Drummers are susceptible to developing pain behind their ankles due to the repetitive activity occurring while playing the kick drum or drums. The most common injury that can develop from playing either single or double bass drum is Achilles tendonitis. The Achilles tendon is the large tendon at the back of the ankle that connects the large calf muscles (Gastrocnemius and Soleus) to the heal bone (calcaneus), providing the power in the push off phase of the gait cycle. Whether you play heel up or heel down, the Achilles tendon is active and/or stretched. The Achilles tendon shortens or contracts to push the foot down while playing heel up. The Achilles tendon stretches when the foot lifts off the pedal in the heel down position.
The Achilles tendon can become inflamed most commonly from overuse as well as a number of other contributory factors. The Achilles tendon has a poor blood supply, which is why it is so vulnerable to injury and slow to heal. Achilles tendonitis can be acute or chronic. Acute Achilles tendonitis may be the result of overuse, practicing or training too much, too soon. Over pronation of the feet can also place an increased strain on the Achilles tendon. As the foot rolls in and flattens, the lower leg rotates inwards which twists the Achilles tendon, applying tortional stresses as well as stresses along its length.
Symptoms of Achilles tendonitis are pain in the tendon during activity or exercise. Achilles pain will gradually develop with prolonged exercise but will go away with rest. Swelling over the Achilles tendon is a common finding and may be associated with redness over the skin. You can sometimes feel a creaking when you press your fingers into the tendon and move the foot.
Chronic Achilles tendonitis may often develop from acute Achilles tendonitis if the acute tendon injury is not treated properly or allowed to heal. Chronic Achilles tendonitis is a difficult condition to treat, particularly in older individuals. The pains experienced during the acute phase of the injury tend to disappear after a warm up but return when activity has stopped. Eventually the injury and pain become so severe that it is difficult to walk and impossible to run.
Treatment for Achilles tendonitis can be difficult. Rest from the activity causing the injury is the first line of treatment for Achilles pain. The application of cold therapy or ice (not directly onto the skin) for fifteen minutes at a time every 2 to three hours can be extremely helpful. Wearing a felt heel pad to raise the heel and take some of the strain off the Achilles tendon is also very helpful in the early stages of Achilles tendonitis. This should be a temporary measure while the Achilles tendon is healing. Stretching exercises for the Achilles tendon complex are very important. Physical therapy is utilized in those cases that do not respond to early treatments. The judicial use of non-steroidal anti-inflammatory medications can also be beneficial.
The goal of early treatment is to limit the duration of the acute stages of Achilles tendonitis and to prevent Achilles tendon rupture from occurring.