Achilles Injuries and Achilles Tendinosis

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Achilles tendon

The Achilles Tendon

In June 2009 Usain Bolt, the World’s fastest man over 100m and 200m,  suffered from an Achilles injury and was advised to take at least 3 weeks complete rest. It meant that he missed the 2009 Adidas Grand Prix.

Usain was advised by Dr. Hans Muller-Wohlfahrt to take a rest to avoid any further injury. He is received the best care possible and his coach predicted that a full recovery would take around 4 weeks.

This just goes to show that even the best runners in the world can be afflicted with these injuries.

What Is are Achilles Injuries?

An Achilles injury is when the Achilles tendon either becomes tight or ruptured. The Achilles tendon connects the calf muscles to the heel bone to allow the up and down movement of the foot. It is put under a lot of stress by sprinters and other athletes as the entire bodyweight is applied to each individual tendon repeatedly. It is the strongest tendon in the body but is also put under the most pressure. When the calf muscles are contracted the Achilles is pulled, which pushes the toes downward. This is required for walking, running etc.


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Injuries can occur any time but are more common in athletes and when people are middle-aged. Overuse and a sudden increase in use is the most common cause of injury. Obviously for professional athletes the Achilles is put under strain all the time. Not warming up properly before exercise is possibly the biggest risk for fit athletes.

Achilles Tendinosis

Achilles Tendinosis is when the Achilles is tight and sore. It affects movement, often resulting in reduce extension of the food and discomfort when running. In most people that suffer acute tendinosis walking is not a problem. However, tendinosis will generally persist until it is treated, it is not a problem that just goes away, although some doctors seem to think it is (I was told by my doctor that it will clear up in time, but it could take anywhere from several months to years before it gets better!).

Achilles Tendon Ruptures

This is a far more serious injury and comes on very suddenly, it is the equivalent of a break. The Achilles becomes torn, either partially or completely. A popping sound is often heard when the rupture occurs. It generally affects older people, athletes included, who have not been training so much.

Treatment for Achilles Injuries

The best treatments for an Achilles injury are:

  • Total rest, i.e. no exercise that applies pressure to the Achilles. You can still work your upper body and swimming should be possible in mild cases.
  • Muscle conditioning – increasing the strength of the calf muscles helps to strengthen the Achilles and heal the Achilles.
  • Ice – putting your foot (Achilles) on ice while elevated is a common treatment for Achilles injuries.
  • If the Achilles is ruptured then complete immobilisation is required.
  • Reducing the movement of the foot when walking with heel padding helps.

How to Prevent Achilles Injuries

The best ways to prevent injury are to strengthen the calf muscles and to warm up and stretch thoroughly before any intensive exercise. Calf raises are the best way to strengthen the calves. When performing calf raises it is important to do them slowly, especially as you lower yourself. The Achilles are strengthened most in the eccentric phase of the movement (i.e. lowering). If done too quickly you do not strengthen them.

Staying fit and not being overweight are the most important preventative measures. Most problems occur in people that have not exercised properly for a while causing the tendon to become tighter which then cannot cope with the unexpected stresses of sudden movements.


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Exercising on softer surfaces is important, or doing more low impact exercise. Cycling, cross training, swimming and running on grass are all recommended. Road running is not good due to the additional impact. If you do run on roads and pavements it is wise to invest in some specialist running shoes.

If you have not exercised for a long time then build up your fitness levels slowly. Throwing yourself into an intensive exercise regime is likely to lead to injury. Take it slow and listen to your body. The person that said “no pain no gain” should be put on trail for causing thousands on unnecessary fitness injuries!

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