Who knew that an injury could be such a pain? Pun intended. I’ve been running for most of my adult life and never had an injury that kept me from running…until now. 

My Achilles tendon has been bugging me (and by bugging I mean shooting sharp pain) for a little over  3 weeks now and has put a major crimp in my marathon training. I’ve had a little plantar fasciitis (posterior heel pain) for a few months, but nothing that kept me from training…hard. Maybe that’s my first mistake. Who knows.

There is so much conflicting information on how to treat Achilles tendonitis but I have found a couple of articles that make sense to me.

***Remember…the  information I provide is solely my opinion and passed along from what I think are credible sources. While I am a registered emergency nurse, I am not a medical doctor, physical therapist or coach. Proceed at your own risk. *** 🙂

As an RN I have been advising patients for years who have acute injuries to rest, ice, compress and elevate (RICE), just like Dr Mirkin originally recommended. Come to find out that might not be the best treatment for a speedy recovery. And we all want a speedy recovery! For his article on why that may not be the best advise go here.  

The gist of the article says that while ice may help with immediate swelling, ultimately it can delay healing because it decreases blood flow to the area which is needed for healing. My general advise for patients is to use ice for 10 or 15 minutes x 3 the first 24 hours for acute injuries. For general aches and pains, like chronic back or neck pain I recommend ice for 10 to 15 minutes to decrease swelling and numb the area, then follow with heat for 10 to 15 minutes to increase blood flow to the area for healing (and it just feels good). That’s my spiel.

Turns out I’m not completely wrong but treatment for Achilles tendonitis is it’s own beast because it has very little blood flow to begin with.

Achilles Tendon

I will spare you the detailed anatomy lesson but the long and short of it is the Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel. 

 “Achilles tendonitis… typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes.” ∼ John Davis

I pretty much did all those things. 🙁

Go here to read the complete article about treating Achilles tendonitis written by John Davis in Runner’s Connect. I haven’t checked his credentials but what he says makes a lot of sense to me. You decide.

Bottom line…

 Causes:

• Weak calf muscles.
• Speed training—guilty–How do you train for a BQ without it?
• Uphill running—guilty 
• Forefoot striking style of running–I land flat footed.

Treatment:

• Eccentric heel drop exercises.  Go to Runner’s Connect for how to do these.
• Ice after each run (for immediate swelling).
• Heat to calf before each run.
• Contrast bath during the day – take two small buckets/trash cans and fill one with hot (hot bath temp) water and the other with ice water (cold enough so some ice still doesn’t melt) and put your whole leg (up to the calf) in the cold. Hold for 5 minutes and then switch to the hot for 5 minutes. Repeat 2 or 3 times, ending with cold. This helps rush blood in and out of the area, which facilitates healing. (copied directly from Runner’s Connect)
• No anti-inflammatories. Delays the body’s natural healing process.
• No excessive stretches. Stretching can cause extra stress on the tendon. 
• Foam roll calf. 
• Heel inserts and/or new shoes with a higher heels.
• Ankle strengthening exercises.

I didn’t read much about rest except that if you have pain then don’t run until it feels better…well I think that is a given. Although I’m sure there are some hard core runners that believe you should run through the pain. I’m not that hard core. 😉 It does seem to be recommended though, to keep moving, if even just a little. I find that on the days that I work I don’t have Achilles pain. I contribute that to wearing my clogs and the support they provide as opposed to my off days when I wear flip flops. To counter my lack of running I have been doing things to stay strong…squats, calf raises, lunges, planks and weights.  I’m hoping for the best.

Have you had a nagging injury that sidelined your training?

Has your Achilles ever given you trouble?

Does what I’ve researched make sense to you too or do you firmly believe in ice and Ibuprofen? 

Let me know your thoughts.

Thanks for reading!                                         

Keep running my friends!

               Denise