In Greek mythology, Achilles was a mighty warrior
who said to be indestructible. You see, as a child heíd been picked by the
gods to be a great warrior and theyíd protected him by dipping him in a river
and this ceremonial dipping was said to have left him impenetrable to his
enemiesí weapons. As the story goes, Achilles was eventually brought down by
an arrow that pierced his heel and later lead to his death. Apparently when the
gods had dipped him in the river, they held onto his heel and that was the only
part of his body that was not protected by the water. From the tale we get the
term ďAchilles HeelĒ which refers to a personís weak spot. Itís also the
name of the large tendon on the back of the calf that joins the calf muscles to,
you guessed it, the heel. Achilles tendonitis is probably more common in other
sports such as basketball but it does affect runners. Itís another easy
condition to treat if caught early and itís usually caused by a runner
neglecting to do both of the calf stretches discussed below.
The Achilles tendon is an enormous tendon that
joins the calf muscles (Gastrocnemius and Soleus) to the heel allow us to stand
on our toes, jump, push off during running etc. The gastrocnemius is the outer
calf muscle and itís the one thatís visible when we stand on our toes. The
soleus is a deeper, postural muscle. The gastrocnemius crosses over the knee
joint a bit so itís stretched when the knee is straight and the soleus
doesnít cross the knee joint so itís stretched with the knee bent. Also
of note, if you are doing weights to strengthen your calves, calf raises with
the knee straight (standing calf raises) will work the gastrocnemius while calf
raises with the knee bent (seated calf raises) will target the soleus.
- Pain in the lower part
of the calf muscle on the back of the lower leg.
- Pain may also be located
on the back of the heel, where the tendon attaches. This area is often
- Pain is often aggravated
by running, especially the first few minutes of running or after climbing
- More prevalent in women
who wear high heels, because the calf is chronically shortened.
In fact, high heels (or even shoes/boots with 1 inch heel) will often
be relieving or may eliminate the pain completely by decreasing the pull of
the tendon on the heel.
- Often associated with
old shoes or running in Ďcross-trainersí.
For one reason or another, the calf muscles
have shortened to some degree and this causes tension in the Achilles tendon and
it reacts by getting inflamed. This will often be the result of spending too
much time in shoes with high heels (even a 1 inch heel). Wearing heels allows
the calf muscles to relax and over time the tendon will begin to shorten. Some
women who wear heels exclusively will not be able to walk barefoot because their
tendons have become chronically short. But most runners get problems because
they forget to stretch the soleus muscle. They stretch the gastrocnemius
but not the soleus. This causes things to shorten slowly and thatís why
tendonitis develops. It will often develop after running up hills because as we
run up hills the calves are being stretched and this will aggravate tight
calves. This is similar to the person who tries to run for any extended period
of time in cross-trainers. They just arenít made for distance running. They
donít have the same shape to the classic running shoe. If you look at a
running shoe, youíll notice that it has quite a high heel compared to the toe.
It looks like its built on a wedge. This eases the stress on the achilles. Cross
trainers are much flatter on the ground and therefore not suitable for running.
If your running shoe is too old and worn out the heel may have lost some or all
of itís shock absorption properties and this can lead to Achilles problems as
well. When in doubt, replace your worn out shoes. Often thatís all the
treatment required. Achilles Tendinitis may also be due to some faulty foot
mechanics. This is often beyond the scope of self-treatment and requires a
professional to address gait, foot biomechanics, etc.
To Do About It
Unless you have
faulty foot mechanics you may be able to treat Achilles tendonitis on your own,
providing you have caught it before it became chronic. If youíve been
neglecting to do both calf stretches thatís the best place to start. Here are
a few other things to try:
Use ice when very sore, especially after activity
Soak with the Epsom salts. This is the single best thing-apart from
stretching-that you can do. Ideally soak halfway or more up your calf. After
soaking, stretch your calves. Alternately, if you donít have a bucket, you can
soak a face cloth in a pot of hot water and Epsom salts, wring it out a bit,
place it over the Achilles and heel, wrap in saran wrap to keep in the heat and
then wrap that with a tensor bandage and leave it for 20-45 minutes.
Reduce or stop running (especially hills) until pain has disappeared.
Maintain fitness with water running or any other activity that does not increase
Stretch the gastrocnemius and soleus muscles
Adding a heel (up to ľ inch) temporarily will help, as will wearing
heels but remember this is only temporary and if you rely on some sort of heel
lift you may end up shortening the Achilles even more.
Change old shoes.
Have your foot checked for
faulty foot mechanics if youíre not improving with the above suggestions.