Is your Achilles your Achilles?

Achilles Tendinopa­thy is one of the most com­mon run­ning ail­ments. If not treated prop­erly, it can be­come a ma­jor, longterm prob­lem. Here’s how to deal with a cranky Achilles

Canadian Running - - THE FIX - By Brittany Mo­ran

The Achilles role is to act as a shock ab­sorber and for en­ergy stor­age and trans­fer, both com­po­nents that are vi­tal to run­ning. It’s like a spring that helps us move for­ward, with­out it we would not be up on two feet. It’s also some­thing that has a ten­dency to get in­jured.

Time and time again we have been told if some­thing hurts or is tight to stretch it. But with ten­dons this isn’t what you want to do. When it comes to the anatomy of ten­dons, stretch­ing can cause more com­pres­sion given the way they wrap around the boney in­ser­tion. Specif­i­cally, with the Achilles, it wraps un­der the heel bone so tak­ing the heel to end range dor­sif lex­ion ( bring­ing toes up) you are actually com­press­ing the in­jured part of the ten­don.

The pre­cur­sor to the Achilles get­ting in­jured is rel­a­tive overload, which de­creases the ten­don’s ca­pac­ity to adapt to a load. Re­mem­ber the load can be in­creased dis­tance but also in­creased in­ten­sity. It’s the clas­sic “too much, too soon” is­sue. This be­comes a neg­a­tive feed­back cycle when it comes to dis­tance run­ning. Ten­dons take longer to re­spond to load and often get in­jured when an ath­lete is com­ing back from an un­re­lated in­jury.

The goal from a re­ha­bil­i­ta­tion per­spec­tive is to in­crease the ca­pac­ity of the ten­don.

There are three stages of re­ha­bil­i­ta­tion for your banged up ten­don: the first step is get­ting back ba­sic mus­cle and ten­don func­tion; then, you’ ll want to fo­cus on power in your lower limb ki­netic chain; and lastly, sport­spe­cific func­tion. Re­mem­ber, with the last step, if you are plan­ning to run a marathon, ex­er­cises should not be more than a 2–3/10 rat­ing on the pain scale, and should not cause in­creased pain the next day. If it does, you have to go back a step.

Along with the spe­cific Achilles fo­cused ex­er­cises it is also im­por­tant to make sure you are mov­ing well biome­chan­i­cally up the ki­netic chain. It is rec­om­mended to keep ex­er­cises iso­met­ric, mean­ing that you are keep­ing the joint in a neu­tral po­si­tion as you con­tract the mus­cle – this has been shown to de­crease pain. You want these ex­er­cises to be heavy and sin­gle leg. And I will stress it again: do not stretch the in­jured ten­don. You will get tem­po­rary re­lief with this but it is not help­ing to heal the in­jury long term. The Achilles can often be­come a chronic is­sue that will f lare up ev­ery so often. You can try to avoid this by be­ing thought­ful with your in­creases in load (dis­tance and in­ten­sity of your run­ning and any other sports you might do). But if it does f lare up you have to go back to stage one in the re­ha­bil­i­ta­tion process. Dr. Brittany Mo­ran is a chi­ro­prac­tor and ac­com­plished run­ner based at the Run­ner’s Academy in Toronto. Check out her strength and con­di­tion­ing video se­ries on our In­sta­gram feed.

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