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How to avoid / treat pesky tendinitis of the Achilles

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Achilles tendinitis is a common complaint among runners, involving pain in the Achilles on motion, tenderness, and sometimes warmth and swelling to the area. Stiffness and pain on getting up in the morning is a symptom. It is a chronic injury, i.e. an accumulation of stresses leading to the tendon being overloaded. Causes can be worn out shoes, training on road or uneven terrain, and, most likely, sharp increases in volume of running. Other factors are excessive pronation during running, and lack of flexibility and strength in the calves.

I used to subscribe to a sports research newsletter called Peak Performance, from which the following advice is taken. It is more than twenty years old but I think the exercises and the science behind them are sound and really useful today. Basically, this one exercise – Balance and eccentric reach with toe – emphasises the eccentric action of the calves and Achilles (lengthening under tension) which they undergo during running. It can be used to prevent or treat Achilles tendinitis.

Stand on your right leg facing a wall, about one stride length from the wall. Left foot is off the ground. Bend the right leg, maintaining a relatively upright body position, and reach the left toes forward, with leg quite straight, aiming to just touch the wall. Return to the start position. Then reach left leg forward and left aiming your toes to the wall, bending right leg. As you do this, your right foot will pronate (roll inward), forcing the calf and Achilles to eccentrically control the motion, as it does during running. Return to the start position. Then reach left toes forward and across to the right, aiming for the wall. As you do this your right foot will supinate (roll outward) as it naturally does towards the end of the stance phase of the gait cycle. Return to the start. That’s one rep.

Aim for 4-6 reps at first. Then gradually progress the exercise as you gain strength and coordination, by increasing repetitions, adding weights, increasing the range of motion at the knee, or increasing speed of movement.

You can really feel the work in your Achilles and lower calf.

There is one other exercise I like to help the management of Achilles tendinitis, which I will describe next week, along with some great calf stretches involving rotation.

Lisa :)

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