Achilles tendon pain can be one of the most limiting issues a person can experience.  Athletes, particularly those in sports that involve long duration running, are the most common population to have Achilles tendon pain, but Achilles tendon pain (particularly due to tears) is also common in older adults.  Achilles tendon pain is also common in people who spend any amount of time walking up hills.  In a place like Eugene, which is filled with runners and hikers, Achilles pain is a likely issue for someone living in the area.

Like most injuries, management of Achilles tendonitis depends on the severity.  If the pain is only present during an activity like running or walking, some calf stretching and lower extremity strengthening should take care of it.  If the pain is constant or more severe, you’ll need to be a little more cautious about your approach, and start by minimizing any aggravating activities.  Completely stopping activity is rarely recommended though!  Rest might help with short term pain relief, but the reason the pain started is still going be there, so you’ll need to address those issues.

For tendon pain, there are a few general ideas to follow:

  • Strengthening, especially the calves –  As long as you can tolerate calf raises (meaning there’s no long-lasting increase in pain), emphasize the lowering movement of the calf raise.  This puts a greater amount of tension on the tendon, which allows the tendon to break down and actually repair itself.  The lower your heel drops the more load the tendon has to resist, so work up to things like stairs or blocks.  Think about a 3-5 second lowering from the top of a calf raise.
    • Other options include nerve gliding and hip strengthening, which were described in our blog about Plantar Fasciitis.  Never underestimate the influence your nervous system has on pain, and remember that your hips don’t lie!
  • Load management – For the Achilles tendon, use of a heel lift can help reduce the amount of stretch the tendon goes through when the heel hits the ground while walking or running.  Heel lifts can be found at most pharmacies or medical supply companies.  Start off by being a little more conservative and using a smaller lift.  A lift as small as 2mm can make a huge difference in how someone walks.  Keep in mind that heel lifts should generally be considered a short term solution!  Physical therapists can help you work your back to activity without a heel lift as well.

If you take nothing else away from this article, remember that managing tendon pain is about identifying the source.  Just because the tendon is painful, it doesn’t necessarily mean that the tendon is the problem!  Working on the soft tissues in the entire leg (both legs even!) can make a huge difference in improving mobility and balancing out strength imbalances.  Strengthening the tendon itself is a great idea, but there’s likely another reason why someone experiences tendon pain!

Got questions?  Feel limited in what you’re able to do?  The staff at Limitless Physical Therapy in Eugene, OR can show you how to be limitless.

***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice.  Please contact a certified healthcare professional or your primary physician for any personal concerns.

 

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