Achilles Tendon Injuries: Know the Warning Signs
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
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 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.
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”.
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