This injury is Achilles Tendinitis as well as Bursitis in the Achilles area.
The sad truth about if you get it, it can last a few weeks (If you can catch it early and get off your foot.) To several months and believe it or not quite a few runners deal with this for 2-3 years. Many runners, can't deal with the recovery and even give up running because of it.The good news is, for the most part you can take many precautions to prevent this from ever happening to you!
So these are what I call Kristy's tips on avoiding Achilles tendon issues and tips on what to do if you think you may have it. Note, these are just my tips, you should see a doctor or trust a doctors advice if you have any injuries or pains you are worried about.
Tip #1 - More than likely the injury won't happen while your running! It will most likely happen while you are walking down the street, stepping off a curve or pushing or lifting something heavy when the calf is stretched.
Tip #2 - If you have high arches, or even medium arches. Especially if you are a distance runner avoid wearing flat shoes, flip flops, low drop and flats when you are not running.
Tip #3 - Low Drop A.K.A Minimal shoes, Natural Shoes and Barefoot Running Shoes - Don't use them! I know they are becoming increasingly popular with runners, but runners injuries are also on the rise.
The shoes may work for flat foot runners or people who have difficulties with other shoes and a foot doctor may recommend them for some with problems with regular shoes (which is fine).
But unless your doctor recommends you switch and you are having issues running with regular types of running shoes DON'T make the switch just for the heck of it!!! Doing so can increase your risk of tendon injury, but there are also several other injuries runners get with wearing the wrong shoes for them.
I can't tell you how many runners who have told me this is how their started, including myself who had issue because of these type of shoes. (FYI mine was from walking around in a minimal shoe at work.)
Tip #4 - If you feel any pain in the Achilles area (even slight) that doesn't go away after a short time, that may be the start. Start R.I.C.E methods and don't run on it or walk on it much until the pain goes away. Catch it early you may only be out a week or so if it didn't pull bad. Not doing this, you could end up like me 9 months with little to no running or years like others I have spoken to.
I'd also like to add to this, it starts so gradual at times and a lot of this has to do with paying attention to your body, know what "good pains" and "bad pains" are so you can help correct issues before they start!
Tip #5 - If you don't see a noticeable recovery after 1 week, make sure you see a doctor!
Tip #6 - Walking or gradually warming up before you run will help. Additionally building up strong calves using toe raiser exercises can help prevent it. The standing leg stretch is also a great way to keep this tendon loose. However, there are many other stretches and foam rollers that can help too.
Tip #7 - If you your Achilles is bothering you. You can buy a brace at a local store that will be supportive and help apply compression to the area - A doctor may later put you into a walking boot.
Tip #8 - Cross training, this will help you in a lot of ways. This can help strengthen your legs/caves and ankles in ways that running and stretching alone will not and can be a great preventative measure!
Tip #9 - Most important of all, if you need to visit a doctor, ONLY visit one who is a runner or who works with runners! Doctors who are runners get us, they understand us and they know the best recovery programs for us to help keep us lifelong runners. Non-running doctors, you risk getting told "to find a new sport." There are plenty of them out there, if you don't know of one, just ask a local running store, or ask other runners in the area. Most experienced runners have a short list of running doctors to visit, and they'll gladly share! (Well at least I would if asked:)
Tip #10 - Be smart!
I may not have made all of the mistakes listed above, but I did make a few!
Sometimes life happens, and injuries are a part of life. But when you get them, they are not fun and really the best thing you can get out of them is what to never do again. Pay attention to your body, its so easy to think a small slight pain will go away the next day.. Then the next, and before you know it, it can get worse so gradually you'll pass up on warning signs. When in doubt, take a day or two off running and see if it gets better, if it doesn't then you have some choices to make! The smarter the choice, the sooner you'll be back doing what you love pain free again!
Some runners who have tendinitis (tendons that haven't yet ruptured) choose to run through the pain. This choice is entirely yours. But from what I have learned it is best not too. Scar tissue can build up, and you may get through several years of running with just minimal pain in the area, only to hit a point where your running career is over for good. Take care of yourself, it is better to pass up a few runs or one race, rather than a lifetime of running!
Stay safe my running friends, and pay attention to your body! I hope to be joining you all on the race courses and logging in the road miles very very soon!!! - Cheers -
Disclaimer: I am not a doctor, nor a sports physical therapist. None of the information above should be taken as medical advice. If you are injured or suspect injury, you should visit a doctor as soon as possible.
These are great tips Kristy, I'll have to keep these in mind. Thanks again.
ReplyDeleteThanks Matilda, if the info can help anyone avoid it, then it's worth sharing!
