935Heel Start

Heel Start

MR9 71It did for the Greek warrior who took on the Trojans and will put the skids under your running if you injure it, so look after your Achilles tendon.

words: Stuart Mailer

What is the Achilles?

At around 15cm, the Achilles is the largest tendon in the body, even if you’re Ron Jeremy. Composed of collagen, it originates at the muscle-tendon junction of the two calf muscles called the gastrocnemius and soleus and extends to the base of the heel bone.

Why do runners get Achilles problems?

When you run, your leg moves from heel strike to mid-stance (the middle phase of the running cycle, where your weight is fully on the ground). During this time, the Achilles tendon stretches, and stores energy, known as elastic energy. This energy is then released as the Achilles contracts again, at toe-off, and it helps propel the body forwards, reducing the work of the calf muscles. This creates a large amount of stress on the Achilles tendon, which can lead to injury.

What are common Achilles injuries?

Achilles tendinopathy and bursitis both cause Achilles pain. Achilles tendinopathy is more commonly known as Achilles tendonitis, but despite its name, it isn’t an inflammatory condition, but the breakdown and degeneration of a tendon. Bursitis, however, is an inflammation - in this instance of the small fluid sac that reduces friction between the moving structures at the Achilles.

What contributes to Achilles problems?

Muscle weakness, poor flexibility, poor footwear or stiff ankle joints can all lead to Achilles problems. Strengthening and maintaining good flexibility of the calf muscles allows the tendon to use its elastic energy more efficiently. Footwear with adequate shock absorption can also reduce stress on the Achilles. So running in stilettos is definitely out.

If I run long distances or increase my running speed, am I at greater risk?

Increased mileage puts prolonged stress on the Achilles, so can cause overuse injuries. You average 70-90 strides per minute, so if you’re running for 30 minutes that’s between 2,100 and 2,700 strides. However, fast running increases the force on the Achilles so can cause pain. It’s not so much the run that creates the problem, but the effect it has on areas of weakness or tightness in your body.

What should I do if I get a problem with my Achilles?

The first thing to do is modify your running. According to research in Clinical Sports Medicine by Peter Brukner and Karim Khan, an eccentric loading programme (exercise that focuses on lengthening the muscles) has been shown to improve tendon repair.

Are there any stretches that will help?

It’s important to maintain good flexibility and strength. Stretch by keeping your heel and foot flat on the floor and bending your knee forward. Standing with your toe on the edge of a step and allowing your heel to drop towards the floor will also stretch the Achilles and calf muscles.

How long does it take for Achilles problems to resolve?

Achilles tendinopathy probably takes the longest time to heel - between three and six months.

Do you have any other advice for dealing with Achilles pain?

Reduce your activity levels and see your physiotherapist for an appropriate treatment, rehabilitation and management plan. Try to avoid jumping or hopping as that may make the pain worse. You may be able to continue running, at a gentle jogging pace, as long as it’s not painful.


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