Still Troubleshooting: Back to the Achilles Tendon Injury
Updated: Jul 19, 2020
Well 9 days now without a run and the hip still has some soreness from time to time, along with the clicks/snaps when extending/walking at certain times. So continuing to troubleshoot, stretch various areas of both legs (from my hips to my feet), and exercises (the latter due based on the ones outlined in the Runner's Fix book).
Thinking about it more this morning, my mind went back to my last and still on going injury, my left Achilles tendon injury. I still wake up with it tight and sore, sore doesn't quite describe it but something along those lines. It's definitely awkward to walk on it first thing in the morning until it loosens up.
With that Achilles tightness pain/Achille tendon pain still lingering, I knew I needed to step back and research more on that specific injury that occurred while running. My working hunch is (and as I have noted before, I am by no way a PT nor medical professional), my hip is a secondary injury due to babying my Achilles and/or walking/running differently because the tendon is injured. The latter likely even occurring without my conscious thought and action.
A Bit of History
This Achilles tendon injury, in my left leg, cropped up after a specific run that I remember well back in May 2nd. It was 600+ ft of elevation gain and loss packed into 2 miles of constant hill repeat running (see the inserted Garmin Connect activity below).
Research & Action
This led to additional research, which landed me back to searching the internet and landing on the following articles:
So what did the internet say?
With limited health insurance, I found myself searching the internet for an answer, or at least a direction to point myself in that would net positive results without further injurying my Achilles tendon. That said, please seek medical attention if you're even questioning an injury. Again, I'm not a medical professional, and the running certification I'm working on recommends and flat out states to refer out for any and all injuries, as diagnosing them is not my specialty and outside my practice and expertise.
WebMD.com - What Is an Achilles Tendon Injury?: https://www.webmd.com/fitness-exercise/guide/achilles-tendon-injury#4-7
Overall comprehensive in the topics covered and definitely clinical in nature, as I would expect from WebMD.com
The following are the most relevant points that were almost comical how many applied to me, ha!
Achilles tendon injuries are common in people who do things where they quickly speed up, slow down, or pivot, such as: Running: Check!
Men over 30 are particularly prone to Achilles tendon injuries: Check!
These things also can make you more likely to have this kind of injury:
You have "flat feet," also called fallen arches. This means that when you take a step, the impact causes the arch of your foot to collapse, stretching the muscles and tendons: Check!
Your leg muscles or tendons are too tight: (Likely also a) Check!
MayoClinic.org - Achilles tendinitis: https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025
Similar to WebMD but not as extensive.
Really confirmed that rest is one of the treatments, among other recommendations. So doubly confirming that me resting my leg for my hip was also helpful to my Achille tendon pain (and likely Achille tendinitis).
RunnersConnect.net - The Ultimate Runner’s Guide to Achilles Tendon Injuries: https://runnersconnect.net/achilles-tendonitis-and-insertional-achilles-tendinopathy-in-runners/
This one really hit the nail on the head with how my Achilles is feeling.
It also gave me the point to do the eccentric heel drop stretch, and NOT actual perform the lift with the injured leg to return to the starting position. To which this stretch has already been proving beneficial with a noticeable difference in my Achilles a few days on now.
How to Treat and Prevent Running Injuries: Achilles Tendonitis: https://www.active.com/running/articles/how-to-treat-and-prevent-running-injuries-achilles-tendonitis
Honestly just skimmed this article as it was the last one I came to and read.
Where does this leave me?
The positive: The resting I've already been doing for my hip helps with the Achilles.
The negative: I should have been doing more eccentric heel drop stretch (shown below), to help the tendon more properly heal, back in May.
My Runner's Fix book does note calf raises for the Achilles, along with various stretches. Though I'll admit I haven't been doing them as of late and definitely not on a step or raised surface, in order to let heel drop below my forefoot.
Back to the above article from Runners Connect, I liked that it just outlined doing the stretch, along with the "why," and emphasized NOT to do a lift. The reasoning is that a lift, especially lifting with the injured leg in order to go back up from the stretch or repeated lifts, can further injury the tendon.
In all, I take this as a point to really go back to that injury, do the pointed stretches and exercises to get it sorted, and then move forward from there.
What happened back in May after the injury?
Looking back at my training log, I can see that after that run I switched back into my trail shoes and out of my super minimal shoes. I do also recall doing the calf lifts and stretches (outlined in the Runner's Fix) book. Though I was still running. After doing more research now, I realized I should have stopped running all together back then and just focused on healing the Achilles. However, since I didn't feel it when running with the trail shoe, it gave me a false sense of security and I broke a cardinal sin of trying to run through the injury, wrong! Ha!
Here and Now
Anyways, here I am, two bigs goals, 1) the 3 hour marathon and 2) the 35 mi birthday run, dashed by injury (toe) upon injury (Achilles) upon injury (hip). Though, you know what, I'm fine with all of that. Unfortunate for sure, though likely all my own doing in trying to ramp back up and jump back in too aggressively before really getting a solid base back under me built over time.
Again, my goals weren't built around specific races nor did I have monetary investment in them. Even then, I would hope I would have, and likely done, the right thing by taking the break, properly heal, and then reassess if such races, goals, etc. are even feasible at that point and cancel/reschedule/etc. accordingly. That's where I am now.
I think the hip was definitely my body saying, "Hey! You never fixed the Achilles! Let's give you something else to get your attention!" Ha! All very true and, yes, now I'm listening.
My wife also pointed out that, going into these goals, I am the most out of shape (relatively speaking) compared to rolling into other big goals in the past. This period goes back to my 100km attempt back in September 2019 (with the 14 mile follow-up run a week later to finish the race on my own). After that, I did shorter runs somewhat consistently, but no double digits runs until Earth Day (2020), where I did a 10 miler. I could tell with that 10 miler, which I was feeling towards the end with tired legs and hungry, that I was definitely not in the same shape as I have been in recent times. So my wife noted that I would usually have a much longer lead up to a big run, which I know and should've known better. Though I thought I could've gotten away with it on experience alone and knowing I've done a quick 2-3ish month ramp up for an ultra. Granted, in that case, I had done an ultra (75km) race earlier in the year (2017) and then a quick ramp up for my birthday run (ended up being 33 mi) in August of that same year.
Well after just doing the eccentric stretching, a couple times, yesterday, my Achilles was a lot less stiff upon waking up and walking around this morning. I definitely take that as a good sign. Still notice that something's up with it and a bit in my hip, but not as much as previous mornings and days for that matter.
Happy Running! ✌🏻😊