How Should I Treat Achilles Tendinitis?

Question: I’ve had Achilles tendinitis for much of the season. My doctor said that I could ride TRAM (300 miles across Minnesota) but then I would have to stop cycling and deal with the problem. Is it possible to continue riding after TRAM? — Pat D.

Coach Fred Matheny Replies: Most likely. Here, from the pages of Andy Pruitt’s Medical Guide for Cyclists, is Andy’s expert information for Achilles tendinitis sufferers.

First, here’s what usually causes this injury:

• Faulty foot mechanics such as excessive pronation (inward bending of the ankle)
• A tight Achilles tendon
• Having the foot positioned too far forward on the pedal (pedaling “on your toes”), resulting in excessive use of the calf muscle during the pedal stroke
• A pedal system with excessive float, which makes the Achilles tendon work hard to stabilize the foot on the pedal

Custom cycling orthotics often help by correcting rear foot angulation. 

Switching to pedals with less float can bring relief. To reduce strain on the Achilles, move your feet forward on the pedals by moving the cleats toward the rear of the shoes. Lower the saddle an amount equal to the distance you move the cleats.

If those fixes don’t help, tape the ankle. Lessening movement during the pedal stroke reduces stress on the tendon.

To tape, point your toe down about 30 degrees and run a pre-stretched strip of three-inch elastic tape from the ball of the foot to the heel, then up the Achilles to the middle of the calf. Then hold this elastic tape in place with adhesive tape applied like you’d normally tape an ankle for stability.

The idea is to immobilize the ankle so much that you can’t dorsiflex it (i.e., bring your toes toward your shin) while you pedal. This reduces strain on the Achilles tendon.