Hey. This is Sock Doc and today I'm going to talk about a common running
injury called Achilles tendinitis. This is an injury that many people
suffer from if they're training hard, if they're racing a lot. It's a pain
in the lower part of your leg, right where your Achilles tendon attaches to
the heel of your bone. So your Achilles tendon is actually an extension of
your two calf muscles, your gastrocnemius and your soleus muscle, and they go down
and form a tendon. Tendons attach muscles to bones and it's called your
Achilles tendon.
We'll just get right to it. Your Achilles tendon is right here and many
people will feel pain right where their Achilles tendon attaches to the
calcaneus, their heel bone. Now you can see right there I have a very
little bump that I had from when I had some Achilles tendinitis back in
1992-1993, when I was training hard in college. It's the one time I
actually got a cortisone shot right there in my heel bone and it basically
calcified up. So to this day I still have a little bit of a bump.
Now some people might call that a heel spur and there's actually a term
called a pump bump, kind of a funny name, when that spur kind of flares up
a little bit. There's also a term called retrocalcaneal bursitis, which is
when the bursa, which is underneath that Achilles tendon flares up and you
have bursitis, another type of inflammation, -itis means inflammation, so bursitis -
inflammation of the bursa; tendinitis - inflammation of the tendon.
Many people say that the pump bump, that swelling on the outside, the
lateral part of your Achilles is from scuffing against the back of a shoe
or a walking shoe. I don't agree with that at all. Typically you have the
Achilles tendinitis or you have a calf issue resulting in a strain of the
Achilles tendon, and then that flaring up, that inflammation of the
Achilles causes you to approximate the distance between your heel and the
shoe more, in other words you have less space, and that rubbing then
creates the spur or the pump bump.
Here's the important thing though. As I've talked about in the other videos
it's always more important to diagnose why you have a problem rather than
what exactly you have. Whether you want to call this Achilles tendinitis,
whether you want to call your pain a heel spur, a bone spur, retrocalcaneal
bursitis, or a pump bump, ultimately it really doesn't matter. Diagnosing
what you have does very little, if anything, to fix the problem. So we're
going to diagnose why you have it and that's the important thing, to
hopefully prevent it from happening again and recover from this injury
faster than you would otherwise.
One of the Sock Doc rules, as you know, is we don't stretch any injuries.
Stretching pulls muscle fibers away from one another and when you want to
heal muscle fibers you want to approximate those back together. Even
physical therapist today are starting to use methods such as scraping
methods, very painful methods, when they go down the belly of a muscle and
try to line those fibers up. And that's now proven that lining those fibers
up and approximating these fibers helps to heal injuries.
It's actually, in my opinion, one of the most effective ways you can heal an
injury. And this is also known as trigger point therapy or origin insertion
technique. So it's very painful and I'm going to show you how to do that
right now because the Achilles tendon is an extension, again, of your calf
muscle. So we're going to look for an injury here on the calf and you're
going to especially look right here, right where the meaty part of your
calf muscle starts to narrow down and come to the more narrow part of your
calf and then ultimately into your Achilles tendon. You're going to look
for tender spots, like right in there and push with your thumb.
See what's tender, poke around. You can squeeze with your thumb and index
finger too, down this soleus, the lower part of your calf, down to your
Achilles here, and look for any tender spots. And if you find them either
hold them or rub them out in a circular motion. They're going to be very
tender, very hot, compared to the other side that might not be injured and
you can see what might really be painful. A lot of runners have tender
calves anyway and sometimes it's because there's an injury that's starting
and you can possibly prevent it if you start to work those out.
So you're going to work those out. Sometimes they'll wash away, we say, they
sort of dissolve and feel better. And they might not, but they hopefully
feel better the next day or even right now. If you work them out a little
bit you might notice that as you walk or run more they don't hurt as bad.
Typically, as you may know, with Achilles tendinitis, if you have it, it
hurts more when you walk or run up hill because of the plantar flexion
aspect of using your calves while you're doing that activity.
Another little device I like to use sometimes on people is The Stick. You
might have seen these at running stores or expos. It's got these little
movable beads in the middle and you hold it like this and then go up the
back side of your leg so you're working it up and down your calf like that,
especially over, obviously, the tender area. I'm putting pressure towards
my leg and my leg pressure towards The Stick and you're rolling that up and
down. This is a nice little instrument to use for hamstring issues and calf
issues where you can get right in there. So look for those injuries in the
calf.
Second, remember, no stretching. And third, as usual, with any injury, as
I've always said, no orthotics. Let's get off those orthotics and those
built up shoes. The more your foot can stay closer to the ground, the more
you can walk barefoot, the more you can use minimalist shoes with a very
low heel to forefoot drop, a wide toe box, and very little support or
cushion, the more you'll strengthen your feet and get over your injury
quicker and prevent other injuries from hopefully occurring.
But there's other reasons why injuries can occur just other than bad
footwear and one of those reasons, again, as I've talked about before, is
when you overtrain. Training at too high of a heart rate anaerobically,
training too often, racing too often, or too high of stress levels which
could even be from eating a poor diet, or from too much emotional stress
like if you're working too many hours, family stress, or any other mental
stress you might have that's basically too much that you can handle.
That tends to stress our bodies out and injuries result from that because
there are certain links between stress levels in the body and cortisol
levels, which are one of your stress hormones, like adrenaline, and these
tend to provoke injuries in people. It happens basically from the way that
they work with muscles, the relationship between your hormones and muscles.
And I talk more about this on the Sock Doc website about eating better,
about eating more appropriately, no hydrogenated fats, low sugar in your
diet, and staying away from things like MSG, refined foods and monitoring
stress levels, training aerobically rather than anaerobically, using heart
rate monitors and that sort of thing.
So if you're training properly, if you're eating well, if your stress levels
are in check, and you have the proper equipment, in this case, with a
running injury, that usually just means footwear, and if your feet are
strong from wearing the proper footwear, and not wearing orthotics and
walking barefoot often, you're going to probably never end up with an
injury like Achilles tendinitis, or a pump bump, or a retrocalcaneal
bursitis, or a heel spur, or a bone spur, whatever you want to call it, and
your feet are going to feel very strong and you're going to have strong
calves and lower legs and great balance.
The other thing is, other than no stretching, no orthotics, is with the
entire Sock Doc philosophy make sure you always stay off that injury,
especially in the acute phase. It might be okay to ice it a little bit if
you need to settle down the injury, if that makes it feel better, to cut
down on some of the inflammation. But ultimately, to heal the injury, you
need to look distant from the injury, as I've talked about in the other
videos like plantar fasciitis and iliotibial band injuries. In this case,
stay off your Achilles. Don't be pushing around right where that Achilles
inserts into your calcaneus, your heel bone. Go up towards the calf. You
might even have to go all the way up towards where your calf actually comes
over to the other side, behind your knee bone, the tendons of the calf
muscles up here where it's closer to your hamstring.
So focus on that area behind your leg, and not too much on the Achilles
tendon area because often pushing on the Achilles and doing any strong
techniques there, the trigger point therapy, or using The Stick actually on
your Achilles, will most likely just inflame it. You should be able to
settle down a lot of it, hopefully all of it, by addressing the muscle
further up. But don't forget to address why you have the problem. And
again, it might not be from the shoes. It could be from over training and
those other aspects that quickly result in an injury. And that's how you'll
go about getting over this injury much faster than anybody has every told
you and hopefully preventing your Achilles tendinitis from happening again.
I hope you enjoyed it; thanks!