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February 29, 2020

Ask the Practitioner - Achilles Tendonitis Featured

Written by Dena Evans


In March, we examine another common concern for many runners.  Dr. Adam Tenforde returns to discuss a problem that can trip up runners like himself (28:23 for 10,000m), as well as recreational runners alike.

FNF:  What is Achilles tendonitis?

AT: Achilles tendonitis describes a condition involving the tendon that connects the calf muscles (gastrocnemius and soleus) to the calcaneous (heel bone).  The condition can either result from an acute stress (such as increase in training) or develop over time from chronic stressors, such as biomechanical factors or poor footwear.


FNF: What are the signs that you might have Achilles tendonitis?

AT: The most classic sign is pain in the Achilles tendon, particularly around the heel or just a bit above the heel.  As with most tendon injuries, it might feel worse when starting to exercise and may improve as people gradually warm up. You may have some swelling or crepitus (a sensation caused by inflammation around the tendon like there is a balloon or a small pocket of fluid on the tendon). As it moves toward being a chronic disease of the tendon, the tendon may become thicker as it attempts to repair itself.  This poor healing process may also become a new source of pain as the tendon isn’t able work as well in its compromised state.

FNF: What are some things we can do to alleviate the symptoms and prevent them?

AT: The main thing is to recognize the symptoms. There could be a number of different factors that contribute to developing achilles tendonitis including factors related to training, including: volume, running surfaces, change in intensity, and other factors that include change in footwear or shoes that haven't been replaced recently.

Early on, rest and ice are important to address the inflammation. A trial of anti-inflammation medication (under the care of a physician) may also be tried with monitoring for improvement in the symptoms.  If it has been an ongoing issue, seeing a doctor and getting set up with an appropriate set of physical therapy exercises to improve the strength and flexibility of the tendon and surrounding muscles.  Calf muscle (gastrocnemius and soleus) soreness and tightness can also be a factor, so it is important to keep those muscles loose.

Last modified on May 12, 2020
Dena Evans

Dena Evans

Dena Evans joined runcoach in July, 2008 and has a wide range of experience working with athletes of all stripes- from youth to veteran division competitors, novice to international caliber athletes.

From 1999-2005, she served on the Stanford Track & Field/ Cross Country staff. Dena earned NCAA Women’s Cross Country Coach of the Year honors in 2003 as Stanford won the NCAA Division I Championship. She was named Pac-10 Cross Country Coach of the Year in 2003-04, and West Regional Coach of the Year in 2004.

From 2006-08, she worked with the Bay Area Women’s Sports Initiative, helping to expand the after school fitness programs for elementary school aged girls to Mountain View, East Menlo Park, and Redwood City. She has also served both the Stanford Center on Ethics and the Stanford Center on the Legal Profession as a program coordinator.

Dena graduated from Stanford in 1996.

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