Achilles – Achilles‘ heel of runners
Achilles tendon pain is one of the most common injuries not only of runners, but also of other athletes, mainly athletes, football players, cyclists. These difficulties can develop gradually or appear suddenly after a major workout or inappropriate sharp movement. The problem in the Achilles tendon often develops over a long period of time, long before you start to feel pain. The sharp, uncoordinated movement that triggered the pain in the Achilles tendon is often the last straw, when the pain until then subliminal, increases and you begin to perceive it.
Chronic Achilles tendon pain has been found to be accompanied by degenerative tendon changes, not chronic inflammation, as is often reported. Thus, anti-inflammatory treatment has no effect (drugs with anti-inflammatory effect, icing, etc.). The so-called sterile inflammation can accompany degenerative changes in acute microtraumatization of tendon fibers or overload of tendon sheaths. Around the Achilles tendon then appears swelling, possibly redness and local increase in temperature. In this case, of course, the suppression of inflammation makes sense, but such a phase usually lasts only a week.
Difficulties with the Achilles tendon are most often manifested by such symptoms:
• the feeling of a stiff tendon in the morning, within a few minutes or tens of minutes passes
•stiff Achilles tendon at run-up/at the beginning of training
•tendon pain, in lighter cases it appears only in the morning or at the beginning of the load, in the worst case it appears even after the load and in the most severe case it is even during normal daily activities or even at rest
• swelling of the tendon, most often in its middle third, which forms a ring around the tendon, or a thickened surface of the tendon in a certain part of it
• burning pain when pressing on the tendon, can be in its various parts
Of course, the Achilles tendon of runners or other athletes is very burdened. But why do only some of them have these problems, and why do non-sports suffer from these difficulties? The cause is not in the excessive load, training surface or shoes. The cause is in the musculoskeletal system itself and, moreover, often very far from the place of pain. If you want to solve the protracted problem with the achilles, you can not treat the achilles, but the place of the disorder.
We successfully treat Achilles tendon pain.
Certain functional disorders of the musculoskeletal system lead to an increased or uneven load on the Achilles tendon and thus predispose it to traumatization and the development of degenerative changes. The extent of these changes and difficulties is then probably due to functional disorders and other influences, such as the type of physical activity performed, shoes used, age, hormonal changes, etc., but these are secondary.
Let’s take the example of a recreational runner with age-old achilles pain. He hurts both of them, in the morning he is stiff that he can not go down the stairs, but within half an hour he breaks up. It hurts at the beginning of the run and then at the end. Running has to be a little restrictive. He has already tried everything – ultrasound, laser, shock wave, ice, compresses, anti-inflammatory drugs, exercises on the arch and on unstable surfaces. Some of it helped for a while, some of it was without effect. He already takes such troubles as a necessary part of aging, even though he is a fresh forty-year-old.
Then it gets into the hands of doctors for acute back pain. Problems with achilles do not even occur to him to mention, because he does not know that the two problems may be related. However, the physiotherapist reveals the problems with the achilles because he sees the connection. The master has a planted pelvis, overloaded loin, failure of the deep muscles of the trunk, on the contrary, overload of the superficial ones, unprimanded thoracic spine and very tight hamstrings and calves.The disorder in the posture of the pelvis and spine secondarily created tension in the lower limbs, namely on their back side, and the resulting tension is directed directly through the achilles to the heels.
In the body, by its coordination, it has created such changes that lead to overloading of the lower back. However, the body is able to compensate well for its shortcomings, so back pain has only now appeared. But long-term achilles pain tells us that the problem in the musculoskeletal system was long before that. In therapy, we do not focus on the achilles at all, but on the problem in the trunk.It is necessary to improve the position of the pelvis and spine, and in the next row to remove secondary changes in the lower limbs – that is, to relieve tension directed to the heels. And then just teach the runner to move a little differently – to straighten up while running, optimize the frequency of the step and learn how to use the feet. Running does not need to be changed immediately and from the ground up. It is enough to exercise before 10 minutes, sometimes remember a better style while running and practice it for a few minutes and after finishing he will work out a little again. The results will not be long in coming.
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Dagmar Lisá
