Monday, September 6, 2010

Achilles tendonitis - Enemy of the Weekend Warrior

Avoiding Injuries this Fall: Prevention and Treatment of Achilles Tendonitis

With Labor Day weekend now behind us, the transition from the scorching heat of summer to the cool of autumn means that going outside for a workout is more tolerable. September is a great month to start increasing your exercise activities. If our legs are going to take us longer than we’ve gone over the past several months then we also become more prone to running-related injuries. With flag football games popping up around the neighborhood, now is not the time to be laid up on the couch covered in ice packs and popping pain pills. Here are some tips to both prevent and treat one of the most common running injuries: Achilles tendonitis.

Achilles Tendonitis:

What is it?
An inflammation of the Achilles tendon (heel cord) that often presents itself as a recurring, localized, and sometimes debilitating pain on the back of the heel. Hill running and tight calf muscles make runners especially susceptible to this injury. Achilles tendonitis is thought to account for 11% of all running injuries.

How can I prevent it?
Stretch! Dynamic/active stretching (stretching that involves movement) before a run, and static stretching (holding a stretch for a certain length of time) after a run have been shown to reduce many types of running injuries. One of the simplest ways to stretch the Achilles is to find a set of steps, place the balls of your feet on the steps leaving your ankles hanging of the steps. Holding onto a railing or putting your hand on a wall as a guide, allow your weight to drop your heels below the level of the stairs, and then slowly raise yourself back up. Repeat this exercise 10 to 12 times for a complete set, and then add sets of 10 to 12 as you feel comfortable. I normally do 3 sets of these after my runs to keep my calves from getting too tight.
Another way to prevent Achilles tendonitis is simply a matter of maintaining a consistent training schedule. Weekend warriors (the runners you only see on a Saturday morning working off a week’s worth of doughnuts) are much more prone to injuries because their bodies are not used to the routine of running. Running, like any other sport, takes practice, and the people that incorporate it into their daily routine have fewer injuries.

What can I do to treat it? If you acquire Achilles tendonitis, taking a day or three of rest at first will be the most beneficial. Trying to run through the pain can turn the injury from something acute to chronic, and greatly increases your risk of rupturing your Achilles tendon (you do not want to go there!). A lift in your shoe will decrease the pull of the tendon during ambulation and an immobilizing wrap can also calm down the inflammation. Consider using over the counter non-steroidal anti inflammatory drugs (Ibuprofen, Aleve, etc.). These drugs are sometimes useful in relieving the pain/swelling associated with injury. Icing the tendon for 15 minutes 2 times per day will also help with the inflammation. Cross training on an elliptical machine, a bike, or in a swimming pool can help you maintain your current level of fitness without putting strain on the injured tendon. Many elite athletes have been able to cross train through injuries and have been able to perform exceptionally well at world-class competitions. If your injury persists for longer than a couple weeks, seeking out the advice of a podiatrist (foot and ankle doctor) is helpful. A podiatrist can offer treatments, such as ultrasound or cold laser, as well as prescribe stronger anti-inflammatory medications that might be needed to help heal your injury. Sometimes, prescription orthotics might be suggested by the podiatrist to correct any biomechanical issues that might be leading to recurring Achilles tendon injuries.

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