Achilles tendon pain is one of the common injuries encountered by runners, and improper treatment often results in prolonged and persistent pain. Today, Wise Running is your one-stop solution for Achilles tendon pain. Overview – thick and strong is not a problem? The Achilles tendon is located in the lower part of the calf, with an average length of 15cm, and is the largest and thickest tendon in the human body. It is the largest and strongest tendon in the human body. The cushioning of the ankle and the ground-picking action during running are all dependent on this powerful tendon. Runners are the most susceptible to this pathology, and studies have shown that the incidence of Achilles tendinopathy in runners is around 10%. Research has shown that the incidence of Achilles tendinopathy is around 10% in runners, and that Achilles tendon injuries tend to increase with age, with middle-aged runners over the age of 30 more prone to the problem, which is related to Achilles tendon degeneration. Cause – Overuse is the root cause Achilles tendon pain is a very typical overuse injury. In the process of running, the Achilles tendon has to withstand up to 8-12 times the role of body weight, that is to say, the Achilles tendon has been subjected to a huge force of repeated pulling, resulting in repeated occurrence of minor trauma, triggering the mechanical failure of the Achilles tendon, and subsequent structural changes, the pain is naturally difficult to avoid. In fact, the term “Achilles tendonitis” that runners often hear is not accurate. In fact, there are no inflammatory cells localized in the Achilles tendon, so it is more accurate to define it as “Achilles tendinopathy”, which is the more scientific term used in the following. Achilles tendinopathy occurs frequently in two locations: (1) pain in the body of the Achilles tendon (2-6 cm proximal to the Achilles tendon stop); and (2) pain at the Achilles tendon stop. Of these, pain in the body of the Achilles tendon is more common. We are going to discuss mainly tendon body pain today; pain at the stop is more complex. Risks – more than just overuse If the strike is caused by overworking the Achilles tendon because it’s working extra hard, then why are you always the one who gets injured when everyone runs and everyone else runs more than you? This suggests that some runners may have specific risk factors that make them more susceptible to Achilles tendinopathy, i.e. high risk factors combined with overuse make you the unfortunate “that runner”. What factors can trigger Achilles tendinopathy? 1. Abnormal toe-hooking activities If the toe-hooking range is not enough when the knee is straight, the Achilles tendon is usually considered to be too tight, and the risk of Achilles tendinopathy is therefore increased. 2, abnormal ankle internal and external turning activities In addition to the ankle to realize the flexion and extension movement, but also has the internal and external turning movement, some runners have had a broken foot, may lead to the ankle becomes flaccid, internal and external turning movement increased, which is also the cause of Achilles tendinopathy. 3, taut foot weak calf muscle is the most important calf muscle, the main function is taut foot (scientific name metatarsal flexion). Running foot pick ground action is actually relying on this muscle to achieve, so the calf muscle strength is particularly important, when the taut foot strength is insufficient, the Achilles tendon tends to withstand a greater load, so it is more likely to occur Achilles tendinopathy. 4, flat feet Many runners have flat feet and are fine, but if the flat feet are accompanied by ankle force line abnormalities (heel bone axis and Achilles tendon axis is not a straight line), the Achilles tendon will cause a “whiplash effect”, which leads to abnormal Achilles tendon force. The above factors are the intrinsic risk factors for the development of Achilles tendinopathy, while the extrinsic risk factors include improper training, environmental factors and running shoes. For example, improper training includes: sudden increase in distance, increase in intensity, hill climbing training, returning to training too quickly after a break, etc. Achilles tendinopathy is more likely to occur in winter than in summer. This may be due to increased friction between the Achilles tendon and fascial tissues during cold temperatures. Symptoms – Achilles tendon tendon body pain Achilles tendon pain is, of course, the most prominent symptom of Achilles tendinopathy, but there are also specific manifestations of pain. Including: 1, after a long period of inactivity (such as sleeping, sitting for a long time), the Achilles tendon localized pain and feel stiff, after a little activity to relieve; 2, the beginning of the exercise feel pain in the Achilles tendon, the pain is reduced after the activity, but soon to the end of the pain, that is, the beginning and end of the activity pain. However, as the disease progresses, the pain may accompany the whole exercise process. Therefore, it causes a lot of trouble to the movement; 3, the pain is aggravated when walking up and down the stairs, tiptoeing; Diagnosis – pay attention to distinguish between the tendon body and the stopping point of pain Typical pain is located in the Achilles tendon tendon body, that is, the Achilles tendon attached to the Achilles bone (Achilles tendon stopping point) above the 2-6cm; if the pain is not in the tendon body, but in the location of Achilles tendon connection to the Achilles bone (that is to say the pain site), it is not in the Achilles tendon body. If the pain is not in the tendon body but in the position where the Achilles tendon attaches to the Achilles bone (i.e., the pain site is lower), then in addition to Achilles tendinopathy, it may also be Achilles bursitis, Haglund deformity of the Achilles bone, etc.; Painful sensation when pressing on the tendon body of the Achilles tendon, and the appearance of the Achilles tendon may be normal, or the appearance of the Achilles tendon may show a pike-shaped enlargement, a sense of nodularity, and accompanied by the swelling of the Achilles tendon thickening; When doing the one-legged heel lift in the standing position, the heel lifting capacity of the affected side decreases when compared with that of the healthy side, e.g. the healthy side can X-rays are not helpful in diagnosing Achilles tendinopathy, while ultrasound and MRI are helpful in determining the structure of the Achilles tendon and are often used as an adjunctive examination. 