Pushing it hard, Achilles injury

Out of the blue?

So my VLM is over before it started……bugger!

As anyone who has suffered an acute injury knows, the body can be a delicate system…and as a physiologist and athlete, I tested those boundaries through self-experimentation…ultimately with negative consequences.  As a practitioner who ‘does’ know better about recovery and low volume adaptation I became my own worst enemy, a Jeckyl and Hyde of training recommendation and execution, like some bizarre juxtaposition. The faster my sustainable runs became the more I was pushing myself, not sticking to my own programme, and feeling I should up my mileage because ‘that is what is expected of me’. Wrong, even after backing off training volume due to tight calves. More of that in a mo.

Achilles rehab – feels like a poisoned arrow stuck in it!

My last decent run was a mid-week track session, 20km with a ‘Herculean mile’ thrown in the middle at Wimbledon athletics track for fun. I had started experiencing Achilles discomfort in both heels a week or so before, which I thought had subsided enough. Wrong again. My right was fine, but after 10km and a decent 5’30” or so mile that heel was tender again, then the next day was really sore, unable to walk sort of uncomfortable soreness. I’m not going into the details of Achilles tendinitis or tendonisis here because many others have done so already…such as here. It’s not fun is my conclusion, incapacitating best describes it and Uber now have more business because of me.

But the long and the short of it is that it’s an event killer and lesson from the client-side, not just on avoiding injury but managing expectation, disapointment and not putting all your eggs in one basket. 4-6 weeks out of action more or less, even with a full RICE method. Rest, Ice, Compression and Elevation is standard prescription for remedy. You can throw in a couple of other methods people use, like anti-inflammatories such as ibuprofen/ other NSAIDS such as asprin, plus a heel insert to keep the pressure off the extension of the tendon (Walking up hill is more uncomfortable). Initially the ibuprofen seemed to work…not bad for £0.35 a pack. But soon realise that the physiology/ sports medicine books are indeed correct, in suggesting it’s just a pharmaceutical mask. I kept off it throughout a few days of popping pills, but if you inhibit the inflammation which itself is the healing mechanism, then it’s not good.

So far I have been a compliant patient, which meant minimal walking….interesting existence, but wasn’t going to opt for the crutches or wheelchair just yet. After a few days, I went for a short ride and all seemed well, with little aggravation. A short run proved the opposite, and then all of a sudden it was 7 weeks till the London marathon. Luckily the brief Polar vortex freak weather meant there wasn’t much to be attempted outside anyway. I felt that there may even be a balance between movement and rest to provoke healing… so kept moving a little every now and then, to promote blood flow.

Negotiating performance….postponing objectives

After the snow had cleared and the sun came out I was still weighing up my options for London, as now I have a fairly sizeable gap in training, I have taken a holistic view as all performance practitioners should do…and even though my training programme has basically stopped, I’ve been considering my options to change target event and divert the focus for later in the year. This may have been a better plan from the outset and avoid winter season training which might have even contributed to my ailment, intensity on cold and tight muscles, not good.

I have also realised that I may be in a long taper period where recovering from this Achilles tendonitis could be a blessing in disguise as my training in reality had started at the Venice marathon in October 2016. So basically this down period may act as an effective 6 week taper after 18 months of training, working on strength and stretching and re-start some running when possible. But would be foolish to count on it.

Relapse

Typically, not being able to keep still for too long,  I attempted another ride, after not having much of a problem from riding short distances, trying to keep the cardio-respiratory system in check even for running somewhat. This time didn’t work, and the soreness returned to leave a very stiff and ‘squeaky’ ankle. So I Uber’ed it to the pharmacist where I picked up some Super Sport Heel supports (about £12 for a pair), a bit like orthotics, they keep the heel slightly raised to take the tension off the tendon. Supposedly this ‘treatment’ is highly rated by Achilles sufferers, which can manifest as a long term condition and even ruin running careers. So far, walking in normal shoes is easier with them. I’m not brave enough to attempt them in trainers, as this flare up may last another few days. I should do some temporary icing, but probably not use the ibuprofen again…which just delayed healing.

Plan revision….

So the ‘plan’ is…. to be pain free for VLM in 6 weeks, and just get round, perhaps using it as a training event for something later in the year. Unfortunately Berlin entry is now closed, but Turin is an option. If somehow I preserve some form, I may even attempt a qualification time which will help for another year and then all this nonsense can be put to rest…quite literally. (edited) I have realised that the medical certificate is a pain for Italian marathons, and have been recommended Stockholm instead, which is flat and happens in June. So a proper pb could still be on the cards this year…..if that Achilles behaves itself!

Lesson

All-in-all, its been an eye-opener….from exceptionally effective training (during a busy time with clients) and results on target for marathon objectives straight into unforeseen injury. Ironically I had been bleating about not ever being injured….idiot. Reasons for the Achilles problem?… as I eluded to, probably not enough stretching or warm-up, running straight from my desk…upping training volume to two half-marathons a week, plus adding in some significant interval intensity on the track. A recipe for disaster in hindsight.

I convinced myself of the old practitioner ‘dupe’ of thinking I should fit a certain model, running more than 70km/ week regardless of pace. Which just isn’t suitable case-by-case and why I always prescribe training to fit to work/ life and athletic history before matching physiology with event demands. It’s not the end of the world, perhaps if I hadn’t had the coach head wanting to experiment a bit then all would be good, but failure is knowledge, I failed so my clients can avoid a similar fate of not doing more than the minimal effective dose…..but as we all know, it’s what you least expect that takes you out of the equation. Hope to have some sort of report from London for you…and so, no, my race number isn’t for sale, at the moment!! A few snippets of info from the VLM for you.

See you on the road.

Edit: UPDATE…My soft-tissue mobilisation therapist Des at PSP recommended Kinesio taping: