Contact us

Make an appointment

our specialists


  01 40 79 40 36






Sports Clinic

36 bd St Marcel

75005 PARIS

Sports clinic Paris

Metro: Saint Marcel

Parking 6 rue test


'Pages chirurgiedusport :


Ce site respecte les principes de la charte HONcode de HON Ce site respecte les principes de la charte HONcode.
Site certifié en partenariat avec la Haute Autorité de Sant├ę (HAS).
Check here


Youtube video

Achilles tendinitis: weak point of the runner

Print Article

You train diligently, you run a lot, you prepare for competitions, this disabling injury threat! Here are explanations and tips to prevent and treat it.
The Achilles tendon connects the calf muscle to the heel bone, the calcaneus. When the muscle shortens, it transmits the force and extends the ankle. At each of your stride, it is put to use during the propulsion phase. He works harder when depreciation. Under these conditions, the heel hit the ground and the muscle pulls in the opposite direction to slow the movement. The tendon is torn. This braking mechanism is ubiquitous in the race and missing bike. This explains why Achilles tendinitis is common among runners and almost nonexistent among cyclists.
Achilles tendonitis, what is it?
This cord mistreated during braking of each stride is made of microscopic fibers in spirals. When constraints are excessive, some tear. When the recovery time between workouts is insufficient, these small lesions join, disrupt the mechanics of the tendon and become painful. The white blood cells arrive to evacuate waste. This first stage of inflammation shows beneficial and stimulates tissue reconstruction. Sometimes it becomes excessive and the process is racing: our cleaning cells also nibble healthy fiber. Quickly, a scar is formed. In most cases, particularly in cases of complete rest, it looks like a fragile magma. It is at this point that tendinitis is really embarrassing. The fibers oriented in any direction does not assume the mechanical and the building is cracked, a bit like your winter chapping when you smile. At this stage, there is more inflammation. On the contrary, the scar is not moving and still breakable. Treatment is needed.
How to know if it's serious?
The pace of tendon pain is associated with different stages of severity. They were described by a doctor appointed Blazina. Initially, it hurts after your workout. Inflammation snaps stopping the effort to clean waste from microcracks. That stimulates the rebuilding process. When the lesions are more advanced, small anarchic scars are responsible for adhesions between the tendon and surrounding tissues. You suffer when you return you moving in the morning out of bed or when you start exercising. This stiffness is proving quite beneficial. In the next stage, you evil throughout the activity, even at rest. Each stride destroyed some healthy tendon fibers. Your tendinitis worsens.
The rest is not systematic: manage your pain
Pain after training: Reduce the length and speed of your workouts, consider cycling and swimming. Try to put a little heel, stretch after sessions ... a little, not too much. This strategy could be sufficient.
Transferor pain warming up. You can continue your session. Stop if pain reappears. Again, reduce your workload. Pedal and swim to complete your program. Make an appointment with your doctor to initiate treatment and to rehabilitation.
Persistent pain on exertion. Stop running! To keep fit, go swimming and cycling, avoid large gears and do not put on the pedals. quickly see your sports doctor
Your pain goes to heating: Continue to run, reduce your workouts.
What drugs against Achilles tendinitis?
Usually anti-inflammatories are not useful because the harmful inflammation is rare in case of tendinitis. In fact, in the medical world, this word has been changed to "tendinopathy" for the "pathy" suffix meaning disease, while "itis" means inflammation. In practice, it does not prescribe an anti-inflammatory treatment at the earliest stage of the lesion when the cleaning process beyond their primary mission and attacks healthy fibers. It may occasionally repeat when training or rehabilitation techniques proved too intense. Conversely, we suggest products that promote the relaxation of old scars. Silica plays a key role in linking the fibers together and restoring elastic cohesive structure. It can be ingested orally or applied topically because the tendon is really just under the skin. The Dissolvurol brand offers 2 options: drops and frost.
Physical therapy: a must