DeleteKristy, I have just had this post open all morning and haven't responded. I'm in the same boat and the fact that you have been sidelined longer terrifies me b/c I know if I push it, I may have the same fate. That's hard to swallow when I have aspired to run the PHM for 3 years now and I WILL do it in 2014, I'll walk if I have to. *sigh* I have been thinking about my minimal shoes and what to do. I have been running in 4mm drop shoes for MONTHS and not had a problem, but the injury popped up (I think mine is heel bursitis and not actually an achilles pull) when I ran 8 miles. I have no idea how to proceed at this point, whether I should change shoes or hope that taking it slow when I start back up will be ok to continue with my shoes. I have no pain when moving, but if things bump or push on my heel, it hurts. It's a little better each day but I have no idea when I should start back up. Sorry, made that ALL about me. Thanks for the info though, it's more for me to think on and I hope you heal quickly!
ReplyDeleteKaren I didn't realize you were going through bursitis. The only reason I put the 2 in the heading is because one can usually lead to the other (I had the tendinitis issues that brought on the bursitis). The doctors have told me they are both treated the same way.
DeleteI'm not a doctor, but if it were me I would do 2 things immediately. First, get in to see a doctor (don't let them talk you into a cortizone shot, they are too risky) but there are other things that can help.
Second, switch your shoes. My doctors have all terrified me from ever switching to the minimals now. But I have higher arches so they are just not made for me. I have been pretty open with my injury and I can honestly say I have had over a dozen runners (men and women) tell me they have had same or simular injuries and all were caused by running in minimal shoes. There is such a long break in period to adjust to those shoes and it can take months. I was chatting with a gal on twitter just 2 days ago who just had bursitis like you, and she was telling me that she switched shoes back and the pain gradually went away over a 3 week period. That and her doctor had her doing a little PT with the switch.
Bursitis can be a funny thing, although I have it in my ankle, I had it in BAD my hip 2 years ago. A visit to my doctor and some quick help, they helped me be able to run 4 marathons over the next 6 weeks.
For me, one of the tricks was to apply heat to the area when running. I used those sticky heat patches. It was easier on the hip area, so I don't know if it would work on the ankle, but you could always try heating before running and see what it does. (I still iced after I ran). My thoughts will be with you, pulling for you to get through this quick!!!
Thanks Kristy! I'm so bummed about the shoes, I have FOUR freaking pair, two that I haven't even started using yet! It's hard b/c I switched to lower drop more minimal shoes because I had plantar fasciitis...and that is gone, so I'm terrified that will come back (it was much worse than this) if I switch back to regular 10-12mm drop shoes! Ugh. The heel does not hurt until something pushes on it, it sometimes burns when I stretch (so I have taken this whole week off from even cross training and stretching) but I've been resting it mostly for 5 weeks. I wonder if I can find some shoe that is a "middle" between the normal shoes and minimals? I actually thought that was what I was doing and I had no problems all spring and summer and then BAM, right after my longest run. I won't be seeing a dr. anytime soon (no insurance) and it's giving absolutely no issues on a normal daily basis, but my running shoe pushes on it when I go to slip it on and then it burns. I was actually thinking of cutting the back of it out until I heal, but I think I will need to start looking for new shoes. Ugh...I thought I had found the perfect match! I HATE trying to find the right shoe!
Deletesorry for writing a book! I should have emailed you! LOL
DeleteNo worries:) You know I was thinking. Since you won't be getting in to see a doctor, one easy cheaper idea to try before buying new shoes. Why don't you go and buy heel inserts, they'd only run ya $5-$8, and put those in your shoes and see if by chance that extra lift puts ya back in the normal zone and makes any difference in the pain or not.
DeleteSo sorry you are having to deal with this! I am having so many set backs with my own injury I totally feel your pain!!! (literally) Good luck Karen!
Great tips! I've gone thru peroneal tendonitis due to wearing a zero drop shoe too far too soon. Live and learn!
ReplyDeleteSorry you had to go through peroneal tendonitis, I actually had that earlier this year, and when I didn't take care of it, it worsened and caused my achilles tendonitis and bursitis that I have now.
DeleteI think the shoes can be right for some people, but they are a risk:) Hopefully you are healed up now!
I'm still a big believer in minimal shoes but they're not for everyone. They just make physiological sense to me.
ReplyDeleteI do believe they work for some, but not everyone too! Plus I think a lot of people don't take the time it takes to transition. But I read your story and I know you took the time and did it right, probably why you have had success with them!
DeleteGood post with good tips. Luckily I've avoided this particular injury so far. If you've got any tips for ITB or ACL I'd be keen to hear it.
