FIGHT ACHILLES TENDINOPATHY

How pedalling can cause Achilles problems in cyclists

WHAT IS IT?

The Achilles tendon joins the heel bone to the calf muscle, and its function is to bend the foot downwards at the ankle. Achilles tendinopathy is common in runners, but pedalling can cause pain and swelling in cyclists. Symptoms usually come on gradually. The pain can make it difficult to walk and the tendon may feel tender. Tendon rupture presents as severe pain around the heel that comes on suddenly and needs immediate medical treatment.

WHAT CAUSES IT?

Achilles tendinopathy is believed to be the result of numerous tiny injuries to the tendon that haven’t completely healed. The Achilles tendon also weakens with age, making it more susceptible to injury. This is more likely to happen if you only ride at weekends or if you suddenly increase the intensity of training. Weak or tight calf muscles, a saddle that is too high, or cleats too far forward can contribute to the problem. Some antibiotics are known to increase the risk of Achilles tendinopathy.

HOW CAN I TREAT IT?

Initial treatment involves rest, painkillers and applying ice packs. It is essential to correct any errors in bike setup – it may be worth getting a professional fitting. An exercise programme to stretch the tendon can help recovery and prevent recurrence. Suitable exercises are available here: bit.ly/10wRdlW. Medical interventions include shockwave therapy, shoe inserts and GTN patches (a drug normally used for the heart). Most cases will settle in three to six months.

GP and cyclist @awkwardcyclist

Andy Ward,