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Achilles Tendinitis


Achilles Tendinitis, one of the more common and difficult injuries to treat in athletes, involves inflammation, degeneration or rupture of the Achilles tendon. The Achilles tendon is located at the back of the heel and inserts into the rear portion of the heel bone. It is surrounded by a vascular sheath which provides the tendon fibers with its blood supply.


The symptoms of this injury tend to come in stages or degrees of severity.

Stage 1 The athlete will experience a burning or prickly pain in the achilles tendon about 1 to 3 inches above the heel bone. This is the result of inflammation of the vascular sheath and may be due to shoe counter irritation.

Stage 2 The Achilles tendon actually begins to deteriorate (tendinosis) and the pain becomes a shooting or piercing sensation which occurs during activity, especially when changing direction or running uphill.

Stage 3 The collagen protein fibers in the Achilles tendon weaken to a point that the tendon will snap or rupture and there will be a great deal of swelling.

The main cause of tendon damage is sudden overstretching of tendon fibers. The Achilles tendon must be properly preconditioned to withstand sudden stretches and the strain of body weight during activity. If a chronic tendinosis is ignored and the tendon ruptures, the cells that repair the tendon (tenocytes) cannot work quickly enough to heal the damage done by the overenthusiastic athlete.

Causes of Injury

The positioning of the tendon in the calf makes it susceptible to running injuries.

  • Overpronation strains the coleus tendon.
  • Oversupination or high arches strains the gastrocnemius fibers in the calf muscle. Both cause injury high up in the Achilles tendon.
  • Constant rubbing of the back of the shoe against the tendon.
  • Improper shoe selection.
  • Improper warm-up.
  • Direct trauma.
  • A sudden dramatic increase in activity or intensity of activity.
  • Heel bone deformity.
  • A high-mileage, long-term running program that does not incorporate enough rest.

Short Term Treatment

  • Decrease mileage and intensity for 7 to 10 days; never run through pain.
  • Avoid hills during recovery.
  • Ice treatment after running.
  • Flexibility program concentrating on the soleus and gastrocnemius, including stretching and heel lifts.
  • Asprin or ibuprofen, never acetomenophen, to reduce inflammation.
  • Orthotic devices or proper shoe selection.
  • If the injury persists for more than two weeks it is recommended that the athlete see a physician.

Long Term Treatment

  • Continuous flexibility program.
  • Orthotic devices.
  • Professional treatment by a physician may be required.

For overall prevention of injury, all athletes should be aware of shoe deterioration and purchase shoes designed to correct any stride problems such as overpronation or oversupination.