Understanding and Managing Achilles Tendon Pain in Runners

Achilles tendon pain, also known as Achilles tendinopathy, is a common issue among athletes, particularly runners. This blog post will help you understand the main risk factors, how to diagnose it, and the best ways to manage and treat it.

Incidence and Risk Factors

Achilles tendon pain affects 2.0-18.5% of runners annually and is the top injury for older runners. Key risk factors include:

• Weak calf muscles: Especially in older male runners.
• Previous Achilles tendon problems.
• Use of certain antibiotics (e.g., Cipro).
• Sudden increases in training intensity: Such as adding more hills or speedwork.
• Changes in footwear.

Types of Achilles Tendon Pain

Achilles tendon pain can be classified into two types:

• Mid-portion Achilles tendinopathy: Often caused by overstretching.
• Insertional Achilles tendinopathy: Often caused by pressure at the heel, suspect compression.

Rehabilitation Techniques

Effective treatment focuses on managing the load on the Achilles tendon and gradually increasing activity. The rehabilitation program is structured in phases:

Phase I: Initial Management

• Daily heavy muscle holds (4 sets of 45 seconds each).
• Progress if pain level is ≤3/10 and Phase I is completed for ≥1 week.

Phase II: Heavy Exercises

• Continue daily muscle holds.
• Heavy exercises every other day:
  • Week 1-2: 3 sets of 12 reps
  • Week 3: 4 sets of 10 reps
  • Week 4-on: 4 sets of 6 reps

Phase III: Jump Training

• Jump training (3-6 sets of 15 reps, starting with both legs, then one leg).
• Continue heavy slow exercises.

Phase IV: Return to Activity

• Gradual return to running and phase out jump training.
• Continue Phase I exercises as a warmup.

Supportive Treatments

Various supportive treatments can help during rehabilitation:

• Shoe modifications: Use shoes with a higher heel or heel lifts for heel-related Achilles pain.
• Load management: Adjust training to avoid excessive strain, particularly avoiding hills and speedwork.

Monitoring Progress

It's crucial to monitor pain levels during exercises. Acceptable pain levels are in the 0-3/10 range, with 4-5/10 being okay in some cases. Pain levels above 6/10 indicate excessive strain and should be avoided.

By understanding the risk factors, using effective examination strategies, and following a structured rehabilitation program, athletes can manage Achilles tendon pain effectively and return to pain-free running.

Are you struggling with Achilles tendon pain or any other running-related injury? At Redefine Physio, we specialize in helping runners overcome injuries and get back to their passion. Schedule a consultation today and take the first step towards pain-free running!

Tags: Achilles Tendon Pain, Runner's Injuries, Running Health, Physical Therapy, Rehabilitation, Muscle Holds, Jump Training, Footwear Modifications, Running Performance

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