6, treatment – not all methods are effective Doctors and therapists have used a large number of methods for the treatment of Achilles tendonitis, after rigorous evidence-based, found that some methods are indeed very effective, some methods may be effective, and some methods are controversial. Runners are advised to use the most effective methods or consult a specialized sports injury physician or rehabilitation therapist. (1) Rehabilitation Training Rehabilitation training is the most effective treatment for Achilles tendinopathy, but only if the runner does it correctly. Achilles tendinopathy rehabilitation is mainly centrifugal training, what is centrifugal training? What is centrifugal training? (2) Physical therapy Among the many physical therapy modalities, low-level laser therapy and iontophoresis are the most effective, while shockwave therapy, which has been widely adopted in the past two years, has been reported to be controversial. (3) Stretching Repetitive and consistent stretching can also help to improve the lack of toe hook amplitude and thus improve function. This is because limited toe hooking is a risk factor for Achilles tendinopathy. (4) Foot orthotics Foot orthotics, represented by orthopedic insoles, can be helpful for runners with flat feet accompanied by ankle force line abnormalities, as they can alter the incorrect ankle forces during running. (5) Taping Taping, represented by muscle patches, can reduce tension on the Achilles tendon, and more and more runners are adopting muscle patches, which can be used flexibly at will, so it is worthwhile to try it when running. (6) Heel pads Heel pads can help reduce tension in the Achilles tendon. However, it is not effective for every runner. (7) Stretching – do more in place and more fully to be effective Stretching as the most important way of relaxation, but also the treatment of Achilles tendinopathy, for the improvement of Achilles tendon elasticity, reduce the pressure on the Achilles tendon, to avoid tension in the calf muscles is of great significance. For Achilles tendinopathy, stretching involves more types of movements, longer stretches and is more thorough, rather than being done casually like relaxing after a run. The following four movements are must-do stretches for Achilles tendinopathy. Each action is required to do four groups, each group of 30 seconds of stretching, which means that the four stretching actions will have to do 16 groups, so as to treat Achilles tendinopathy. (1) calf gastrocnemius muscle pulling one of the strongest action (2) calf superficial gastrocnemius muscle standing position pulling two common action (3) calf deep flounder muscle pulling action, back foot on the ground, fully bent knee, feel with the above action is not the same as the feeling of pulling 8, rehabilitation – centrifugal training is the most effective way The previous article in the treatment of In the treatment method, it has been mentioned that for Achilles tendinopathy, rehabilitation training is really the most effective way of rehabilitation, how to do? (1) The most core rehabilitation method – centrifugal training Find a step or stool, the forefoot of the foot on it, do fast rise and slow fall exercises, the requirements of the heel 1-2 seconds, and restore the fall of 6-8 seconds, that is to say, to strengthen the process of restoration of the action, rather than to emphasize the process of lifting the heel. This means that the strength of the Achilles tendon is trained by asking the calf muscles to lengthen and contract again. The purpose of finding a step is to allow the heel to hang in the air, so that when you drop down, you can let the heel fall below the forefoot. It should be noted that runners suffering from Achilles tendinopathy often heel restoration process accompanied by Achilles tendon pain, all rehabilitation training to the extent that does not produce pain, do not tolerate pain training. (2) Pressing the tennis ball exercise Many runners have learned to use the soles of the feet to roll tennis balls to relax the plantar fascia muscles, for Achilles tendinopathy, the soles of the feet under the pressure of the tennis ball is also another kind of rehabilitation training for the Achilles tendon. Put the tennis ball to the bottom of the foot, and use the muscles of the back of the calf to flatten the tennis ball, instead of rolling the tennis ball back and forth. (3) Express Hooking Exercise Do express hooking 330-50 times with both feet until the front calf muscles are fatigued. The anterior calf muscles and the posterior calf muscles are antagonistic muscle groups, on the one hand, from the muscle balance point of view, you can not only exercise the posterior calf muscles, on the other hand, to enhance the strength of the anterior calf muscles can reduce the posterior calf muscle tension, the terminology is known as the interaction inhibition. (4) Ankle artificial resistance internal and external turning exercises Many runners in the training of the calf only do heel lift exercises, but ignored the ankle also has the ability to internal and external turning, internal and external turning activities are abnormal is also a risk factor for the occurrence of Achilles tendinopathy, so strengthen internal and external turning training for the stabilization of the ankle to reduce the Achilles tendon tension has a positive significance. You can use the hand to hold the forefoot for inward and outward self-confrontation training, and self-confrontation can also control the size of resistance, which is a very good training method.