Your Achilles Heel


    The Achilles tendon is actually 2 separate muscles that come together to form one tendon at the back of the leg, which then attaches to the heel.  Those 2 muscles are the Gastrocnemius and the Soleus, both of which make that bulky calf muscle and work to point your foot and lift you up into relevĂ©.  They also work in reverse, or eccentrically, to slow down and absorb shock when coming down flat or landing from a jump.  

    When either of these muscles or the tendon itself gets tight, or if there is weakness, several issues can arise that may cause pain.  The most common for dancers are:

  • Achilles Tendonitis-- Swelling and pain in the tendon
  • Plantar Fasciitis-- Tightness, inflammation, and pain in the long arch of the foot and sometimes on the bottom of the heel
  • Sever's Apophysitis--Pain and swelling on the back of the heel bone, possibly with an enlarged "bump" on the bone. This is usually seen in younger kids, ages 9-13, and often starts after a big growth spurt.  
    These are all overuse injuries, often resulting from an increase or change in activity.  That may be a change in class or rehearsal schedule or increasing pointe work.  They could also be caused by a change in footwear or following a big growth spurt.  Whatever the cause, there is usually an imbalance between the strength and length of the muscles and tendon, and its workload is more than it can handle.

What to do??  Always see a doctor and/or a PT if you have a lot of pain or a sudden onset of new symptoms.  There is no substitute for a professional evaluation and treatment recommendations specific to your case.  If you have very mild symptoms though, there is a lot you can do to manage things on your own and to prevent it from getting worse: 
  • Rest and Ice!  
    • This is the first thing to do in order to get the swelling and pain to calm down.  A couple of weeks off from dance class or pointe work may sometimes be necessary.
  • Don't walk around barefoot  
    • Give your heel a little lift and cushioning and give your arch some support.  Flip flops or canvas sneakers with no support aren't going to help you here.  Good footwear with proper arch support can make a huge difference.
  • Stretch and Roll
    • Gentle rolling using whatever tools you have (even a tennis ball) are a good start.
    • Work up to standing stretches as things improve.  Make sure to hold your stretches long enough (20-30 seconds at a time), and remember--stretching shouldn't be painful. If it is, back off and go more gently, or you may just aggravate things.  
Gastrocnemius Stretch
  
Soleus Stretch



  • Begin gradual strengthening
    • This is where seeing a PT is really most necessary--A strengthening program tailored to your specific needs with supervised progression of exercises.  



    Although these are common problems in dancers and can often be managed at home with this type of conservative approach, there are certainly other causes of heel pain not mentioned here, and lots of other treatment options.  Again, always see a doctor and/or PT for a thorough evaluation, especially if your pain is severe or if your symptoms aren't getting better on your own.  

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