Injury Archives: Inflamed Achilles
With the normal stress of running, small micro-tears occur in the
tissue of the Achilles tendon. Normally they heal quickly. However,
if there is too much stress and too little rest, they won't heal,
will collect in an area and produce inflammation.
Diagnosis. Inflammation is usually at the narrowest part
of the tendon, at the paratenon sheath. The fluid between the tendon
and the sheath expands. There is often a cracking noise when moving
the tendon, and it may be sore. (This is rare.)
Treatment: Ice massage for 10 minutes at least twice a day.
Use a heel lift felt, cork, etc. (a Spenco is too soft) in both
running and street shoes to reduce tension on the tendon. Take
aspirin (with meals or with milk) if okay with your stomach and
your doctor. Be regular with it for a week or so to tell if it's
effective. It reduces swelling. Consult with doctor about length
Achilles Tear: When the tendon is already weakened, it can
be partially torn by the additional stress of speedwork, hill running
or simply stepping in a hole. A complete tear is a more serious
and painful injury. This often requires surgery, but fortunately
tendon tears occur in only about two percent of Achilles injuries.
Diagnosis: If you can't rise up on your toes while standing,
you may have a tear. There is a lump in the lower calf area and
a gap where the tendon is torn. You can feel this through the skin.
If you suspect a tear, try to find a specialist who has a good deal
of experience with Achilles problems.
Treatment. Ice massage and use heel lift as for inflamed
Achilles (above). Don't run for at least 4-6 weeks (or length of
time prescribed by doctor) to let swelling subside and healing process
begin. If you stop at an early stage, your "vacation" may be only
a few weeks, but if you push the tendon too far in this state you
may be out for months. Consult with your doctor. When starting back,
run every other day for another 4-6 weeks or until things feel
better and normal functioning has returned.
NOTE: Beware of injections of cortisone or other steroids, for
they may weaken and/or dissolve the tendon. Get several opinions
before getting such a shot; it could set you back months, years
From Galloway's Book on Running by Jeff Galloway (Shelter Publications,
1984) pp. 216-218
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