Drummers are particularly susceptible to developing pain behind their ankles due to the repetitive activity occurring while playing the kick. The most common injury that can develop from playing either single or double bass drum is Achilles tendonosis.
The Achilles tendon is the large tendon at the back of the ankle that functions to connect the large calf muscles (gastrocnemius and soleus) to the heal bone (calcaneus). Contraction of these muscles provides the ability and power to push the foot down. They also provide the power during the push-off phase of the gait cycle. Whether you prefer to play heel up or heel down, the Achilles tendon is stressed. The Achilles shortens or contracts to push the foot down while playing heel up. When playing in the heel-down position, the Achilles stretches when the foot lifts off the pedal.
Symptoms of Achilles tendonosis 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 often associated with redness of the skin. You can sometimes feel a creaking sensation when you press your fingers over the tendon and move the foot.
Chronic Achilles tendonosis may often develop from acute Achilles tendonitis if the tendon injury is not treated properly or allowed to heal. 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, impossible to run or press a kick drum pedal.
Treatment for Achilles tendonosis 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 for 15 minutes at a time every two—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 helpful in the early stages. This should be a temporary measure while the Achilles tendon is healing.
Stretching and eccentric strengthening exercises for the Achilles tendon complex are very important. Physical therapy is often necessary in cases that do not respond to early treatments. For long-standing or chronic cases, newer treatment methods, including orthobiologic treatment with Platelet Rich Plasma (PRP), have been beneficial.