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Achilles tendinitis - progress...
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What it says in the thread title.
I started running after a mere 22 year break in Feb this year and was soon ticking off races - 5 miles, 10K, and by August, a half marathon, which I ran in 1:56
At one stage, with advice from this forum, I realised I was doing too many hard training sessions, and cut right back to a long run, a tempo run and intervals - just 3 sessions a week, down from 5.
The HM was fine, and I took a week's rest before doing anything again. That anything was a humble park-run. Shortly after hte start, I felt my shoes slipping badly on a tarmac track - they're trail shoes and have no girp on wet tarmac. Some slips later, I felt a pain in my achilles tendon - AND SHOULD HAVE STOPPED RIGHT THERE...
but I carried on an finished in my slowest time of the year.
This was early August. The tendinitis was so bad that I was limping even when just walking very slowly, forcing me to cycle nearly everywhere. Early December and I am only just back to walking with no limp or soreness.
So, lessons learned:
1) Nearly 25 years is a long time! Don't let past performances influence training approaches even one jot after a come-back like this! (I easily ran 6 minute miles back then, even at the end of a triathlon.) Let those connective tissues adjust to training volume by just giving it time, even if your cardio-vascular system adjusts rapidly to training.
2) Don't change your shoes from neutrals to supportive a week before a half-marathon and expect to get away with it. If you're training in neutrals and managing fine, race in them, too.
3) Be aware that the stiff design of some heels can directly press on the tendon,, causing problems
4) Watch out for shoes with poor traction, as slipping about during a race is a way to get injured fast.
As I say, the tendon is much calmer now and walking is fine, but it's still stiff first thing in the morning. I think I'm now ready to head very carefully to the gym to do some eccentric calf exercises to see how that feels, and maybe do a very slow test run of just 500m to see if that brings back any pain on touching the tendon afterwards. It really is better to avoid getting this injury in the first place as it's going to take time to fully heal.
Have fun out there.
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Comments
Thanks for some sound advice. I hope your rehab is swift and effective and you are back running asap.
Paco, thanks for the feedback and good wishes, much appreciated.
I wish you a speedy recovery!
Thanks for the good wishes, Timea. Sounds like you have a story to tell, too? Care to share it?
Hope it ended well....
Quick update - I'm aware that there are constant posts on this subject, so hoping this may be of use to someone in a similar position.
After a complete break from mid-August, I went to the gym today since this offers various possibilities for rehabilitation.
Previously, I had done absolutely no running since my injury and had been walking pain-free for 4 weeks.
I did a five minute warm-up on the treadmil at fast walking pace (6.5 km/hr), then 10 calf raises on the squat machine with a light weight (30kg).
I also did a short 'farmer's walk' (holding a 16kg weight in each hand with extended arms pointing downwards and walking around the gym).
Finally, I ran a km at a gentle 10km/hr before walming down with a slow 5Km/hr walk,
No pain either during or after the session.
I was wondering if anyone with experience in this area could tell me whether it's distance that should go up gradually or speed?
Cheers and good luck to anyone who's battling with achilles tendon rehab. Believe me, the complete rest approach is wothwhile if the tendon is very inflamed.
Its the distance that goes up first. Even if you have to take walk breaks initially to get there.
ONce your body is comfortable with the distance you can introduce more paced workouts or intevals.
Thanks Fizziofinn!
Quick progress update for othes with AT history
I've now run two 5km time trials at a distance of 4 weeks apart and have taken 20 seconds a mile off without any problems. I noted this morning (following time-trial yesterday) that I had absolutely no soreness in the achilles tendon on waking up and walking around. This is interesting, because mornings following no running mean a slightly sore AT on waking.
My warm-up, however, is very slow and progressive and includes fast walking, walk runs, slow running and running at pace, along with a lot of dynamic stretching. Also I do a very extended cool-down - same deal - fast walking, walk-running, jogging.
I have now run a maz of 4 miles in one go, and am upping this distance conservatively. Next week I will run 5 miles at tempo pace for the first time since starting over again. In the background, I am doing some very focussed core stability work and continuing with running-specific strength training.
Sounds like you're getting there, qfs. You'll have to resist any form of speedwork, and especially downhills, for the time being. I'd even go carefully with a tempo session. I built up the distance steadily over a few months and never went at anything like my normal pace for the entire 15 months of my injury.
Been symptom free since Feb 2 and loving the sensation. Rather unfit after all this time but I'm hoping to get back to somewhere where I was as 2012 progresses.
Keep stretching that achilles out at every opportunity.
Hey TRex, great to hear you're making gradual but good progress. I think deep tissue massage would be great but for various reasons, it's not possible for me to organise that at the moment.
On the other hand, I do stretch both ATs as often as I can, including doing eccentric calf raises as part of my warm up (once I've done a more general warm-up) and also on completion of a session. I
Keep your calf muscles stretched, not your TA - that's where the issue has been, so why over stretch an over stretch injury? And make sure eccentric calf raises are calf drops.....going up in concentric, and maybe the route of all evil.
Keep going
Hi Six, thanks. I think I know what you mean, but not sure! When I dynamically stretch, it's the whole of the calf, as you advise. Im also strengthening the whole triceps saurae (a few weeks ago I didnt know what this meant, but I saw a great illustration in an anatomy for sport book!) To do this I am using the quad machine on v low reps with a heavy resistance.
Do you mean not to go up in the calf stretches, but just the down bit?
Hi QFS
TA injuries are overuse injuries - as the TA breaks down and stretches, the calf get relatively tighter. You need to restore length in your calf and not to the TA. This is the tricky, and why they can take an extraordinary time to get better.
When you're stretching make sure you only feel it in your calf, not TA. Make sure you're stretching with great form (toes, feet and hips forward and in a line); and don't confuse a stiff ankle joint (which will give you a TA problem) mimicking a tight calf - knee to wall test, left versus right side.
Eccentric loading (a la lots research for t'osis) is controlling a muscle action against gravity. ie making a muscle act as a brake, rather than a motor. Soooooo, eccentrically loading your calf is going up on tie toes on your good leg only, transfering all your weight over to your affected side (on tie toe, but without any load being put upon it whilst going up) and then lowering down on the affected side. This is eccentric loading.
Hope this rings true/makes sense!
Do you ever put heat pads on the tendon?
Hi Six,
Thanks for the detailed post. That all makes so very much appreciated. And you know, I do remember getting tightness in the calf on that side well before anything happened to the AT.
jammy, no heatpads, but the acute phase is well over. I'm at the stage when I only sometimes have soreness in the morning - usually only mornings when I have not run the day before.
This is partly explained that when I run, I now do a massive progressive warm up, dynamic stretches, warm down and passive stretches- all of which takes a lot longer than the little runs Im doing right now.