ReplyDeleteI'm glad you've never had this injury, hopefully you never will!!! Fortunately for me I've never dealt with ITB or ACL, which I hear can both be a bear, sorry if you're dealing with those issues right now!
DeleteI haven't had this injury yet but I suffer with my right ankle in a major way. I have hyper mobility in my ankle and elbows which means when I'm running my ankle will roll over a lot. It doesn't hurt when it rolls and I don't sprain it but my ankle often aches in the evenings. I had wondered if minimalist shoes would help but the previous comments have made me think again. Thank you for this post, I'm always interested in any information that can help avoid injury. - Becky@trailsandultras.wordpress.com
ReplyDeletehyper mobility sounds scary. I'm glad it doesn't bother you more than an evening ache. I've only heard of a very few people having this, and none of the others were runners, so I applaud you for going for it!
DeleteGreat tips. So far no problem with me in this area. But I do find the bottom of my foot hurts first thing every morning when I wake up. Thanks for the tips.
ReplyDeleteSometimes slight morning pains are normal for runners, but if it doesn't get any better you might want to look into it a bit more. I've heard that Plantar Faciitis starts that way and develops more over time.
Deletewow! I didn't realize this was so common. I have high arches and rarely wear flat shoes but it's good to know that it will also benefit me with the running. Luckily I've never experienced this but I do have severe calf pain (like right now) that I have to deal with often.
ReplyDeleteSorry you are having to deal with severe calf pain. A lot of runners with calf pain find great success with those foam calf rollers! I haven't tried them, but after I get through this injury I am buying one to use, to help keep the calf loose:)
DeleteThanks for the tips! I'm just starting to up my mileage and am getting worried about injuries. The tips are very helpful!!
ReplyDeleteYou probably have nothing to worry about, but it's always good to make sure your doing the right things to avoid an injury! Happy Running Megahn, god luck with the increase in mileage!
DeleteFirst off Kristy I wanted to say that I am really sorry that you are dealing with an achilles issue. It is such a scary thing and you are right that it can be an injury that (even after seemingly healed and running with no problems) can resurface again months later.
ReplyDeleteI have to agree with one of your points while at the same time
disagreeing... and that is about minimal shoes/barefooting.
I had an achilles injury about 4 years ago when I was running in regular trainers and the reason why I got it was because my achilles was shortened from being in a shoe that disallowed my achilles (and calf and plantar) to lengthen to their proper normal length. By slowly (and here is where I
agree with you wholeheartedly) very slowly transitioning to zero drop shoes you are allowing your achilles to lengthen out so that when your footstrikes it isn't pulled too tight. The reason why many times an achilles injury happens when you aren't running (although many times and in my case it definitely can happen when you are running) is that you aren't
in those 8 - 14mm drop shoes and your shortened achilles gets put under a lot of stress trying to lengthen itself out when in thinner shoes (like sandals). One of the main reasons that achilles injuries can recur so often is that the reason for their occuring in the first place never gets resolved (which is the tendon is shortened).
Putting lifts in your heels can make it feel better but it tends to have the tendon heal even shorter.
Oh and I have quite high arches (that have gotten significantly higher and stronger since transitioning).
But like I said I agree with you and you are spot on that many transition way too quickly and you will definitely get hurt doing that. Without question. It doesn't take weeks.. it takes months to transition and many aren't willing to make that commitment (and I understand that).
I wrote about my experience transitioning and becoming the first to run the Death Valley Marathon barefoot
http://www.mavrocatstrength.com/2013/05/09/i-still-love-a-great-pair-of-italian-shoes-aka-my-barefoot-journey-part-1/
As I write.. it isn't for everyone and I have never tried to convince anyone to run in any type of shoe (or without them :) . It is up to the individual but I simply have a slightly different take on minimal shoes being a source of achilles
issues (if transitioned into properly).
Oh and one more important thing... When I did have the injury I found that getting Graston work done on the tendon helped a lot. It is painful when they get in there and scrape at it, but the resulting inflammation brough a lot of good blood to it to help it heal. It is one of the only things that I find works. Your chiropractor may be versed in it.
I hope you heal up quickly and can get back to running soon! It is a nasty injury and I'm rooting for you!
In whatever shoe works for you :)
Chris
http://www.mavrocatstrength.com
I very much agree with you, which is why they have all different types of shoes!
DeleteI think the biggest problem with a minimalist shoe, isn't necessarily the shoe, but for those that the shoe would work for, that most don't take the months needed to transition into it.
I am going to have to check out your Death Valley Marathon story about running it barefoot, thanks for leaving the link!
I've heard of Graston, it's something I could look into. Once I get past the injury point and into the recovery zone:) Thanks for the tips and sharing your experience!!!! Good luck with all your running!