Running & Achilles Tendinopathy

Running & Achilles Tendinopathy

Running & Achilles Tendinopathy

  • What is it?

The Achilles tendon is the tendon that attaches the gastrocnemius and soleus muscles (main calf muscles) to the calcaneus (heel bone). With increased/repeated demands on the gastrocnemius and soleus muscles, too much stress can be put on the Achilles tendon, creating irritation of the tendon. To deal with the increased demands on the tendon, the body sends more collagen to the area to thicken the tendon. However, these collagen fibres are deposited in a bit of a mess, creating a thick but inefficient tendon. This is why pain may be felt in the Achilles tendon weeks after an injury/insult.

  • What are the causes?
    • Transitioning to minimalist shoes too quickly: as previously explained, wearing minimalist shoes will increase the activity of the posterior chain muscles, including the gastrocnemius and soleus. If this transition to minimalist shoes is done too quickly, this increased demand may lead to overuse stress on the Achilles tendon.
      • Quick transition to minimalist shoes -> increased demand on calf muscles without giving tissues time to adapt -> increased stress on Achilles
    • Forceful forefoot striking: as previously mentioned, the ideal foot strike is either on the forefoot or midfoot, but more importantly is how this is achieved. If a forefoot strike is a conscious effort, the calf muscles will be overworked as they are not used to this kind of effort. This can lead to overuse stress on the Achilles tendon.
      • Conscious forefoot strike -> increased (unnatural) demand on calf muscles -> increased stress on Achilles
    • Increased running volume: given that your calves work a lot while running, especially with a more minimalist technique, if the running volume is increased too quickly this can lead to overuse stress on the Achilles tendon.
      • Increased running volume (too quickly) -> increased stress on Achilles

 

  • How can you prevent it?
    • Interval (run/walk) running program: to reduce the risk of injuries and overuse stress on the Achilles tendon, a gradual integration of new minimalist running shoes or a gradual increase in running volume is recommended. This will allow the calf muscles to adapt to the new demands.
    • Using less conscious interventions to produce a forefoot strike: changing your running shoes (to more minimalist shoes), increasing your cadence and being “light on your feet” are just a few examples of “less conscious” interventions to encourage a forefoot strike. (See my previous blog posts about minimalist shoes and cadence for more information)
    • Strengthening ankle/foot stabilizers and calf muscles: by strengthening ankle/foot stabilizers, the calf muscles can work more efficiently by pushing off from a stable base. Strengthening the gastroc and soleus muscles, with a focus on eccentric loading (slowly releasing a contraction) can help prepare these muscles for the demands of minimalist running.

 

  • How can you treat it?
    • Soft tissues release: different massage techniques can help decrease the stress on the Achilles tendon by decreasing the tension in the calf muscles.
    • Exercises: eccentric loading of the Achilles tendon can help to remodel it.
    • Taping: certain taping techniques can help decrease the tension on the calf muscles and decreased the load on the Achilles tendon.