Achilles Tendonitis, part 1: What is Achilles tendonitis?

If you’re a runner like me, you’ve likely, at one point or another, experienced an ache in the back of your lower leg, near the heel or just slightly above the heel. It may have started suddenly the day after a long run or doing sprints. Or perhaps after suddenly walking more than usual or up hills when you’re not typically used to walking hills. It may have been just an annoying ache at first, maybe some stiffness in the morning that went away as you got up and moved around. But now it has been weeks… and that annoying ache has turned into a pain. A pain with every step and every time you push off your toes. You feel it walking up stairs. It’s stopped you from exercising. You avoid certain activities because of the pain. What is going on?!

Does this sound familiar?

The Achilles tendon is a strong connector between the calf and our heel bone, the calcaneus. When behaving normally, it helps us to push off our toes when we walk, run, jump, climb stairs, etc, without pain. But when we overdo it, that tendon can become inflamed and irritated. And if we don’t make some necessary changes, that irritation can become a big long-term problem.

In Greek mythology, Achilles was a great hero of the Trojan war. He was described as being invulnerable except for one heel. As the myth goes, his mother, Thetis, dipped the infant Achilles in the river Styx, holding him by his heel and leaving it untouched by the river. It became his only vulnerable body part, and thus the term “Achilles heel” was derived. The term refers to a point of weakness that can lead to the downfall of even a mighty hero.

So even the most seasoned and elite marathoners can find themselves sidelined by a bout of Achilles tendonitis. But so can the average person.

And so, the frantic midnight Google searching begins. What causes pain in the Achilles tendon? How to fix Achilles pain fast? What is this bump in the middle of my Achilles? What does Achilles tendon pain feel like? What is Achilles tendonitis?

Next thing you know, you’re panicking and are convinced that you’re going to have to amputate your leg. You’re scared that you won’t be able to run in the 10k race you registered for. And your weekend pickleball tournament is definitely out of the question.

You’ve decided at this point it is time to see your physician about this pain. He diagnoses you with Achilles Tendonitis and refers you to physical therapy.

Achilles tendonitis most often occurs when there is repetitive strain on the Achilles, which may cause microscopic tears. These small tears will result in inflammation and pain. Tendonitis is typically considered an overuse problem, whereby an individual may have increased activity too much, too soon or has overtrained. But Achilles tendonitis can also be caused by improper shoes, or transitioning into new running shoes too quickly. It can be caused by training errors. Or, it can occur after a nice vacation to Europe where you walked miles on cobblestone streets in flats, crocs, or flip flops.

Phew! Now that you know you won’t have to amputate and that this is a very fixable issue in most instances, you begin to wonder how physical therapy helps?

In most mild cases, it isn’t necessary to completely stop all activity (or running even), but rather to modify activity so that you can participate comfortably and without flaring it up. Physical therapy helps you figure out this delicate balance. A physical therapist will help reduce swelling and pain, look for imbalances, correct movement patterns, make recommendations for orthotics and shoes if needed, help you increase strength, and help you fully return to your prior activity level.

The problem these days, is that sometimes it can take weeks, or even months, to get in to see a physical therapist. What are some things you can start doing at home while you wait for your first visit? Doctor Google has a lot of information available. What will actually help? What should you avoid? And how do you know this information is accurate?

Stay tuned for all this in Achilles Tendonitis, part 2: Treating your Achilles Tendonitis