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Runner Therapy: Home Remedies for Achilles Tendonitis

Posted Nov 04 2010 6:50am

As the countdown to the NYC is well under way I, of course, am slammed at work. As I sit in my cab this morning on my way in at 6:45, 4 runners just passed by on their way to Central Park, clearly on one their last runs before the race.

Today, 5 of my patients will come in with Achilles tendonitis. For those of you with Achilles issues, I will tell you quite clearly, if you still have pain you haven’t seen the right person.

Now I’m sure if you Google this condition you will see tales of chronic pain, months of suffering, or other negative remarks. Don’t listen. You just have not had the right treatment. The right treatment works…quickly.

Three of my Achilles clients are running this weekend because they got the treatment. At the time, each had burning pain, difficulty and pain pushing off, and were rendered useless for their long runs…they thought they would have to pull out. They did not. They all finished every scheduled long run with minimal soreness.

Achilles tendonitis needs to be treated with aggressive deep tissue and cross-friction massage. Not only to the cord-like tendon that attaches to the back of the heel bone, but to the gastrocnemius or calf muscle itself.

This treatment will hurt, but the trick is not to make it hurt so much that you tighten up or squirm- this does not help anyone. You also want to be sure you don’t go so hard the patient can’t run. This delicate balance takes time to learn but eventually is priceless. With physical therapy, this is one of the few problems that’s truly no pain no gain. This is NOT the norm for PT. In general, the harder you can go, the quicker the problem goes away. But like I said, if you go too hard you may keep the client from being able to run.

If you can not get into treatment in the few days before a race, get some relief at home; make sure to use the prostretch to stretch both your gastrocnemius and soleus (see past posting). In addition, do some cross-friction massage yourself! Sit with your involved leg crossed over your other knee so you can reach the tendon. Now, grasp either side with your thumb and forefinger. Squeeze the tendon from the sides pretty hard as if you were clamping down on it like a vice. Now, with the same pressure maintained, make small movements up and down about a half centimeter in either direction, going up and down and up and down repetitively. This should hurt! Find the spots that hurt more and go over those more. Its a bit sadistic, I know. There is no real ‘right or wrong’, so don’t be afraid!

For the calf, try running your heel down the calf in question. Keep exploring with the heel until you hit some serious ‘knots’. Massage those out as well as you can.

You can do this massage of the calf and cross friction to the tendon for 5-10 minutes once or twice a day, depending on soreness and pain. Be smart and listen to your body. If you are extremely sore after and miserable, back off next time. If it feels better instead of worse or isn’t too badly sore, step up the pain!

Be sure to stretch after and then apply ice for 15 minutes, or use an ice cup massage for 5 minutes.

These self-help techniques will be a good home remedy. If they are not, make sure to see someone who isn’t afraid to dig in there!

- Marisa

(Marisa, a MS PT SCS ATC, writes for iRunnerBlog’s Runner Therapy, is a physical therapist in private practice in midtown NYC.  She one of a dozen or so therapists  in the state of NY to be board certified in sports.)

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