Some Contributing Factors: Tight hamstrings, sudden increase in mileage or training, tight calf muscles, training on steep hills, runners who overpronate (their feet rotate too far inward on impact), inflexible running shoes (soles that are too stiff, will make the achilles work harder), Excessive heel cushioning (after heel contact-the heel continues to sink lower while the shoe is absorbing the shock; at this time your leg and body are moving forward over your foot which in turn stretches your achilles tendon more than it should.

Treatment: You must stop running and ice the area for 10-15 minutes several times a day until the inflammation calms down. Aspirin or Ibuprofen can help. Once the inflammation has subsided, start running slow with no hills or speedwork!! Stretch easy (absolutely no over stretching). The Wall Stretch is very effective and won’t overstretch the already tender achilles tendon. Ice down 10-15 minutes after you run. Replace running shoes if heel is worn. Do not wear shoes that have too much heel shock absorption. Shoe must be somewhat flexible where the ball of the foot is.

Preventive Measures: The wall stretch is probably the most effective stretch which won’t aggravate the achilles tendon. A small heel lift should take pressure of the achilles. Orthotics can also help.

Effective Physical Therapy: Ultrasound & electro stimulation. Laser treatment is new but more effect than ultrasound & electro stimulation.

Chondromalacia-This is Patellofemoral Pain Syndrome or commonly known as “Runners Knee” which is a wearing away or softening of the cartilage in the kneecap. The cartilage starts to wear away because the knee cap is not correctly tracking in it’s groove which creates a misalignment in the knee. As the problem worsens over time, the cartilage can have a cracking sensation which will cause pain and swelling.
Symptoms: Pain in and around the kneecap. Pain usually occurs after sitting for awhile with your knees bent. Pain will occur when walking downstairs or running down hill. In some severe cases, when the knee is flexed, a crackling sound will result when worn out cartilage rubs against cartilage in the knee.
Causes: Weak quadricep muscles. Tight hamstrings,tight calf muscles and overpronation. Down hill running,overtraining and muscles imbalance between the Vastus Medialus and the Vastus Lateralus. When one of these muscles are much stronger or weaker than the other, this will put excessive stress on the Patella.
Self Traetment: You nust stop running & turn to swimming if possible (non-impact) to stay in shape while your knee heals. Aspirin a couple of times a day for 10-15 minutes, or a bag of frozen peas will do the trick.
Preventive Treatment- Strengthening your quadtriceps hanstrings and calves. When you reach 300-400 miles on your shoes, it’s time to get rid of them. Avoid overtrainingand have 1-2 days off per weak. If you overpronate consider orthotics or shoes that help this problem. Don’t run on cambered roads or or indoor tracks with bank turns which may be impossible to avoid, but don’t train on them. No down hill running or “if you can’t avoid them”, go slow down hill.
Alternative Treatment-If your knee isn’t responding to self traetment measures you might need physical therapy. Ultrasound is very effective in treating this. Another effective treatment is Laser therapy. This is a newer treatment which a laser light penetrates into the injuried area to heal it faster on some patients.
Medical Treatment- You may need to see a Podiatrist for custom made orthotics which will help control overpronation and leg-length discrepancy. As a last resort if all treatment options are exhausted you may need a sports orthopedic. Surgery is somewhat successful when scraping away any rough edges of cartilage which will decrease some of the pain.