Not sure whats wrong with my lower leg? Am a runner, could it be Achilles Tendonitis?

by John
(Mebane, NC)

For the past 4 years I've run 4000 miles/year 5000 in 2007. I change very little habitwise (80-90 weekly, weekly 20+ miler around marathons). My shoes are the same model and get disposed about 500-600 miles. I think I may have Achilles Tendonitis but not sure so therefore not sure how to treat.

I've been running 10 years. Had a training ending bout with AT about 9 years ago. After switching to a neutral adidas it healed up nicely and didn't return until perhaps recently. I've not had any achilles, calf, soleus or lower leg problems since my injury 9 years ago.

I've stopped running due to pretty intense achilles pain while running. I can't figure out what happened and I'm not even sure it is achilles tendonitis. But pain presents like AT when running. pain along the tendon with each step after a pain free 2-4 mins. Pain lasts until I stop. Then walking is painful afterwards for couple hours.

Squeezing the tendon never hurts from heal to soleus. Behind the tendon is a painful quarter-sized area when I press with my fingers(about halfway between heal and calf towards ankle on inside of leg). And there is a tiny knot (never painful to squeeze) at the base of AT on the AT <1" above heal.

Is it definitely AT? If not what should I do. Is it age related as I am nearing 40?

Its disconcerting as I have had very very few injuries over the last 8 or so years. And I don't really think I changed anything.


Joshua Answers:

Hi John.

Regardless of whether or not you 'officially' have Achilles Tendonitis, you have a Pain Causing Dynamic.

Increasing muscle tightness, shrink wrapping of connective tissue, and some element of a Process of Inflammation.

You might have a little bit of actual damage type Achilles Tendonitis, what with the knot at the base of the tendon (scar tissue build up?).

That painful spot behind the tendon could be a spot where connective tissue takes some strain, is full of pain enhancing chamical from inflammation, isn't getting enough circulation, etc.

The pain while running could also be due to the gastroc/soleus muscle(s) being so chronically TIGHT now after years of running that you've finally hit a point where they are A. ALWAYS putting lots of tension on the tendon and B. unhappy and
putting too much tension on the tendon while you run.

If the nervous system feels that you are in danger, it will tighten up even more, which ironically makes it worse. It will also create a sensation of pain to make you stop doing whatever it is that you're doing so you don't injury yourself.

My first thought is to:

1. Cover your bases with Magnesium for Tendonitis.

2. Self massage, use a roller, stretch, etc and get the connective tissue of your lower legs opened up and your muscles relaxed.

That's probably priority #1 right now.

If your muscle/structure is too tight, and you go banging down the road, this will/can cause the pain you describe, even if you have no actual tendon damage (though damage likely isn't far behind).

3. Ice dip as described on the How To Reduce Inflammation page. 5 gallon bucket, as much of your lower leg in as possible. Something like that.

That's where we start.

For longer term keeping-you-running, while I don't know your lifestyle, I know you're not as young as you used to be, and if you want to keep your body on the road, it's time to bolster it as much as possible with nutrition/protein.

Not enough protein is a sneaky, slow way that adds to runners slowly breaking down.

More protein. More calories so you can utilize that protein for something other than fuel. I'm a big fan of coconut oil for that (Goo packets, I say, are far inferior to some coconut oil).

So there's that.

More questions, more answers.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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