If you're trying to storm the city of Troy or train for a marathon, problems with your Achilles heels can be a nightmare. Achilles tendon problems are one of the most common injuries that can occur in normal runners, regardless of whether you're new to the sport or a seasoned pavement.
Achilles tendinopathy is also one of the most misunderstood injuries a runner can suffer from the normal reaction – to rest completely – may be the exact opposite of what you need to do, as it only weakens your calf muscles and tendon problems will return sooner.
Before You Even Get It By this time, however, it is important to do everything possible to prevent the appearance of Achilles tendons. As with all running injuries, the main part of this prevention is to gradually increase the training load. This is especially important if you are a relatively new runner working through a training plan before a big event like the London Marathon.
For all the advice you need on tendon problems, including what to do instead of rest, if you have Achilles tendonitis, we talked to Seth O & # 39; Neill, a physiotherapy lecturer at the University of Leicester, who is currently researching Achilles problems. [1
O & Neill recommends that you immediately delete the term "tendonitis".
"We do not actually use the term medically – we call it tendinopathy Tendinopathy is just a generic term that says you have a problem with the tendon."
"We use this term in contrast to tendinitis, because Research shows that this is not a typical inflammation like twisting your ankle, it tends to get better with rest and other anti-inflammatory treatments. "
So, most people understand what type of injury they have?  "A tendon is an Achilles tendonitis that most people understand as an achilles tendon inflammation condition," says O'Neill. "It gets swollen and hot and it hurts. For most people it looks like an inflammation, but testing the chemicals and cells in it is not a typical inflammation.
"We should not call it inflammation n, as this influences the type of rehabilitation. They rest, put in ice cream and take anti-inflammatories and then wonder why it does not get better when they walk again.
What are the Achilles tendons that runners usually suffer from?
"This is predominantly a degenerative process. The true cause of Achilles tendonitis is an imbalance in the rate of wear and the rate of repair in the tendon – tissue is broken down over time. Eventually, there is a certain condition in which the tendon can not cope, and then we get pain.
What are the symptoms of achilles tendonitis?
One word stands out when it comes to Achilles tendon symptoms – pain.
"Most patients experience pain that affects either the mid-portion of the tendon or "It's the insertion piece, it's the piece where it's attached to your heel, the middle part is 2 to 6 inches above it."
"The pain tends to It often disappears before it is injured again, or it does not hurt to make a run and then flare up – it can hurt for hours – or the pain can come in the morning after a run . "
How do you handle it?
Unlike many other problems, Achilles tendonitis is key to staying active while you recover.
"Think of the muscles," says O & Neill. "A tendon is simply part of a muscle – how the muscles attach to the bone. When you rest your muscles, they waste. The last thing you want to do with a tendon that can not cope with the exercise is to completely rest it as it continues to degrade and waste.
"If you do not walk that hard enough, the symptoms will be even faster. The key is an active approach to your rehabilitation.
As part of this active rehabilitation, you need to strengthen your calf muscles.
"When it comes to Achilles, the calf muscles absorb the ability to shock and protect the tendon is the key," says O'Neill
"Weight training for the calf muscles improves their coordination and strength so that they protect the Achilles tendon while walking.
"For Normal Endurance Race Unlike sprinting, most people think it's about the thigh and butt muscles, but the key is the calf muscles, and the calf generates forces from the soleus – the deep muscle – eight times your body weight and out of the gastrocnemius – the superficial muscle – three times the weight of the body, they do most of the power for running. "
So ice and rest are out?
"You can use these things in the short term when they really flare up," says O Neill. If you can walk without limp, you should go for a jog – you just have to drastically reduce. And start making some heel raises to straighten and strengthen the calf muscles.
How do you prevent Achilles tendonitis?
Strong calf muscles and a close eye on your workload are the two most important factors, but that can be a difficult balance.
"The key is to make sure your calf muscles are beautiful and strong, but the challenge you have as a runner is to incorporate this into your exercise regimen," says O & Neill.
"Adding strength training to a normal load can cause overloading that affects the tendon and causes a problem. They need to balance the strain on the tendon, including exercise in the gym and running. "
Days of rest are crucial, as weekly training does not build up too quickly.
Of the major risk factors, there is no possibility of having two days break per week. Less than this is associated with Achilles tendon problems. Nevertheless, there are runners who train every day. As long as it gradually builds up to this level, you'll be able to cope – tendon and muscle will adapt and become more robust. "
O & Neill recommends calculating the workload over the past four weeks and comparing it to the workload in the current week. There should be no big jump from the average to the current workload.
"If your average workout load is 12 miles," says O'Neill, "you should see a 13 or 14-mile increase this week, and if you've suddenly increased it to 18 or 20 miles, it can degrade the tissue because it's not tough enough to handle. "
Are there any exercises and stretches that are particularly effective at strengthening your calf muscles?
The calf can It's a tough area for power work but a variety of calf raises should be sufficient to hit both the deep and superficial muscles, and choose your calf elevation based on where the pain is.
"When the mid-range pain – in In the middle of the tendon – raising the heel over one step is good because it takes up the entire area of the muscle, "says O & Neill.
" When it comes to insertion [ Where it attaches to your heel]increasing the heel on a flat surface would initially be better. Add increments over a step later.
Other exercises that you can try are bent-knee heel lifts that are surprisingly hard, or seated heel lifts where you have a weight on your leg. You can also use a Leg Press Machine with the heels over the end to target your calf muscles. Do not forget the rehab time – it takes time to increase the strength in the calf muscles.
"Build up to lift 50% of your body weight, which is equivalent to a backpack on your back while lifting your calves," says O & # 39; Neill "That's the long-term goal – it'll take six to eight weeks to do that."
How much difference can running style or shoes make?
Theoretically, heel strikeers are less susceptible to Achilles tendons. They burden the area less than metatarsal or forefoot strikers. However, since your body is usually used to your running style, O'Neill does not recommend fighting the tendon problems.
"The trigger for most runners is always an increase in training load," says O & Neill. "That's the reason for the tendon collapse and the symptoms. In this case, it is best to correct the training load.
"I would not normally change people's running style, as this is difficult and you can get better results if you target calf strength."
However, if you want to change your running style – for example, if you are barefoot Trend – you need to make the change step by step.
"If someone has changed his running pattern, as if he has walked away. Normal footwear barefoot, then they tend to move towards the forefoot. If they do this step by step over a period of time, this is not a problem, but if the change is fast, the strain on the tendon and calf will be increased, and that will ruin it.
The potential for tendon problems should also be Considered when choosing a new pair of coaches. The offset in the sole – how much higher the heel is compared to the toes – is the key value.
"Many of the new trainers have switched from a 10mm heel drop to 6mm or a flat sole." O & # 39; Neill.
"A flat shoe increases the movement that the ankle undergoes during a stride, potentially adding more strain to the Achilles tendons. So, suddenly changing your shoe to a lower level can increase the Achilles tendon load.
"Using a heel or using a heel insert that raises the heel can reduce the weight on the Achilles tendon. We sometimes use this for humans when the tendon flares up. "