Achilles Tendonitis

What is it?
Achilles Tendonitis is a common condition affecting runners resulting in pain at the lower portion of the tendon near where it inserts on the heel. Interestingly recent research has proven that most often there is no inflammation present and that the condition should be called tendonosis. This is significant as all remedies that would be used to help a tendonitis would be useless for tendonosis and possibly detrimental.

How did I get it?
There are many anatomical factors that contribute to development of Achilles Tendonitis/Tendonosis. Bowed legs, high arched feet, excessive internal rotation of the lower leg and overpronation are some of the most common. Overpronation causes excessive internal rotation of the lower leg resulting in excessive, repetitive strain on Achilles tendon and is one the most common reasons for development of the condition.

How is it treated?
There are many ways that Achilles Tendonitis/Tendonosis can be treated. What is important is that the right treatment is provided for the right cause.

Custom Orthotics: A proper foot orthotic can go a long way in taking the stress off of your achilles tendon. The right custom-made, biomechanical orthotic can address the underlying cause of your Achilles pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and designed with your specific body weight and activity in mind. The restoration of correct mechanical function takes the abnormal stress off the Achilles thus allowing it to heal.

Stretching/Strengthening: Often we are often told by runners that they have been stretching in an attempt to relieve pain associated with Achilles Tendonitis/Tendonosis. The stretching exercise is directed at lengthening the tendon. The problem is that most stretching programs do take a scientific approach. In fact, there is a research based stretching and strengthening protocol that helps most people suffering from the condition. Strengthening of certain muscles may be effective but it is important to remember, it takes 4-6 weeks before muscles begin to strengthen in response to training. In addition anyone who has worked out in a gym can tell you that if you stop strengthening muscles they begin to shrink, lose strength and atrophy within two weeks! If prescribed the proper stretching and strengthening program, based on scientific research, most runners will begin to heal within 2-3 weeks!

Rest: For many rest is not a realistic option, the race you are training for is looming Our bodies are wonderful “machines”, if you rest it long enough it will heal itself. How long? This is uncertain. If you rest too long you may not be able to achieve your race goal. If you do not rest long enough the injury may not heal. Many have already followed the advice of resting only to have the injury reappear once you began running again.

Drugs/Anti-inflammatories: Drugs such as Ibuprofen are anti-inflammatory agents not healing agents. They actually impair the healing process and many times allow a runner to injure themselves further. Studies have shown that these medications are harmful to your body, can cause ulcers and strain your liver. Some research suggests that these drugs may be responsible in part to the condition becoming chronic and causing the tendon to become fibrotic.

Ice: Ice is often recommended and is another example of a non-healing modality. A runner often reports that they have been icing their Achilles after running. Doing this may help with the pain and inflammation at the moment but how will it help to remove the abnormal stress that is occurring in your Achilles tendon and ankle? It won’t. What it will allow you to do is further injure your Achilles, resulting in permanent damage. Addressing the underlying biomechanical cause prevents further damage from occurring and allows you to complete your race injury free.

Steroid Injections: Steroid injections are extremely painful and most doctors are reluctant to inject the Achilles tendon anyway. Recent research has shown that in the majority of patients with Achilles tendonitis the tissue is not inflamed but scarred (tendonosis). During the initial injury inflammation was present but inflammation only last up to seventy two hours, then scarring takes place. Steroid injections have also been shown to increase the chance of rupture of the tendons.

How long will it take to heal?
This depends on how long you have been suffering from Achilles tendonitis/tendonosis. By correcting the cause of the injury with San Diego Running Institute orthotics and following the treatment regimen provided by Dr. Runco you can expect 50-100% relief usually within two-three weeks. Ask your San Diego Running Institute expert about how to get your Achilles tendonitis/tendonosis fixed today.

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"Dr. Runco, Just wanted to let you know that I ran with my new shoes with orthotics today and although I only ran 4 miles, it was completely pain free. Even the achilles tendon didn’t act up thanks to the stretching exercises you showed me. I walked around the house in them for about an hour; it was like they weren’t even in there. I’ll probably run again on Friday and Saturday and hope to add a mile or so each run. Hopefully those runs will be pain free as well. I’ll keep you posted. And btw… Chavva, the girl who fitted me for orthotics and shoes was very knowledgeable and personable. Of course it helps that she used to be a boxer. Thanks again for getting me back on the road." -J.L.