Pathologies of the Achilles tendon are best treated early if not prevented in the first place, and at-home care includes the P.R.I.C.E. protocol. Photo courtesy Regenexx.

The Achilles tendon is one of the most robust tendons in the body. Three relatively large and extremely strong muscles in the calf all attach to the back of heel bone (calcaneus) via the Achilles tendon. This particular tendon, like many others in the body, is encased in a sheath called a paratenon that produces a lubricating fluid designed to prevent friction between the tendon, its sheath, and other structures the tendon contacts.

The forces generated through this tendon during running are some of the largest anywhere in the body. When a muscle contracts and shortens, it is called a "concentric" contraction; when it lengthens in a controlled release of its contraction, it is called an "eccentric" contraction. During a toe raise exercise, the calf muscles contract concentrically and, via the Achilles, lift the body weight on to the toes. When you consider that the average, untrained man can do a standing toe raise with somewhere around 200 pounds on his shoulders, and a well-trained man can lift over 400 pounds with his calves, you can begin to appreciate the magnitude of forces transmitted through the Achilles tendon during activities such as uphill running, or when jumping across puddles and over parking bumpers.

During flat, steady-state running, the calf muscles perform an eccentric, or lengthening contraction, to slow the forward progression of your body weight as the shin bone moves over the foot in mid-stance.

Pain Presentation

There are three different conditions of Achilles tendon dysfunction, and their pain presentations have similarities -- but with careful observation and palpation, it is possible to provide a more exact diagnosis. All Achilles tendon injuries hold the risk of complete tendon rupture. In fact, the Achilles tendon sometimes suffers spontaneous rupture with no history of previous injury or pain. For these reasons it is imperative to stretch the Achilles tendon daily and keep the calf muscles strong.

Achilles Tendonitis

The Achilles tendon, like all tendons, is comprised of collagen fibers that are constantly reacting to the stress of the forces created during activities of daily life and exercise. In normal use, the body has little problem keeping up by repairing fibers damaged under the loads of walking, running, and jumping. Achilles tendonitis occurs when the stress of these activities outpaces the body's ability to repair micro damage to the fibers. Chronic inflammation results and pain is soon to follow.

Read More . . .

Additionally, look for Forster's soon to be released book, Healthy Running, Step by Step, due out this Fall.