Monday, April 9, 2012

State of the Union (between my achilles and heel)

Running injuries are a balance between running and recovery. This is as true for returning from injury as it is for creating injury. Old school injury management was RICE - rest, ice, compression, elevation, and of course vitamin I. Lots of anecdote and some real data suggest that tendon/ligament injuries recover faster with continued running, to encourage proper blood flow and inflammation, and of course, no vitamin I (again, inflammation promotes repair). Given all the panic stories about achilles tendonosis, I followed the old school management school for the past 4 weeks, sort of. I continued to train, but on roller skis.

I've decided to transition back into running, for no other reason than I want to. I did a 3 x 2/3 mi jog yesterday with 1/3 mi walk breaks. Pain was 0/10. Pain last night was 0/10. Pain this morning was 0/10. This afternoon, I was going to do something similar but a 2/10 achilles pain began within about 1/4 mile. I then decided that walking would be fruitless. So I decided to run 1 loop of back cove, easy, but without walk breaks. After maybe 1.5 miles, the pain settled down to maybe 1/10. There were hints of it disappearing all together, but these were short lived.

Now its 3 hours later and I have 1-2/10 pain simply walking around. Do I go back to old school and not run, or do I have faith in the new school and run (ez) through it? With the exception of my metatarsal stress fracture, I've largely run through my injuries, with at most a few days off. This includes multiple bouts of minor plantar fascitis, calf strain, achilles weirdness, posterior tibial tendonosis, "piriformis syndrome" (both sides but at different times), and osteitis pubis. But these running injuries didn't really hurt while running although the OP hurt to cough or sneeze and the piriformis hurts to sit. Running through the injuries has taken a variable amount of time. The OP took 2 whole seasons. The left piriformis too 2 whole seasons (that is, the injury lasted through ski season despite effectively not running for 2-3 months).

I can't say I'm very optimistic about my achilles. First, it's a weird location. While running, it feels like plantar fascitis, but I'm fairly convinced its insertional achilles tendonosis/itis, that is where the achilles joins the heel bone. I don't look forward to running with this all season, or simply dealing with it walking around. But, I'm an experiment of one and I'm impatient to run. So inflame on!


  1. Are you massaging your calves and/or hamstrings in any capacity? I'm wondering if some time on the foam roller might help, if you're not doing it already.

  2. I'm doing daily heel drops modified for insertional achilles and the occasional roll of the lacrosse ball with my foot (on the plantar fascia) - that's it. Maybe I'll roll my calf with the ball too.

  3. I have found in the past....(had this injury a few times) that running moderately (shoes with raised heels...not inov-8) speed work at all and then icing immediately after combined with stretching and wearing an archilles stretch boot while sleeping worked the a combination of old and new school. I have been told the problem is that sheathing around the tendon swells and that restricts the tendon movement. The danger when running through this injury is ripping the tendon totally off....

  4. Thanks Kevin. So far my 2 runs in Nike Frees (11 mm drop?) have been largely painless but my run in the inov8s (3-6 mm drop?) yesterday was more sore. BUT both runs in Nike Frees were followed by 1/2 mile barefoot (0 mm drop) which was also painless. I'm stumped...but pressing on!

  5. Sounds like you're trying, and doing everything you can. I'm still glad you can run after the heart scare!