What's Your Achilles Heel?

By Erin Higgins, DPT, Jumpstart Physical therapy

Remember the story of Achilles? A Greek hero and the star of The Iliad whose only "weak spot" was his Achilles? For some of you, this - annoying heel pain that interrupts your daily life and ability to exercise - may be more than myth.

Your Achilles is the tendon that connects your heel bone to your calf muscle. It helps you go up on your toes, which is needed during all walking and running activities. With overuse the tendon can become inflamed and irritated. This can lead to tendonitis, aka inflammation of your Achilles tendon. Typically the pain starts randomly and gets worse with time. Achilles tendonitis can be quite disabling, frequently causing pain with prolonged walking, stairs, walking uphill, squatting, and running/exercising. People with tendonitis also typically complain of pain and stiffness upon waking in the morning or after sitting for a long period of time, which improves once they start moving around for a few minutes to warm up the tissue.

Common causes of tendonitis include tight heel cords/calf muscles, a sudden increase in exercise, or weak calf muscles. Therefore, in order to prevent or decrease your risk for Achilles tendonitis, it is important to make sure you keep your calf muscle loose and strong. Additionally, make sure you start a new exercise routine slowly. Gradually increase the time, mileage, and/or intensity of your workouts in order to avoid such overuse injuries. Go especially slowly if the exercise routine involves running and jumping, as impact activities are the most likely to cause Achilles tendonitis.

If you already have pain, here are some remedies:

Ice

- After exercising or if your Achilles is particularly sore, make sure you ice in order to decrease swelling and inflammation.  

Calf stretching- Try to lightly stretch your calf by leaning against the wall with one foot in front of the other. This should be relatively pain free to avoid further irritation to your Achilles. If a tight calf is causing your pain and you do not stretch it, the tendonitis will likely just keep coming back!

Strengthening-

Eccentric exercises have been shown to help tendonitis symptoms heal quicker. Eccentric exercise means loading the calf muscle while lengthening it. To do so, do a calf raise on two feet and then slowly lower on the affected leg. Similar to stretching, this should be relatively pain free when performing to avoid re-aggravating it.  

Avoiding aggravating activities- Whether it be running, skipping, jumping, or uphill walking, resting from such aggravating activities will allow the Achilles to heal. Try modifying you exercise with non-impact activities such as biking, weight lifting, or the elliptical in the meantime. Slowly progress back to your normal activities.

Wearing a heel lift in your shoe- A heel lift can decrease the pressure on your Achilles and allow it to heal. This can be used as a short-term fix; try to avoid it for a long period of time as it can cause your calf muscle to tighten over time.

As mentioned, Achilles tendonitis can be quite a disabling condition. If you have pain in the back of your heel, contact your local physical therapist or other medical professional to ensure proper diagnosis and personalized treatment plan so that that you can quickly get back to your previous activity level.