Achilles Tendon Injuries: Know the Warning Signs

Sep 17, 2013   //   by Leigh Boyle   //   Achilles Tendinopathy, Injury & Rehab Information  //  14 Comments  //  Affiliate Disclosure  

One of the most frustrating things about of many of the Achilles Tendon overuse injuries I see, such as Achilles Tendinopathy, is that the majority of them seem to “come out of nowhere”.

There’s no acute injury that we can point to and say this is what happened. There’s no dramatic pop or tearing sensation. There’s just a gradual onset of pain and stiffness that worsens over time. Sometimes, the symptoms start well after a workout while we’re sitting at home on the couch or driving home from the track.

Sounds frustrating, right? Wrong! There are actually warning signs along the way. We’re all just programmed to see them as the normal aches and pains of training and ignore them.

Achilles Tendon & Calf Anatomy

Achilles Tendon Anatomy
Achilles Tendon and Calf Anatomy

The big thing to remember about the Achilles tendon (and the calf in general for that matter) is that there are two muscles that share the tendon. Most athletes are familiar with the larger Gastroc muscle because we can all see it. The smaller Soleus muscle however gets forgotten more often than not. The Posterior Tibialis which is located under both of them on the inside of the lower leg is even easier to forget.

My main point in bringing up the anatomy is that the lower leg is a busy place. You have a good mix of large and small muscles and imbalances in just one of those can cause all kinds of problems.

What do Achilles Tendon problems look like in the early stages?

Stiff and Tight Muscles

Have you ever gotten out of bed in the morning and felt like your feet and ankles don’t move at all for the first few steps? It’s like having blocks for feet?

Your steps are loud and you have this short little stride instead of a normal step. The first time down the stairs might be tricky or result in you having to turn your feet sideways a bit. It loosens up once we’re up and about which is why we tend to overlook it, but the truth is that this is a warning sign.

When we sleep, most of us have our ankles pointed down for 6-8 hours at a time. This allows the calf to tighten up. Normally, it’s not enough to cause “block feet” in the mornings but if you already have a good amount of tightness in those muscles, it can be just enough to make that a problem.

New Calluses

New blister and callus patterns are a great warning sign that your foot is working harder than it should be. This is typically common under the big toe or along the outer ridge of the foot.

An easy way to look at it is this. When the foot makes contact, it “rolls” to absorb impact and transfer it from the outer part of the foot over to the big toe to prepare for push off/propulsion. This allows the ankle and calf to do the heavy lifting. If you’re getting new blisters in the same spots or calluses, then something is off and that foot is “rolling” more/less than it should.

Scuffing Your Toes or Clipping the Inside of Your Ankle

These are both warning signs that things are off in the lower leg/foot. Scuffing your toes or tripping over that “invisible speed bump” is a sign that your push off isn’t working. In a nice, strong push off the toes are cleared as the leg swings up. Its a relaxed motion that requires zero energy on our part. When we don’t have that, we have have to pull our toes and ankles up so we don’t fall over them.

The muscles along the front of the shin that do that unfortunately aren’t not designed to maintain that function and eventually will start to fail. When they do, the scuffing starts.

Likewise, if you find yourself clipping the insides of your ankles with your shoe, that’s a warning sign. When the leg swings through after that push off, it swings through nice and straight. If you’re catching the inside of your leg/ankle, again something is out of balance.

Pay Attention!

The great thing about warning signs is just that! They warn us that we need to start paying attention. If you find yourself  experiencing any of the signs above, here are a few tips to start loosening up those calves and ankles.

  • The easiest and cheapest way to go after muscles is always to break out the foam roller. Here are some tips to walk you through a session with the roller using three techniques.
  • Typically I start off with 2-3 minutes with the foam roller. The goal here isn’t to beat my calves up. It’s to get some slack in there and find where the “problem spots” are (aka where it hurts the most). Once I’ve narrowed it down to those, then I like to dig a little deeper with a tennis ball using the cross friction/trigger point techniques. Both of these are described in the link above.
  • From there I like to use mobilizations to free up the ankle itself, and then further mobilizing techniques to get in and work the calves and the achilles tendon itself.
  • Lastly, I always follow it up with stretching. Frequency trumps everything with these. Aim to get in 1-2 reps every few hours versus one killer stretch session at the end of the day. Here’s a video to walk you through the stretch routine.

