Achilles Tendon Pain in Runners

Are you a serious runner planning to take on the Kansas City Marathon this year? Or maybe you just run on occasion to relax, or are trying to get back in shape for the Thanksgiving Day Turkey Trot?  With the Kansas City Marathon less than three weeks away, many runners are finishing up their training programs or perhaps trying to get in a few extra last-minute miles to help make up for some days of missed workouts along the way.  Whether it’s from many months of hard training or more recent rapid increase in activity that you aren’t accustomed to, many runners will be sidelined this year by a commonly found running condition known as Achilles tendinopathy.  Achilles tendinopathy is a term referring to a larger category of conditions such as Achilles tendinitis, Achilles tendinosis, or non-insertional Achilles tendinosis.  One thing these disorders all have in common is that they can be characterized by inflammation and degeneration of the Achilles tendon, leading to severe pain in the back of the heel.

 Achilles tendon

Most frequently found in runners, non-insertional Achilles tendinosis leads to damage in the area 2-6 cm from the tendon’s insertion in the heel bone, better known as the “watershed zone.”  This got its name from it being a naturally occurring area of diminished blood supply, therefore making healing time longer and often more difficult.  Achilles tendinosis in runners is commonly a result of several factors; including hereditary foot instability, misalignment, and excessive foot flexibility or laxity.  Other causes can be found with improper running technique, worn out or inappropriate running shoes, stressful running environments such as concrete, hill intervals and most importantly, attempting to increase running mileage too quickly without the necessary training required.  Due to the high impact nature of running, the Achilles tendon can be forced to handle forces 10-12 times your total body weight just to keep up with the rest of the body.  This really adds up over time, and can eventually lead to chronic Achilles tendon degeneration, thickening, and inflammation.

How common is this condition?  Several studies have reported on the lifetime incidence of Achilles tendinopathy in competitive runners, and the numbers are surprisingly high, ranging from 40-50%.  Furthermore, this condition can account for 6-17% of all injuries in recreational runners.  The risk of complications increases with age and in males… sorry guys.  Over time, chronic degeneration of the tendon fibers can also make runners more susceptible to Achilles tendon ruptures, which often need surgical repair and can require months to upwards of a year for rehabilitation time.

This condition will usually present as pain, swelling or thickening of the back of the heel that is worse at the beginning of a workout and post-exercise.  It often responds well to conservative therapy such as stretching, icing, anti-inflammatory medication, heel lifts, custom orthotics, physical therapy or a period of immobilization.  At Kansas City Foot and Ankle, we have a wide variety of the latest technology and treatment protocols to help keep you out of the operating room, often even in the most challenging of cases.  Technology that professional athletes rely on, such as musculoskeletal laser therapy and extracorporeal shockwave therapy (ESWT) and also advanced healing treatments such as Amniofix regenerative matrix and platelet rich-plasma (PRP) injections can rapidly accelerate the healing process.  But in circumstances where surgery cannot be avoided, we have a team of skilled surgeons to guide you through the process and get you back on your feet as fast as possible.

So, if you think you may be suffering from Achilles tendon pain, a similar type condition, or you just want to make sure that you’re race day ready, give our office a call today at 816-943-1111 and we will get you back up and running!