CLINIC: To Fix Achilles Problems, Don't Discount a Change of Shoe

Wed, 5 Sept. 2012 - 12:18 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:

 I was diagnosed with Achilles tendonitis, and my pain is severe in the lower right leg, as well as the pain in the ankle area of my left foot. After running I can hardly walk and the pain is severe going up and down stairs; it subsides when I don’t run.

 

I am a weekend runner and will be 67 in August. I run four to five miles at a time, and have been doing so since 1977. I was injured in January playing tennis with a leg cramp, and then the tendonitis showed up. I had been inactive in racquet sports for years prior to the leg cramp incident.

 

I went to an orthopedist who found no stress fractures or breaks in the x-ray. He prescribed physical therapy, but after five visits I stopped. I saw a friend who is a podiatrist and he said that arthritis is setting in—which seemed to coalesce with the fact that in the morning I now have lower back pain and tightness in my legs.

 

I run on street surfaces, and am 5’ 6”, 175 lbs. I’d love to continue my running.

 

David Mortgensen

Fort Pierce, FL

 

ANSWER:

If you have both Achilles tendonitis and arthritis, I would make sure that you are running in a stable running shoe and/or an orthotic. One of the most common reasons for both injuries is overpronation (where the arch and ankle collapse too much, increasing strain on joints and tendons). Excessively-cushioned running shoes can make these problems worse. Stable running shoes, by contrast, help align the foot and decrease the workload on certain structures. 

 

If you already have a stability shoe, then you should focus on an orthotic. I’ve treated plenty of runners who have been able to continue training simply by changing shoes, adding orthotics, and also doing physical therapy. If you haven’t found a running-oriented physical therapist in your area, ask other sports medicine specialists who they would recommend, or call the local running stores and running clubs and see who they suggest.

 

Paul Langer, DPM

Minneapolis, MN

 

ANSEWER:

The apparent Achilles tendonitis is likely related to the tennis injury you described. Conservative treatment is the early mainstay. A course of physical therapy beyond the five visits you mentioned may be helpful, as well as use of a heel lift, as noted above, to decrease tension on the tendon. You should also incorporate Achilles stretching exercises. Ideally, symptoms should improve in several weeks with this treatment outline. If this fails, you will need a thorough biomechanical examination by a sports medicine professional.

 

James Gardiner, DPM

Yonkers, NY

 

 

 

DISCLAIMER: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.

The American Running Association (ARA) and its Clinic Advisory Board disclaims responsibility and shall have no liability for any consequences suffered as a result of your reliance on the information contained in this site. ARA does not endorse specifically any test, treatment, or procedure mentioned on this site.


(RUNNING & FITNEWS®March / April 2008 • Volume 26, Number 2)




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