The warrior Achilles is known as one of the greatest heroes in Greek Mythology. He was strong, courageous in battle, and nearly invincible everywhere but in his heel. An arrow shot directly to this area ultimately led to his downfall. This is where the term “Achilles heel” originates from.
Unlike the warrior Achilles most of us don’t fight in epic battles. However, if you are out beating the pavement, logging miles, you’ve likely had a dustup or two with your own Achilles. The Achilles most runners battle with is the Achilles tendon.
The Achilles is the large thick tendon extending down from the calf muscles (gastrocnemius and soleus) and connecting to your heel bone (calcaneus). The calf muscle is responsible for generating the power you need to push off of your big toe and propel forward as you begin your running stride. The Achilles tendon is the bridge that helps translate that power into action and is a vital component to an efficient running form.
Achilles tendonitis is typically an over use injury. This means, like most runners, you don’t listen to your body and back off when your calf is crying uncle. Other factors that increase the likelihood of this occurring are ramping up your training too fast, having overly tight calf muscles, or the smaller possibility of having a bone spur that is rubbing on the tendon.
Irritation is commonly present in the bottom third of the tendon or directly where the tendon connects to the bone. If it is red, hot, swollen, and generally angry looking it is likely tendonitis (“itis” meaning: inflammation of). If you are like most runners and continue to ignore and power through as the pain worsens, then you likely now have tendonosis. Tendonosis occurs at the point where the body is no longer trying to actively heal the injured area and the associated tissues are now degenerating. Yikes! Sounds scary, but help is on the way.
If you’ve had or currently are experiencing some of the symptoms I’ve described, then it is time to get on board with some basic stretches and exercises that will decrease the loading and increase the health of your tendon. “An ounce of prevention is worth a pound of cure.” I guess granny was right with that saying.
Below are my must-do exercises for having happy Achilles. The stretches will address the different heads of the calf muscles (gastrocnemius and soleus). Stretching these often will help decrease the load put on the tendon during exercise and keep you out running with fewer break downs. The other must do is eccentric calf raises. Eccentric training (contracting a muscle as it is lengthening) is proven to help re-align the fibers in the tendon to help heal minor damage and better tolerate the pounding your tendon endures during running.
So, what if you’ve minded your P’s and Q’s and are still having issues? You’ve rested, iced, taken anti-inflammatory meds, and faithfully done the Achilles “must-do’s.” However, every time you try to ramp back up the pain returns. It might be time to seek out some more advanced help to get over the healing hump.
Physical therapists are movement specialists and most are armed with doctoral level educations to help assess and treat your issue. An evaluation may serve to find local tightness in the calf muscles as well as weakness or muscular imbalances further up the chain in your hips, glutes, or knees that may be contributing to the problem.
Still not getting what you want in terms of results? Well the rabbit hole always goes deeper. A video running analysis could prove helpful as all of these little chinks in the armor (weakness, imbalance, and flexibility issues) may be caused by or contributing to an unhealthy running stride. Getting an expert tune up to your mechanics may help alleviate the issues at the root of your problem.
Good luck and don’t let this injury be your “Achilles Heel!”
Pic 1-3: All 3 of these stretches address the gastrochnemius with each hitting a different area of the muscle belly. Place the ball of your foot up onto a bolster (a book or rolled towels will also work) keeping your heel in contact with the ground and leg straight. Step your opposite leg forward and plant it. You can shift more weight to your front foot to increase the stretch if needed. Repeat each stretch 2-3 reps holding at least 30 seconds
~ Pic 1: foot straight, Pic 2: foot turned out approx. 30 degrees, Pic 3: foot turned in approx. 30 degrees
Pic 4: This stretch addresses the soleus muscle. Step over the bolster keeping your heel in contact with the ground, but allow the back leg to bend at the knee. This will move the stretch lower down in the calf closer to the tendon. Repeat stretch 2-3 reps holding at least 30 seconds
ECCENTRIC CALF RAISES
Pics 5-6: Push up raising yourself onto the balls of your feet (clearing your heels from the ground). Once at the top, lift your non-injured leg and slowly control your descent back to the ground with only one leg. Repeat 20-30 reps daily.
Kurt Leschke, PT, DPT, OCS is a doctor of physical therapy and clinic director for Mountain Land Physical Therapy in Layton, Utah. He specializes in treating all athletic and running related injuries. He is trained in video analysis to help runners improve their form and return from injury.