Running from Achilles

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Question:

Hi folks.I’m currently sufferering thru an achilles/inner ankle pain layoff.When I return to running in a couple of weeks I’d like to go back to my preference of rocky,hilly trails.Everything I read about achilles injuries says to avoid,hills,speedwork,and uneven ground.Problem is that’s the only type of running that I really enjoy.Anyone have any suggestions ?

Response:

You know the answer – stay off the speed, hills, uneven terrain after you get back. Said differently, stay flat and even on disgusting roads if necessary for a few weeks and slowly add the fun stuff back in. If you jump back too soon you’ll start to ponder the 1/2 way trip across the bridge. Patience! — Caveat Lector "the further you go outside, the further you go inside" – B. McKibben Doug Freese

Response:

What’s missing here is a review of appropriate running shoes for your style. Either overpronation or oversupination place strain on the achilles tendon and often trigger achilles tendonitis. Go to a real runing store and have someone watch you while you run, or look at the wear pattern on your shoes, and if the wear is toward the edges make appropriate choices. You could need orthotics. Lyndon "Speed Kills…It kills those that don’t have it!" –US Olympic Track Coach Brooks Johnson

Response:

My sincere sympathies I love hills and trails also (most aren’t rocky though) and work on hills a fair amount in my job (field ecologist), and running/walking flat only was not an acceptable long-term solution as someone suggested to me recently. A physical therapist did a gait analysis and identified some biomechanics issues in my toes and the way I overpronate, which can whiplash the achilles. He’ll be making some shoe suggestions, exercises, and probably orthotics, but won’t know until he’s had a chance to do a full evaluation. (He did a quicky free evaluation when I was in from field this summer, and we’ve been waiting for me to get finished with field work to get started.) Everything he has picked up on has been consistent with some niggling discomfort in my feet last winter so it makes sense. In the meantime, I’ve been doing some barefoot walking/running to strengthen feet (got brownie points with PT for doing this, but will probably need to dig out neoprene socks to continue this much longer in Alaska) even after I’ve started some normal running again. For a while this summer, it seemed like all my shoes (everyday walking and hiking included) were aggravating the minor AT, but discovered that barefoot walking was tolerable and actually beneficial, and eventually built it up to some running. And figured out which shoes wouldn’t aggravate feet. Some really good exercises for recovery/strengthening – NOT for the actual healing, at least in my case, since they may aggravate the inflammation – before running again are on http://www.pponline.co.uk/encyc/0125.htm I’ve also found many foot exercises, like toe clenches, seem to help, but that may be because of my toe issues. And the usual achilles, calf, hamstring stretches help also – but not if the achilles is still inflamed / injured. My field work and general hiking, including hills, in a particular pair of hiking boots (fairly flexible and has a good notch for achilles) have also helped. If a hill got in the way with the little bit of running I did during the summer, I walked it or ran it sideways to keep the foot flat – lousy form, BUT *for me* it’s a reasonable compromise between insanity from totally flat. Actually, it’s the way my GP suggested walking when recovering from AT/PF 5 yrs ago when I was headed out for some hilly field work. I was being reasonably patient, but I couldn’t abstain completely and some gentle exercise helps recovery in my case. I also mountain biked some of the flatter (many are too steep for my mtb conditioning as it was this summer), but hilly trails to relieve some of the insanity. Good luck. Dot

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