I am more frightened of Achilles tendon injuries than any other type. For good reason. In my early fifties I suffered through a three-year period when calf and especially Achilles strains regularly thwarted my running.
I never knew when the next pull would occur. Some struck in the middle of hard races, but most came during typical easy-day runs. I’ve never been so exasperated at any other time in my long running career.
I visited a series of medical professionals, from chiropractors to physical therapists. All could see the problem. My right Achilles tendon was red, swollen, and painful to the touch. It even made a creaking sound—honest, it’s called crepitus—caused by friction rubbing within the tendon sheath.
I tried various treatments, some of which helped for a week or two. Then my leg would seize up again, unexpectedly, on a slow, conservative run. After several years my podiatrist said he was 90 percent certain I would need surgery if I wished to continue running.
I did, but I was 99 percent sure I didn’t want surgery. I kept trying various self-help techniques for Achilles tendinitis. I also endured extended periods of little to no running.
Eventually something clicked. I wish I could tell you exactly what it was. But the truth is, I don’t know. I know only that the tendinitis subsided, and I’ve since enjoyed two decades of healthy running with no Achilles complaints. I learned what I’ve been telling other runners ever since: Most injuries resolve themselves at some point, just not as soon as we would like. Be patient.
An important Achilles tendon note for runners: In 2016 the FDA issued a Drug Safety Communication concerning the link between tendinitis, especially Achilles tendinitis, and a class of antibiotics known as fluoroquinolones. At least one widely prescribed antibiotic, Cipro, belongs to the fluoroquinolones. If you are prescribed Cipro (full name ciprofloxacin) by your doctor, make sure he or she knows you are a runner. Ask if you can be put on a different antibiotic.
Stop running: The sooner you stop running after noticing unusual Achilles pain, the faster you are likely to heal. Achilles injuries get worse when you continue to run on them. Hilly courses and speed work are especially troublesome.
Instead, rest and ice the afflicted area, and take an NSAID for no longer than seven to ten days. Put a heel pad in your shoe so the Achilles won’t be stretched by your normal walking and other activities. Don’t begin stretching and strengthening exercises while your Achilles is in the acute injury phase. Wait until you feel that some healing has taken place.
Take the sleep cure: I said above that I’m not sure what led to the reversal of my Achilles tendon injury. That’s true. But I believe one of the contributing treatments was sleeping in an ankle/Achilles brace. This device kept my calf and Achilles in a slightly stretched position for eight hours every night to facilitate healing. A number of inexpensive braces and socks are designed to do this. They can’t hurt, and I think one of them helped me get back on the road to recovery.
Try specific stretches and strength routines: The strain on your Achilles tendon can be lessened by flexible calf muscles. The simplest, safest calf exercise is the wall stretch. Stand two feet away from a wall, put your hands on the wall, and lean forward, keeping your legs straight and your heels anchored on the floor. You’ll feel the stretch from your ankles to the backs of your knees.
When you’re comfortable with this stretch, you can move to a more aggressive position and perform the bent-knee wall stretch. It’s the same as the above, except you put one foot in front of the other, about halfway to the wall. When you incline forward, bend the front knee, but keep the back knee straight. You’ll feel an increased stretch in the lower part of the back leg.
Many runners with Achilles tendinitis have gotten good results from heel drops and raises. These are usually performed on a stairway. Put the front of your afflicted foot on the tread, with the heel extending beyond the edge of the step. Keep the other foot on the tread for balance and support only.
Let the injured heel drop slowly, then raise it up beyond its starting position. Repeat the dropping and raising rotation, being sure to go slow and maintain control of your movements. Start with just three or four drops and raises. Increase only if you experience no pain.