Common Running injuries and how to avoid them: Achilles Tendinopathy
INTRODUCTION
If you plan to start upping your mileage then you are putting yourself at greater risk of injury. What can you do to reduce your risk?
In this series of podcast episodes I am covering common running injuries and looking at ways we can prevent them before they ever become a problem.
In this episode I’m looking at an injury that is associated with increasing your training volume, Achilles Tendinopathy. Together we will explore the details of the injury, what it feels like, who is more susceptible to this injury and how we can reduce your risk of injuring your achilles tendon.
Let’s have a deeper look into Achilles Tendinopathy…
ACHILLES TENDINOPATHY
This is episode two in a series about common running injuries. This episode is in no way meant to substitute a visit to your GP or physiotherapist. I am exploring this injury in a proactive coaching way, exactly like I would if you was my client. If we can work to strengthen and improve your body then we will reduce your risk of getting this injury. If you are feeling any of the issues I mention, I recommend that you book an appointment at your local GP or physio practice.
That’s the serious bit out the way, let’s have a look at what Achilles Tendinopathy actually is then.
The achilles tendon is the strongest tendon in the body and it attaches the calf muscles to the heel bone. The job of the achilles tendon is to create plantar flexion of the foot at the ankle. This basically means that when you push your toes into the floor and lift your heels off the floor in a calf raise or when you are at the point of toe-off in running gait. The achilles tendon is creating the force for that to happen.
Achilles Tendinopathy is another classic overuse injury like Runner’s knee that we looked at in the previous episode, its a very common injury if you’re running a lot!
There are other risk factors including lack of physical activity that causes stiff tissues in the area, going from low activity levels to sudden intense movements like sprinting bounding or jumping, wearing shoes that elevate the heel (cushioned or high heels), certain medications can also weaken the tendon tissues, your body weight can also increase the load going through the achilles.
Rest and activity modification are two of the main ways to treat this issue so if you are like me and can’t bear to be injured and get extremely frustrated if you do get an injury or illness you might want to be proactive with your training and make sure you implement the following things so that you can avoid having to suffer not being able to run.
HOW YOU CAN REDUCE YOUR RISK OF ACHILLES TENDINOPATHY
As per usual, what I’m going to say sounds very familiar. Strengthening certain areas of your body to help support the achilles, staying physically active, mobilising and keeping tissues supple and listening to your body to know when you are doing too much is going to help reduce your injury risk. There are specifics relating to this injury that you can include in your weekly training plan.
The first risk factor that can influence your chances of getting this injury is your body weight. Maintaining a healthy body weight (not underweight or overweight) will reduce your risk of achilles tendinopathy, why? Well, if you’re underweight you are likely undernourishing your body and tendons become weaker when they are lacking certain nutrients to maintain structural integrity. On the flip side of that, if you are overweight you are likely to put excess strain on the tendons and this could cause inflammation from the constant aggravation. So, it’s essential to maintain a healthy body weight to reduce your risk of weakening the achilles.
Being physically active throughout the day, ensuring that you cross train to keep muscle tissues strong and healthy. Inactivity is a risk factor for tendon injuries. If you spend the majority of your time sedentary driving to and from work, working at a desk all day then you come back home and sit at the dinner table then after that sit on the couch to go to bed. Maybe a few days a week you break that cycle with a run in-between those periods of sedentary living.
Unfortunately that is reducing the loads going through your muscles and joints. This weakens them. As soon as you go out for a run with 2/3 times your body weight landing through your body each step. Your body is simply not strong enough to cope with the demands. Tendons are one of the first places to feel the stress as they attach the muscle to bone and act to move the joints. Strengthening your body to cope with greater stresses will reduce this risk. As will moving about more during the day, you are effectively training your body to stay strong at low intensity movements.
Check your footwear. Cushioned trainers generally have a heel raise. As do most day-to-day footwear unless you specifically choose a barefoot/minimalist shoe. The issue with heel raises on shoes is that if you walk about in a heel raise position all day every day this will shorten the tissues in the achilles and calf area.
Limited Dorsiflexion of the ankle joint (lifting the toes up towards the knee) because of shortened, tight tissues can cause a whole range of issues up the body starting with achilles tendon injuries. Wearing footwear without a heel raise (known as zero drop) will ensure that your achilles is not shortening over time. This will reduce your risk of injuring your achilles.
It is essential to warm up and cooldown effectively. This is very important for tendons and muscle tissue. An abrupt change in training loads, intensity or volume puts the achilles at risk of injury so it is vital that you perform a warmup, especially so in cold weather. A dynamic warmup that wakes your central nervous system up (brain/body connection) loosens the tissues by warming them up so they aren’t so stiff and cold will reduce your risk of injury. Make sure you do a simple standing calf raise exercise to start your warmup. Do this gently for 30-60 seconds. You can the increase the intensity and perform bouncing hops on the balls of your feet as if you are using a skipping rope. These are two essential warmup exercises for the achilles and calf area.
A static calf stretch with toes elevated on an object is an important cooldown stretch for your achilles and calf muscle area.
Strengthening the calf and achilles area with bent knee and straight leg calf raises using a step so that you can increase the loads going through the tissues by lowering the heel below step level is the main exercise you want to add into your weekly strength training plan. This will improve the structural integrity of the muscle tissues. Start with 3 sets of 30 seconds each set with 60 seconds rest in-between sets. Work up to increase the time to 60 seconds per set.
Bounding and skip drills are great for strengthening the springiness in the calf and achilles. If you want a specific strength training and running drill plan for you then contact me via the details in the description and we can understand what you are doing now and what we need to start including in your weekly training.
Consider reducing winter training volume and intensity if not training for a race early 2023. As mentioned earlier, there is a higher risk of achilles injury during the colder months, especially if you neglect your warmup. So, considering reducing how much you are running during these colder months in the UK. Often a good rule to have is 10-15% reduction in overall volume if your out of season. This allows your body time to rest more during the dark, cold, wintery months. You will hit the Spring in season raring to go.
Practice yoga for runners. Work on your mobility to keep tissues supple. Allowing the forces to travel through the body efficiently will reduce your injury risk. Imagine stiff, tense elastic bands as opposed to warm, supple, mobile elastic bands. Which ones are more likely to split if you pull it with force?
You can get personalised advice based on everything I’ve spoken about. As well as coaching from me online or in-person by contacting me on the details below.
SUMMARY
Maintain healthy body weight to reduce the forces going through the achilles tendon. Also not under eating as this may cause lack of nutrients.
Be physically active throughout your day and cross train to keep your muscles and joints strong.
Check your footwear. Shoes with a heel raise will shorten achilles and calf which limits mobility through the ankle.
Warmup and cooldown effectively to reduce risk of tendon injuries. Prepare your body for physical activity demands.
Strengthen with calf raises on a step to fully load the achilles and calf.
Consider reducing winter running volume.
Practice yoga to keep tissues supple.
For personalised advice on anything I’ve spoken about in this episode or 1-2-1 coaching contact me.
HOW TO CONTACT ME
ashfoster1983@gmail.com
Insta: @runbetterwithashfoster
Online: runbetterwithash.com
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I shall speak to you in the next episode my fellow runners!