Achilles Tendinopathy in the Running Athlete

Endurance athletics can be rewarding; running the local trails, cycling over rolling hills, swimming peacefully through the local open-water lakes in Michigan.

Endurance athletics can also be damaging.

Overuse injuries are often slow to develop. They are typically shrugged off as the “normal aches and pains of training”. But then it hits. A sore knee, an achy shoulder… a “twinge” in the Achilles.

If you are an avid runner, you have inevitably had to work through the mid-season overuse injury. A common complaint that we see in our clinic is Achilles tendinitis (acute irritation or flare up of the tendon) or Achilles tendinosis (chronic state of injury/healing/inflammation). Typically when we see our athletes, the damage has already been done … and the rehabilitation/return to sport progression begins.

But researchers have recently identified a few key factors in the goal of reducing Achilles tendinopathy in runners, as cited in the very recent article in Sports Medicine (June, 2014). With all-due respect to the multitude of factors contributing to overuse injuries (training volume, hydration, experience, surface, shoes, running style, pace, intensity, duration/distance)…the authors found 3 key ingredients that led to unfavorable outcomes: running surface (too soft), arch type (too low, unsupported), and running style (high level of brake force during running gait). Coaching through surface selection and training programs is a must. Identifying proper shoes, orthotic selection and fabrication (as needed) will assist any biomechanical flaws. And a thorough analysis of running gait at different speeds and grades will identify any technique flaws that are contributing to soft tissue destruction.

The authors also sited that strength training for runners is also a preventative ingredient, which will be covered in a later write up!

If a coach, therapist, athletic trainer or health care practitioner can identify and address these issues early on in the season, the athlete stands a better chance of running free and easy through the entire season without a concern for the proverbial “Achilles heel”.

So if you haven’t had a running or gait analysis done, seek out your local professional and do it now…it’s not to late to save the rest of your season!