Say No To Achilles Heel
In Greek mythology, there was a great warrior named Achilles, hero of Trojan war. Go see the movie Troy. When he was an infant, his mother dipped him in holy water holding his ankle, to make him immortal. He was killed when an arrow passed through behind the heel. Because of which the back part of heel, which connects the ankle to the calf muscle is known as Achilles Heel. An injury to that region is known as Achilles tendinosis or tendonitis(AT).
This is a very painful and restricting injury. I had it, I guess, 8 years back and when I think about it, it feels like yesterday. Bad days are always so fresh in the memories, isn’t it? I still remember that this injury struck me before I was proceeding on an army course which required a lot and lot of endurance running. I almost tried everything to heal it and before boarding the train to the place of training, I wasn’t even able to wear shoes. It healed up there while on training on its own but it struck me again after a few years. Then I decided to read up on it to avoid it completely. It’s now over 6 years it hasn’t recurred.
Why it strikes?
Now Achilles is the tendon which connects the calf muscles to the back of heel bone. When there is increase in load and stress than usual, it causes the tendon to work hard. Eventually leading to its inflammation and inflexibility of ankle. In extreme cases, it can get ruptured or torn.
There are a number of reasons as to why runners suffer from this problem. They are-
1. Doing too much too soon or overtraining.
2. Increasing hill runs or repeats.
3. Tight or fatigued calf muscles.
4. Overpronation which causes the Achilles to work harder than normal.
5. Inflexible shoes or wearing a shoe with too soft a heel.
6. Running on soft surfaces like sand or on a beach.
7. Tight hip flexors or glutes in some cases.
Achilles tendon issue are quite slow as there is low blood supply. However, don’t be disheartened. Do you know that the legendary Haile Gebrselassie has undergone two achilles tendon surgery and set his world record after it?
How to prevent it?
The injury is very easy to diagnose. If you have injured the Achilles, then pinching the tendon with your thumb and index finger is going to make you jump with pain. Also it will cause discomfort in normal walking on the affected side. However, after diagnosing, it will be easier to treat before further aggravation i.e rupture.
The first step towards its treatment is to stop running immediately atleast for a period of 1-3 weeks. Thereafter, rest of the techniques follow.
1. RICE without the C
First and foremost step in rehabilitation is to stop running and applying ice pack to the tendon region 3-4 times a day for 10-15 minutes to reduce inflammation. Also elevating the affected leg above heart level will help faster recovery.
Next in order is stretching the calf muscles as often as possible throughout the day. Simple leaning on the wall with hand support, stretch the calves several times a day will keep the tendon flexible. Then start doing heel raises to strengthen the calves. But if the Achilles pains don’t push it too much or don’t go all the way during heel raises.
3. 10% rule
Sudden increase in mileage causes undue stress in this connective tendon posing possibilities to a host of injuries. It is always a good idea to gradually allow the body to adapt to the training load. Use the 10% rule of increasing weekly mileage. Also, be wary of returning to heavy training after a prolonged break.
4. Hill work
This second factor in training is also a leading cause in occurrence of this injury. Hill work or repeats, even for that matter track repeats, puts lot of stress on the calves and Achilles tendon, especially if you are running on your toes. Be sensible in introducing track or hill workouts. If you are already struck with the injury, best is to avoid it.
If I were you, I will change the shoes immediately after the first symptom. It may be because of highly cushioned heel or inflexible sole causing overpronation.
6. Orthotics and heel pad
I have tried heel pad with great success. Heel pad raises the heel causing the calf muscle to shorten and enhance recovery. Also, if you are an overpronator, orthotics can limit the pronation of your foot by giving support. However, I will, after recovery from the injury, stay away from orthotics and gain natural foot strength to fight this kind of an injury.
7. Trigger point therapy
I have used trigger point therapy to good use when I was treating my PF case. The same technique can be applies to treating this injury as well. Idea is to focus on finding tight spots in the calf muscles and gentle digging them with fingers to release the tension. It has direct impact on the rehab of your Achilles tendon. See this video by Sock Doc to understand it better.
You can do some activities like gentle cycling, pool running, swimming, upper body strengthening during the lay off. Injuries are part and parcel of a runners life. You can’t ignore them but can prevent them if you are sensible and knowledgeable.
Till then stay fit and keep running.
How have you treated your Achilles problem?
What do you think caused your injury?
Did you do any cross training then?