LIVING WELL By Mark Temme PT
Ways for Runners to Manage Achilles Pain The Achilles tendon is the largest and strongest tendon in the human body. It attaches the calf muscles to the ankle and transmits the force used to push off when you walk or run. Due to the everyday demands on the Achilles tendon, it is a common area to experience pain and loss of function. The technical term is Achilles tendinopathy (AT). Achilles tendinopathy occurs in both active and sedentary populations. It is one of the most common running injuries; in fact, an estimated 10%–15% of all running-related injuries involve the Achilles tendon. While Achilles tendon pain and dysfunction can sometimes be related to medical conditions or medication, it is most often due to overloading the tendon. In the active population, this overload is generally due to errors such as ramping up training and doing too much too soon. In the sedentary population, overload may be related to performing an activity more than usual; for example, increased walking while on vacation. In both cases, the activity involved exceeds the ability of the individual’s Achilles tendon to handle the load placed upon it. The telltale symptoms of Achilles tendinopathy are pain and swelling present during activities and associated morning pain and stiffness. Generally, the pain and swelling will be located 2–6 cm above the heel (mid-portion tendinopathy). Less frequently it occurs at the attachment of the tendon to the heel bone (insertional tendinopathy). The management of these two types of Achilles tendinopathy differs and may require a differentiated diagnosis and specific management by your healthcare provider. Initial management involves the principles of RICE (rest, ice, compression, and elevation) and avoiding the aggravating activity.
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