If you don't recall (why would you?!!) - my right achilles has been injured since November and prevented me from doing Disney.
If you don't recall (why would you?!!) - my right achilles has been injured since November and prevented me from doing Disney.
4TM wrote:
I'm very confident about being fit enough to run 2:37. I think had things gone slightly different in Chicago, I had a 2:38 in me... so I'm sure I can knock a minute off. The bigger questions are how I will handle the Boston course this year...
I think that's the main thing right there. You know the damage the course can do to you if you run it poorly...trust me, I did the same thing. I know you'll learn from last year's experience and run it smarter this year.
4TM wrote:
...I've never been this fit 3 months out from the marathon, so I'm feeling positive right now for sure!
It's a damn good position to be in right now, just keep everything in check...don't try to do too much too soon.
Road Racer - I know you're question was directed at Abu, but I also routinely do preventative measures for chronic calf/foot and most recently, achilles issues.
After my runs, I stretch my calfs more than anything else on my body. Both straight and bent leg.
At least once per day I will do eccentric calf raises. Google these if you don't know what they are. Basically, they're calf raises where you go up fast, down slow and vice versa.
Once or twice per week, I'll run barefoot for about 10 minutes. This is done on the infield of a track.
Ice cups work wonders on localized pain spots (such as an achilles)...not so much for general body soreness though.
I noticed if I stop doing these on a regular basis, aches and pains seem to pop up everywhere on me. Maybe it's just a placebo effect, but once I heal up from Disney, I'll continue to do these preventative measures...they don't seem to hurt me.
GoalRace: Cleveland
GoalTime: 3:2x
m 6ez
t 6
w 8 w/ last 4@ MPace (7:30)
r 5
f 6
s 6 w/ 2x800 in 3:20 Total disaster. For some reason could not run fast
s 6 w/ 6x800 in 3:20ish. Retried workout instead of 10 ez miles
Total: 43
I've started wrestling instead of doubling. Ouch. The first few times after a 15 year break is a little painful.
Roadrunner: I typically do the two exercises prescribed below 4-5 times/wk before my runs.
CONSERVATIVE TREATMENTS FOR ACHILLES TENDINOPATHY
ECCENTRIC TRAINING (lowering of the heel)
Research carried out in 1984 (1) stressed the importance of eccentric training as part of the rehabilitation of tendon injuries. It was demonstrated that a six-week programme of progressive eccentric loading of the tendon was successful in alleviating Achilles tendon pain. During an eccentric contraction, the muscle elongates while under tension (whether this be the result of body weight or through added resistance), as it does during the lowering portion of a heel raise, when the muscle acts to decelerate or control the movement.
The above programme was subsequently incorporated into a 12-week programme of eccentric calf muscle training for painful mid-portion Achilles tendinopathy and scientifically evaluated by Hakan Alfredson et al (2, 3). Alfredson is a professor of sports medicine and an orthopaedic surgeon.
This training programme requires the patient to complete the programme despite pain in the tendon.
If and when the patient experiences no pain while carrying out the programme, the load should be increased until the exercises do cause pain – this sequence is then repeated.
It is reported that Alfredson’s programme is effective when other non-invasive conservative methods have failed (see list above). It is successful in 90% of patients with mid-tendon pain and pathology. Patients with Achilles pain at the tendon insertion do not respond as well to this programme; however, good results are nonetheless achieved in around 30% of those with this type of problem who complete the programme.
THE BEST WAY IS DOWN
Other eccentric training programmes for the treatment of Achilles tendinopathy are reported to have been successful but they have not been subjected to the same rigorous evaluation as the Alfredson programme.
Results of surveys have shown that heel-raise (concentric) training programmes have not proved nearly as effective as heel-drop (eccentric) programmes.
heel-drop technique
Picture 1
Alfredson’s painful heel-drop protocol
Number of exercises: 3 x 15 repetitions
Frequency: 2 x a day, 7 days per week
Technique: There are two versions of the exercise: one is performed with the knee straight – see picture 1 (activating the largest calf muscle, the gastrocnemius) and the other with a bent knee (activating the soleus) – see picture 2.
Important – remember, each time the active (affected heel) is lowered, you should use the unaffected leg to raise the injured foot back up onto its toes prior to the next repetition.
Use your hands/arms to stabilise your body prior to and during each repetition of the exercise.
Picture 2
** In the photographs the athlete performs the exercises in both the straight knee and bent knee version. Note: the heel is in the lowered position in both photos and, out of view, the athlete is holding onto a training partner for stability.
1. Straight knee gastrocnemius drop – The patient begins with the heel raised and the knee fully extended (the leg is straight). He or she then lowers their heel so that the foot is parallel to the ground.
2. Bent knee soleus drop – The patient again adopts a position on the edge of a step, with their heel raised, but this time the knee of the active leg should be flexed at 45 degrees so that the soleus muscle is engaged. The patient then lowers their heel so that the foot is parallel to the ground.
Progression: Do the exercises until they become pain free, using body weight. Then add load, via a barbell or dumbbells, until they are painful again. Progressively add load up to 60kg.
PERSONAL EXPERIENCE – A CASE STUDY
Karen Storey, the co-author of this series of articles, is a qualified physiotherapist and has been a competitive sprinter for 20-plus years . During the summer track season of 2000 (mid-June), Karen suffered from quite severe Achilles tendon pain. Following a rich vein of early season form during which she improved both her 100m and 200m personal bests, Karen competed in a sprints triathlon competition – 100/200/400m in a single afternoon. The repeated efforts, performed on a quite ‘springy’ track, proved to be too much for Karen’s Achilles, and she felt pain the next morning when getting out of bed and putting her feet on the floor.
Experiencing pain on taking the first step of the day is common with people who suffer from Achilles tendonitis. Quite often, the pain lessens throughout the day as mobility improves. However, on this occasion the pain eased only slightly, with the result that Karen had to curtail her training and cancel competitions that had been scheduled for the coming weeks.
The plan had always been to compete in the Scottish National Championships in Glasgow at the end of August, at 400m (Karen’s favoured event). Build-up races had been scheduled but were now shelved, and Karen’s training schedule had to become a rehabilitation programme, with a view to either competing in Glasgow, or being fit enough to commence winter training in September with a clean bill of health.
Karen designed a programme of heel-drop exercises for herself, similar to those of Alfredson’s protocol. The first five days consisted of rest and ice treatment. She continued with the heel-drop protocol and by the tenth day was virtually free of pain.
Over the next 20 days, Karen was able to jog and perform basic sprint drills with limited range on grass.
Three weeks after the onset of the pain she was able to stride on grass, building from 60%; by week five she had progressed to 80% intensity, still running on grass.
A week prior to the Championships, Karen moved onto the track to perform a session of strides at 80%.
To reduce the strain on the Achilles, she used heel raises in her spiked shoes.
The only session of specific starts was performed five days before the competition (to allow any adverse reaction to the Achilles a chance to settle). We considered block starts to be the activity that would place the greatest demand on the Achilles tendon, so only three of these were performed at 400m race pace over 30m.
Thankfully, there was no major reaction and, three days prior to the competition, Karen performed a small number of 60m sprints on the track.
And the happy ending? Karen ran the 400m in the Scottish National Championships as planned, and achieved a personal best of 56.8sec – just six weeks after suffering from Achilles tendonitis.
Pablo & Abu - Thanks!