Phase of irritation, ice is an excellent anti-inflammatory. Very quickly, we must guide the healing of the tendon. Stretching and brake work orient the fibers in the stress axis. As you can see, these are also the movements that hurt your tendon! This is truly a tissue retraining! But this one has an essential virtue: it is progressive. At the stage of anarchic big scar, you have to break the fibrous magma. The ultrasound contribute ... a little! MTP or "deep transverse massages" are much more effective. They also reactivate the healing process by recreating microlesions. Your physical therapist rubbed perpendicular to the tendon tensioned. The "shock waves" can be considered as super MTP. This big gun strikes on your tendon 5 to 15 times per second for 3 to 4 minutes. These two methods are painful but it's for a good cause! After stretching and progressive braking work realign the fibers. If the surgical laser cut fabrics, medical laser softens scars. It is painless and can be used in case of Achilles tendinitis.
Soles and heels to relax your tendon
A heel can be traced back heel. The Achilles tendon is slightly relaxes. Even if you do not suffer from one side, place them in both shoes under the soles clean, so as not to end up wobbly. They must be of moderate height so that the heel remains stabilized by the buttress. Too high, they would incline you forward and your body would be suspended as your Achilles tendons; the remedy would become harmful! They can be mechanical damping to limit vibration impact. The heel of SORBOTHANE include these features. A pair of sole made by a podiatrist sports is sometimes useful. It fixes a hollow foot, tight as a bow that shoots your tendon. It limits the lateral tendon tightness in the heel when the rocker as it occurs during excessive pronation and supinations.
Sport is part of the treatment!
You understood rehabilitation helps to relax the old scars and retrain the tendon! It is the same sport! Must still it is well balanced: the request must contribute to the adaptation tissue without causing injury. Pain is good adviser. It is tolerable for a few minutes to warm-up and sensitivity is possible within hours of the session. In any case, it should persist much less increase during exercise. Start with the little sollicitantes activities for your tendon, be guided by your feelings and gradually increase the constraints. With swimming and aqua jogging without support, your tendon is at rest. On bike, no aggressive braking work that thrust. Same on elliptical but you add the weight of the body. With the stepper heel in vacuum or cycling dancer, you reinsert the slow braking. Hopping in the water, the tendon is again resiliently biased but Archimedes helps you and the movement is slower. gradually decrease the depth! Spend at pattering. Perhaps a bit of carpet in your cardio session hall. You can opt for a jog before increasing duration of your bike training. Unless this is a small jog to go swimming. Gradually increase the running time, lower than the sideline. Accelerate gradually introduce the relief and speed variations and the split more structured. Jump, leap painlessly! You are healed!
Pain in the back of the ankle are not always Achilles tendonitis. Sometimes it is a big bulb between the bone and the skin caused by friction of the buttress. We speak of "exchange inflamed" or "bursitis". Especially among the runner, look for a stress fracture of the calcaneus, the heel bone. From time to time, especially in the footballer, the ankle bone, astragalus, is pinched back, between the tibia and the calcaneus. It is called "syndrome of the posterior crossroads".
Sometimes these are atypical tendinitis in many different treatment. In case of peri-tendinitis fibers are free but the sheath surrounding the tendon is irritated by friction against the stem of a top shoe. This lesion occurs mostly hikers or military. You can also suffer at the attachment point of the tendon on the heel bone, it is called tendinitis insertion. If the lesion is associated with pain of the column, it is sometimes rheumatism. If you're good living, your tendonitis can be caused by clumps of cholesterol or crystals of uric acid that crack the fibers.
The diagnosis of "Achilles tendinitis" is not as easy as it seems. It requires a rigorous examination. To confirm or evaluate the "extent of damage" your doctor may prescribe a blood or images: radio, ultrasound and MRI sometimes.
Dr. St├ęphane Cascua, medicine and sports traumatology.

Doctor St├ęphane CASCUA. - 16 mai 2011.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


Read also ...

Sensitivity and specificity of bell-hammer tear as indirect sign of an anterior cruciate ligament partial rupture on magnetic resonance imaging

Doctor Nicolas LEFEVRE, Doctor Yoann BOHU, Doctor Shahnaz KLOUCHE , Doctor Serge HERMAN.

The most read articles

Technical cruciate ligament

By Dr. Nicolas Lefevre

More videos

Last publications

Feature: knee prosthesis

total knee replacement

Feature: knee ligaments

Dossier: Ambulatory Surgery ACL

Dossier: meniscus


Feature: Shoulder sportsman

Folder: hip prosthesis

Dossier: break hamstring

Dr. Lefevre proximal anatomie_ischio_jambier_rupture chirurgiedusport

Dossier: prosthetic and sports

hip replacement and knee and sports

Dossier: PRP

Chirurgiedusport - Who are we - Contact us - Legal Notice - Web design Digitaline - EMC2 Studio development - Clinique du Sport