Achilles Tendinitis and Compartment Syndrome

As runners and triathletes we put a high level of demand on our bodies, whilst expecting them to keep functioning at a consistent level.

When we pick up an injury we often train through it in the hope that it will go away, but sadly this is never the answer.

Injuries such as ligament damage can take several months to heal, and being on your feet all day means the body doesn't get the time to repair itself. Continuous training on an injury – even if it is only a niggle or slight stiffness that comes and goes – will only continue to exacerbate the problem and cause further damage. This can result in a vicious circle.

I have experience of this recurring injury myself. My Achilles problem has been going on for two years. I am only too familiar with the cycle of increasing your training post-injury and managing to reach your previous level of fitness, then finding the old Achilles pain returns and you need to rest it again. This cycle causes frustration, stops your training and prevents you from being able to better your performance. I realised that unless I broke this cycle and stopped returning to training too soon after injury, the pain would reoccur within six months and I would inevitably be forced to stop and rest it again.

The Achilles is the largest tendon connecting the two major calf muscles. When the calf muscle becomes tight the Achilles is forced to work hard. Over a period of time, if not treated correctly, scar tissue can form, which limits the flexibility and blood flow to the tendon, hence preventing the ligament from repairing. It is therefore important not to run with the injury as it will only reoccur or worsen.

Treatment is vital, ideally within the first week of acquiring the injury. It is important to have a minimum of four sessions with a physiotherapist in order to break down any scar tissue. This will speed up the healing process.

There are a number of contributing factors that can cause persistent or frequently recurring injury. Day to day stress and worries that we all encounter throughout our lives is one such factor, as stress causes the muscles to tense, not giving them a chance to relax. Lack of flexibility is another factor that can contribute to injury. 

Poor choice of footwear is also a major factor. I am not just referring to the shoes we run in but also the shoes we spend most of our time in. When the foot is not being held securely in a shoe with no arch support it can develop a flat arch, which causes the Achilles to be bowed. This means the runner's entire body weight is being directed into the Achilles at an angle, which can lead to a possible rupture or tear.

Alternating between different shoe profiles, for example a pump shoe and a trainer, can alter the length of the Achilles. It is always best to keep footwear consistent if you can.  Both as adults and as children our bodies are constantly changing and our feet are altered by what footwear we use. If we gain or lose weight then areas of the body are being altered, and during this process we can pick up injuries. Our feet are what take all of our weight. In order to support the body properly, it is important that we see shoes not just as a fashionable item, but also as an important tool for our bodies to function correctly.

Muscles tend to swell during strenuous exercise. When you are injured the body will adapt to protect the injured area, overloading another muscle too.


Aiding your recovery

  • It's important for every runner to incorporate a minimum of three strength and conditioning training sessions a week into their programme, which includes flexibility training. Having a strong core will keep an upright posture and less strain going to areas of the body, strengthening all muscle groups so that you do not get a weaker muscle.
  • Magnesium will help with the muscle repair process. It is crucial for energy production and muscle function, making it of critical importance for physical performance. A lack of magnesium results in reduced performance, lactic acid build up and muscle cramping. Over time this causes the muscles to be inflexible and ligaments to be pulled under strain. For the best absorption use a spray or liquid form. It's best to direct the magnesium to the injured area. I personally get the most effective result by applying the spray directly to the injury.
  • Heel pads may be worn. These lessen the strain on the Achilles. However, it is important to stop wearing them when the injury has healed, as they will weaken the ligaments by encouraging the body to rely on them. Once healed, start removing the heel pads gradually.
  • I would strongly recommend exercising a lot of caution when returning to your training. Before you start to run I would spend a week on a cross trainer so that the body adjusts back into training, this needs to be on a low resistance level and at a steady pace. If you feel at the end of a week there are no ill effects on the body, running could be re-introduced. I would start off by alternating between walking and running for two minutes. Only begin to build on this if you do not experience any pain. This will allow the body to gradually build strength back into the muscles. It is better to add another day of running each week and keep to the same distance, until you reach six days and you are certain that the body has no pain. When you increase your mileage this needs to be a 5% increase your training, only by time rather than distance. For example, if you can run for 20 minutes for the first week without any effects then the next week try 25 minutes. After the first 10 minutes I would stretch. Hold the stretch for thirty seconds in order to warm the muscle.
  • Avoid any weight training for the legs, both during injury and during the process of returning to running, as you will only put more stress on the muscles. Weight training shortens the muscles and they become tighter.

It's important to replace your trainers after a six to eight month period. I personally would avoid keeping shoes for a year as there is a high risk of picking up an injury. Ensure that you get your gait reassessed each time you replace your running shoes, as the shoes are constantly upgraded which often alters the support in some form. Anyone who wears orthotics should also have them assessed every year, as the body will always change with time. Visit one of our stores for a free personal shoe fitting.

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