Last Updated on July 10, 2014 by Amir Rehman
This is part 1 of a multi part series on Achilles tendon injuries. Lyle McDonald would understand the multi-part format, heh heh.
I will look into all the aspects of the injury cycle, the how’s and why’s, pros and cons of each phase.
Those who know me know I’ve been suffering from Achilles tendonitis for years now. I’ve tried them all except one last solution which I am currently experimenting with (you’ll see them in upcoming YouTube videos).
But first, let’s look at a typical training and injury cycle:
- You are healthy and start training
- You body is not balanced and possibly overcompensate other parts if the body
- You are tired or doing too much volume (i.e. too much, too fast , too soon syndrome)
- You get injured. This is bad.
- You do rehab to stop the pain and swelling. You ice, take drugs (NSAIDs), stretch, do physio, low level laser and all that jazz
- You decrease your training (or simply do nothing, for days, weeks, months?)
- You get better and start training again
Do you see a pattern here?
I see a vicious cycle, so unless you attack the ROOT CAUSE of the problem, you will always go in circles.
To make a silly analogy:
You see a puddle of water on the kitchen floor. You can mop up the floor from the leak, or fix the pipes that causes the leak. (or do both)
Once you get better, if you continuously do the same thing (i.e. mopping up the floor), it will re-appear again. Then the vicious cycle starts all over again.
Thus you have to find and address the root cause of the problem.
If you hurt your Achilles, 2 things can happen. The most common Achilles tendon injuries are (1) Achilles tendinosis or Achilles tendinopathy (formerly called Achilles tendonitis) and (2) Achilles tendon rupture.
Achilles tendon ruptures or tears, can be full ruptures or partial ruptures, and that is very bad news. Unless you have the multi-million dollar medical support staff like Donovan Bailey, I doubt a full recovery.
If you suffer from Achilles tendinosis or tendonitis, how severe is it? Where are you at?
I’ll break it down to 4 stages.
The 4 Stages
- No pain during exercise, but there is some discomfort or stiffness in the morning getting out of bed in the morning.
- Pain or discomfort during exercise or running, but performance is not affected. The stiffness when first getting out of bed continues to disappear shortly afterward. You may feeling stiff before workout, but as you warm up, the pain goes away. Pinching the Achilles tendon with the forefinger and thumb is slightly painful, but tolerable.
- Pain during exercise or running that is detrimental to performance. Doing tempo on the grass still hurts your Achilles, so instead you modify a heel-toe running style like a distance runner.
- Hurts way too much to walk or run. Pinching the Achilles tendon with the forefinger and thumb is totally excruciating. Everywhere you go, you hobble.
To be continued…
Please keep this up, I am very interested and thinking of making a trip to NC where Mike Young is training a friend of mine Jade Ellis who is coming back from a horrible achillies injury and he had a process done im looking into as well. I have a PR of 7.75m in the long jump with a 7.96w that kept me out of the 2004 trials. This injury has kept me out of alot of competions the last 2 years and im trying to get my body in great shape to compete this year.
@Anthony – Mike Y is a knowlegable guy, so he should be able to help. Those are damn good credentials for LJ. Some more strength & power, consistency at meets, being injury free, and a bit more top speed on the runway and you are looking at 8.40 – 8.50.
I am coming up on my 1-year anniversary of ATR (surgery on 07/30/2010). I ruptured completely at the 2010 USATF Masters Nationals in the M40 100M. I know “the cycle” well. Due to the frustration caused by this cycle, my rupture was an unexpected relief as I was forced to “fix the pipes that causes the leak…”
I have had 11 races since May 2011 and my repaired achilles is fine. Much can be accomplished with PATIENCE and hard work. That said, I do need to focus on my fitness and speed.
I look forward to the upcoming parts of this article.
@buzooti, wow, one year and you are back. You are brave. But you hit it on the haed.. patience and lot of physio and rehab. Hyperbaric chambers help, too, if you have access to it.
Hi Buzooti!
My name is Alison Wood. I am a masters athlete and I am dealing with an AT issue. Is there any way that I can email you directly? I have some pretty big goals for this season and I need advice from someone who has been there.
Thanks!
-Alison
Achilles injuries affect a great number of master athletes. We currently have 4 out of our 10 most consistent runners with problems. I am 42 and have been suffering with reoccurring Achilles injuries for over 7 years missing many major titles in Australia because of them. Your 4 stage description pretty much sums up were I was at our National Titles in April this year having to pull out of the 200m final after finishing second in the 60m (7.48) and 100m (11.8). I’m a 400m runner so my times were pretty good for me.
I am back on the track and starting to run pretty well again with the least amount of pain that I can recall. The pinch test is virtually pain free with no pain in the morning. What I did after the Nats to improve my Achilles.
5 weeks of no running with daily routine of progressive eccentric calf loading. This got me to a point to get back on the track however I still had some pain and soreness in the morning after training.
Started nerve stretching about 4 weeks ago. Gentle nerve stretching 3 times per day has allowed me to get back to 3 track sessions per week pretty much pain free. (a little calf tightness only)
I have been abel to complete some pretty tough session. last week 5x 200m in 30sec with 2minutes rest between each. smashed :)
Rod C.,
I also have had good results with the progressive eccentric calf loading. That said, I believe the rest (with no running) is critical.
Pardon my ignorance, what is nerve stretching?
for a sneak peak of the upcoming rehab/physio exercises, I uploaded them onto my YouTube Channel.
http://www.youtube.com/user/speedendurance
Do Part 1 (the heel drop) first, then Part 2 (eccentric squat and reach). I’ll be posting the details in upcoming articles.
buzooti,
Yes I believe the eccentric calf loading to be critical even when resting from running.
As for the nerve stretching most physio’s will perform it using the slump position however for my Achilles I prefer to do it sitting on the floor. Basically, its a seated one leg hamstring stretch but with the knee slightly bent to take the stretch out of the hamstring and placing it more in the calf. Gently pulling the toes back holding for a count of 15 to 20sec then releasing. I do 3-4 each side 2-3 times per day.
The key for me is to get the stretch in the calf and not the hamstring.
Great site Jimson
Does it hurt doing eccentric? I feel pain in my Achilles while performing them. I’m not sure whether to continue.