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AchillesTendon Pain

The achilles tendon is one of the thickest in the body and is formed by the two muscle bellies of the large gastrocnemius and the thick soleus muscle which lies beneath it.  The tendon attaches to the back of the heel bone (calcaneus).  The action of these two calf muscles is to lift up on the heel.  You use these muscles when you lift yourself up on your toes or push off as in walking or running.   If it is torn or inflamed you will have problems moving around.

We have massaged many people with achilles tendon (C) issues.  Most recently we have worked with members of Legends Drum Corps. (Drum Corp International - Open Class) These 14 - 22 year old performers spend countless hours marching forward, backward and sideways on athletic fields on their toes with their heels raised.  We saw a number of Corps. members wearing ankle braces.  Some had received medical diagnoses of achilles tendonitis.

 

Massage to the superficial calf muscles mentioned above is important when addressing achilles tendon issues.  However, in our experience there is a common trigger point pattern in one of the deeper leg muscles which is often the culprit in achilles tendon pain and is often overlooked in diagnoses of achilles pain.

 

This muscle is called the tibialis posterior.  It lies in between and connects directly to the two lower leg bones (tibia and fibula) and the connective tissue (interosseous membrane) that holds the two bones together.  The muscle is deep to the gastrocnemius (A)  and soleus (B) muscles.  The tendon of the tibialis posterior runs past the inside of the ankle joint and connects to several bones in the arches of the foot.  The muscle serves to lift one on their toes which is why the marchers had problems.

 

The tibialis posterior can develop a trigger point when it is over used.  The referral pattern is concentrated in the achilles tendon area, shown in the yellow area (D).

 

Common medical treatment for the condition is the RICE response = Rest, Ice, Compression (brace) and Elevation.  Often a NSAID (non-steroidal anti-inflammatory drug) is prescribed.  Notice the word “massage” does not appear.

 

When you press into the belly of the muscle you might experience exquisite pain due to the lack of circulation, the build up of metabolic waste products and the heightened tension level of the muscle.  Once the muscle is worked on and circulation is restored, a good stretch is in order.  

 

While it would be a good idea to rest the muscle, you may not have opportunity.  The Drum Corps members do not have the luxury of rest time when they are on tour as they are on the practice field 10 - 12 hours a day.  You may not have the luxury of taking time off from work if you have an achilles issue.  If you like to run and exercise you probably do not like to take time off to rest the achilles.

 

Do massage on yourself on a regular basis or get a professional massage from someone familiar with the condition and techniques to address the trigger point and tight muscles adequately.  If you do not already have a relationship with a professional massage therapist, here are some guidelines on what questions to ask when searching one out.

 

We have recorded a great instructional DVD available on this website for self massage of the leg, ankle and foot.  It would be a worthwhile investment in your present and future health.