although this should not be necessary if you watch out for the warning signs and take appropriate preventative action.

Prevention/rehabilitation

To ensure you limit the likelihood of Achilles pain it is important than you strengthen the Achilles. These exercises can also be used as part of the rehabilitation process. For rehab it is important than one utilises the eccentric movements and minimise the concentric contractions. A concentric movement is when one shortens a muscle under tension. An eccentric movement is when one lengthens a muscle under tension.

  1. Pick up a small object (eg a pen/ or coin) with your toes
  2. Place a tennis/golf ball on the sole of your foot and massage your foot
  3. Eccentric knee squats. Complete a squat facing a wall, point your knees centre, to the right and to the left of the wall.. Try this on one foot.
  4. Eccentric heel drops. Stand on a step and slowly drop your heel off the edge.
  5. Stand on a dura or wobble disc, try this with your eyes closed.
  6. Stretch you whole calf.

a) Stand opposite a wall with your back leg straight, hold for 20-–30 sec

b) Stand opposite a wall with your back leg bent, hold for 20-–30 sec

c) Bend your toes up on a step and move your knee over the front of your toes, hold for 20-–30 sec. This is a subtle but very important stretch.

Things to watch out for

  1. If you have a dent in your Achilles then you probably have a tear, see your masseur.
  2. If your Achilles is hot/red and you have a temperature you may have an infection and should see your doctor
  3. If you experience tingling and numbness in your Achilles then it is likely you have a neural problem and should see your masseur or physiotherapist.
  4. If you have an arrow in your heel you are a warrior, keep running!

For further details, questions, or a massage contact the Momentum Sport Massage Expert

mrowenlewis@hotmail.com or see his website

www.owenmassage.co.uk


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