I have recently taken on a client who wants to focus on distance running. He has a history of Achilles tendonitis. He has used medication and ice over the years to reduce inflammation. Unfortunately, getting back to full mileage without enough recovery from rehab has been his undoing. Is there something other than eccentric loading I should be aware of when bringing this athlete back to full fitness?
The Achilles tendon is one of the longest and strongest tendons in the entire body. That is how it received its name. By a Greek mythology story, Achilles was a mythological hero, and he was the strongest and most fearless warrior for the Greeks. This is fitting since, if you injury your Achilles tendon, you will be out of competition for a long time, just as you cannot go to war without your greatest warrior.
Before you can help to heal your client, you first must find out the severity of the problem. A technique you can use is the Perceived Pain Scale (PPS), where you have your client rate his pain from 1 to 10 (1 being painless and 10 being extremely painful). This will help you to better understand where to start your rehab and strengthening program. Individuals who suffer from Achilles tendonitis often complain that the first steps out of bed in the morning are extremely painful. Another common complaint is pain when steps are taken after long periods of sitting. This pain often lessens with activity, so you must have your client rate his pain the entire day. If you allow the Achilles tendon to go untreated, it can and will rupture.
When it comes to healing or rehabbing the Achilles tendon, there is no well defined correct way to do it. There are many ways to help ease the pain and help prevent problems, but other then complete rest, you’re always risking an injury, especially if you’ve injured it before. Below is list of treatments, preventions, alternatives and causes that will help in assisting your client. Again, there is no completely right way to heal this problem outside of surgery, but you need to be patient and do the treatments, preventions and alternatives until your client is strong enough and healthy enough to do more aggressive and intense running workouts.
With the above R.I.C.E. technique, keep in mind the following:
- Meds, anti-inflammatory (consult your client’s medical doctor first)
- Eccentric Loading - This is a great way to help assist in healing Achilles tendonitis. For a great article on eccentric loading, click here.
- Always stretch (Here are a few stretches that need to be done)
- Cut down on uphill running
- Wear shoes with good support
- Motion-control orthotics
- Progress slowly
- Massage (use oil or anti-inflammatory gel)
- Do not over do it. Stop when you feel PAIN!
Alterative Exercise (when your client has pain)
- Biking (slow gear)
- Non-Weight Bearing
Causes of Achilles Tendonitis
- Progressing too quickly
- Wearing improper lifts
- Problems with your feet and/or ankles. For an article about corrective exercise for the foot and ankle, click here.
- Tight muscles or tendons in the leg