Try This Routine

Here’s a quick five minute routine using the links and information info above…

N.B. Each has video demonstrations and plenty of pictures to show you where and how to use all of the techniques:

  • 2 minutes with the foam roller.
  • 30 seconds cross friction with the tennis ball at the muscle/tendon junction.
  • Ankle mobs with resistance band. 10 reps nice and easy.
  • Calf mobs with the tennis ball right at the muscle tendon junction. 10 reps nice and easy.
  • Stretches: 2 x 20 seconds for the Gastroc and Soleus. Use whatever level (beginner, intermediate, advanced) gives you that “stretch sensation”.

About The Author

My name is Leigh Boyle and I am a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS). For the past 10 years, I was the co-owner of a private physical therapy practice in Southern New Hampshire. I am currently living and working out of Austin, Texas and enjoying a much needed break from the snow and cold. Professionally, I’ve treated injuries ranging from mild ankle sprains to advanced surgical reconstructions and most everything in between. I am certified in the Graston Technique and Active Release Therapy (ART), both of which are soft tissue mobilization techniques. I am also certified in functional taping applications and functional strenghtening. I’ve coached triathlon, cycling, and running teams on injury prevention and helped them develop off-season programs to focus on core strength and self body maintenance.

 

Facebook Comments

14 Comments

  • Awesome article Leigh!! Your new ebook is fantastic, been a longtime follower of your blog posts. Love that you have teamed up with James to share this info about how to pay attention to the warning signs! Thanks.

  • I had a sore achilles in May 2012 but ran through it, in June 2012 my leg started to feel funny whilst running and has never returned to ‘normal’ and I have therefore not run since August 2012.
    Some of the symptoms are clipping inside of other ankle, catching toes and not feeling like I push off properly.
    My foot on affected side is also very stiff after sleeping or prolonged periods of sitting.
    This all sounds like what you describe above, how can I be sure it’s my achilles?
    Thanks.

    • Paul- what you’re describing sounds like several things. It may have started as calf/achilles, but more and more of the leg will be affected as the body tries to compensate. Have you ever had anyone really dig out (massage) your whole leg? Hip down to the foot kind of thing. It won’t be pleasant, but it will be a big start towards getting that leg to loosen up. First step towards running is getting to the point where that leg is 100% symptom free with your daily stuff (sitting, standing, sleeping, etc).

      • Thanks for your reply.
        Before this all happened, I used to have weekly or bi-weekly massages, which hurt a bit.
        I was running well for 2 years with these massages but once this problem kicked in, the guy was unable to treat it so I haven’t been for a year now.
        I will go again if you suggest that it would help.
        I haven’t run for 15 months so I’m pretty desperate.

  • […] Calf tightness unfortunately also increases your risk of other more serious injuries, this blog here by James Dunne from the UK expalins why this tightness may lead to achilles tendonitis […]

  • I have a thickening of my Achilles about an inch above my ankle. The thickened area is about 2 inches long and is twice as thick as normal. It has been that way for over a year. I play tennis 2-3 times a week. What’s going on here?

  • Hi I am reading this article-warning signs for Achilles problems. I have been experiencing the clipping of my ankle. Probably more the left ankle. What I have been noticing is on the top of my feet sometimes feel almost numb like and on the sides. There is also a tightness sensation. At times have felt it up along the outside of my calf on the left side. Not sure if this is tight muscles along the whole leg or maybe a nerve problem???? Thanks

  • Just to let you know I thought your article was great and really useful, tweeted it today and it already has been retweeted 29 times. Popular stuff!

  • Hi i was out running and got a sharp stabbing pain below my calf muscle forcing me to stop! possible tear of soleus muscle. does this sound right and how long til safe to run again

  • Great post…I am having problems and thei helps greatly!

  • Great article and I have recognised 2 symptoms – I recently fell tripping over the invisible speed bump! And get block feet in the morning as well as tender Achilles post runs. Time to wise up and follow your suggestions. As a Vet runner staying injury free is high on the priority list. Thank you.

  • […] Achilles Tendon injuries: Know the warning signs and don’t ignore them. […]

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