By Wiltsey, resident megalomaniac and fitness fanatic
How Not To Treat an Achilles Injury
Okay, sooner or later a lot of people are going to hit this problem. You’re running with your team, or on your own, and that nice large tendon in the back of your ankle starts to feel a little stiff. Maybe you’re smart and treat it right away. Maybe you’re like me and try to run through it. Sometimes this works, but as a note to all you pushers out there, it most likely wont.
Okay, so this particular training tip doesn’t really apply to skiers. You’ve got your heavy boots on, your ankle doesn’t try its full range of motion, you have less to worry about. This is more for those runners and sprinters who find this page.
You would think that if your Achilles is getting ready to sideline you, you would know it right? NOT if you don’t know what to look for. Inexperienced runners, beginners, or even seasoned runners with no previous injury experience all can misinterpret the body’s way of telling you you’re being dumb. Admittedly, athletes (including me) are reluctant to slow or stop their training for anything. Unfortunately, Achilles tendonitis isn’t a small weekend problem. It causes swelling, and places undue stress on a weakening tendon. This is a serious problem that can lead to rupture of the tendon. Even if this doesn’t happen, you will most likely give yourself a lifelong problem.
Symptoms and Causes
Achilles Tendonitis is characterized by a stiffening pain in the tendon, which can become sharp enough to impair walking. Sufferers often find that their first steps out of bed, or movement after prolonged sitting, is painful. While this pain tends to go away with movement, this is only due to the tendon stretching itself to fit your movement, and should not be considered a sign of the problem lessening.
A rather obvious sign of tendonitis is an audible creaking sound from the tendon when it moves. This is caused by the primary tendon running out of lubricant, and rubbing against its outer sheath.
Achilles tendonitis is rather obviously aggravated by activities that repeatedly stress the tendon. Leg lifts, hills, sprints and skipping merrily down the hall are all activities that should be avoided.
There are two primary causes of Achilles tendonitis. The first is over-pronation of the foot, a condition that causes the inside of the foot to have increased contact with the ground. This places an unnatural torque on the Achilles, and strains it considerably. The second is inadequate stretching of the Achilles and related muscles. An interesting fact I found at the doctors office was that the calf muscle can translate stiffness into the Achilles. Simply put, if you ain’t loose all over, you’re gonna have some problems. Other causes include a naturally tight tendon, trauma to the tendon, and having an improper shoe.
Once the causes have been identified, the problem itself is relatively easy to treat.
“You ain’t goin’ nowhere flatfoot…” -- Over-pronation can be easily fixed by adding some arch-support orthotics to your shoes. These are easily available at any properly stocked drugstore. Walking barefoot will aggravate it, so avoid this. Try to find one with additional heel cushion, as the shock from the heel strike can translate into bad things for the tendon
“Be limber”— Stretching, before a warm up, after a warm up, and after a workout is particularly important. If you only do one thing, make this it.
Without diagrams, this is especially hard to describe.
The basic idea is that when you stretch, you want to remove the calf from the stretch, so as to center the Achilles. Try any calf stretch you know, preferably standing. Now bend your knee forward, until the stretch shifts from the calf to the Achilles.
Another stretch that is useful is the wall stretch. Place your foot flush against the wall, heel on the ground, perpendicular to the floor. Lever your calf forward until a stretch is felt in the Achilles.
Simply, any stretch you can find that works will do the trick nicely. But hold the stretches for at least 30 seconds to get the full benefit.
“Bigger, Stronger, Huh?” – Okay, bear with me, for I still don’t have diagrams, so these will be even harder to describe than the stretches. I promise I’ll try to get some pictures ASAP!
Okay, first, you will need a fairly long resistance band, again, available at the drugstore. The idea of these exercises is to provide light resistance to the ankle’s range of motion.
Take the band, and depending on the exercise you do, hold it or loop it around a post. The band’s resistance should always be opposite the direction your foot moves in.
With the band around the upper area of your foot, flex your foot up towards your knee, point flex away from you, and over-pronate to each side, always with the resistance opposite the movement. Each one of these should be done for two or three sets and about 15 reps, with a short rest.
Now that I’ve thoroughly confused the poor reader, let’s do something simple. This is more a test for the tendon healing, but it has some strength building qualities.
The beginning is the same as a leg raise, with your heels hanging off the edge of a step or book. Go up on tiptoes with your weight evenly distributed over your feet. Now, shift your weight to whichever ankle has the problem, and slowly descend. Even your weight balance, and repeat. Once you can descend with no pain about ten times, consider yourself well on the way to recovery.
“Pain sucks”--This might seem obvious, but if it hurts, back off. Cut down your workout to minimal, preferably rest. Although this is anathema to most training athletes, better to miss a couple weeks than your entire season, like me.
My doctor gave me a simple rule to live by- “Let pain be your guide.” Simply, if it hurts, don’t do it and back off. A good recovery program is a must. Consult your coach, or begin with 5 minute sets of walking and every few days add thirty seconds of light jogging.
“Corpsman!”-- If it becomes serious, then consult a sports physician. I have tried my best to recreate the excellent service I received, but there is no substitute for the doctors if it doesn’t get better. Preferably, go to see a doctor at the first signs of pain to save your season. The doctor will probably tell you what I have, but with hands-on experience, a little more equipment to recover on, and a nice bill.
“Hot and Cold” -- Ice can’t hurt, and heat pads are the greatest invention. For sore muscle, use a heat pad. For the Achilles, after practice, use an ice pack for 15 minutes on, walk around some, then repeat. Ice can only help, and it will reduce inflammation and save your tendon a lot of stress. Packing an ice pack in an oven mitt works well to keep it cold.
Although a very long page here, I feel that the length was justified. Achilles tendonitis is a bad injury to take, and can give you serious problems throughout your life if not treated. Catching and treating it early on will save you a lot of time and grief. It didn’t save my season, but maybe it’ll save yours.
A short history- I first noticed a pain, and yes, that “creaking” halfway through XC running. My coach, whom I informed of this, didn’t tell me it was serious and kept me running (Coaches are notorious for glossing over injury.) Anyways, I kept on it, and pretty much put myself down for the season. What a bummer.
P.S. – A special thanks to all the excellent doctors and staff at Les Harpel’s office! Thanks Guys!
Training Tips From the um, hmm…Well, Whatever…Just Read It…
-When you practice, always give it everything you have. It will let you go a lot farther come race day.
- Stay hydrated. Water is your best friend. By the time you’re thirsty, you’re already dehydrated.
- No carbonated drinks right before workout or race. For some reason they make you breathe harder.
- Layers are key. You can always take off what you don’t need. Layer Lycra, Sporthills, whatever.
- Although carbs are great for fast energy, the night before the race, take in enough protein to give yourself a solid base for the next day. You will need it. And avoid junk food- this will slow you down mentally and physically.
- Duct tape is a good wind protector. Put it over your earmuffs or your pants. This cuts down on the windchill to sensitive regions of the body.
- Always do aerobic work before weights. Also, your muscles tear when you lift weights, so a day recovery will make you stronger. Do upper body even days, lower body odd days.
- High reps, low weight for slow twitch muscle. Useful for skiers and runners. Heavy weights are good for fast-twitch muscle and sprinters.
- Ice can’t hurt you, unless you get hit by an icicle. Rephrase for Nat- icing a sore tendon or muscle cant hurt.
-If you start hurting, back off. Go at your own pace, but don’t shirk your workout.
- On cold days, drink cold drinks. They force your body temperature to rise to negate the cold of the drink. This is only a temporary solution though.