Q: About 6 weeks ago, in a quest to train for a marathon, I started experiencing pains in my achilles tendon after a faster than normal run. I have been training on the elliptical machine every day except the day after long runs. My Achilles feels great, until I have to get back on the pavement and then, it starts to hurt again. It does not appear to hurt that badly if I stretch it. What should I do now?
A: It sounds like you have inflammation of the achilles tendon or some form thereof. The cause is difficult to identify in this context, but the factors contributing to, or limiting recovery can usually be controlled. The achilles tendon has a poor blood supply so it takes quite some time for it to completely heal. I am not suggesting that you stop running, but from your question it seems clear that you should control your mileage until the pain diminishes. This is likely something you cannot run through.
Helpful Tips:
Ice after running. Stretch the calf muscles and achilles before and after running, as well as one other time during the day. Don't force the stretching; it can irritate the tendon. Check that the heel cup of the shoe does not apply pressure to the tendon. Do not run hills and do not do speed work. Try running at a moderate and consistent pace throughout your run. Do not run more than 2 consecutive days without a rest day. That is, don’t run three days in a row. Feel free to exercise on the rest day providing the exercise does not irritate the tendon or leave you feeling sore the following day. Long-term problems with the achilles can cause scaring and calcification (bone build up) in the tendon. Therefore, it is important to seek medical advise with this injury to deter from having continuous problems for years to come.
Dr. Nick Brown
Dr. Brown is a postdoctoral researcher in the Department of Biomedical Engineering at The University of Texas.
