Anyone who runs knows a little bit about or has heard of Achilles tendinopathy. It is a frustrating over-load induced injury. Different factors contribute to tendinopathy. The site of irritation may be a clue, as insertional tendinopathy is commonly viewed as a compressive overload\u00a0injury where midportion is viewed as a tensile overload injury. Although there is some evidence to suggest plantaris may have a compressive effect in mid portion Achilles tendinopathy\u00a0(source)<\/a>. Traditionally both midportion and insertional were treated the same way. New research has highlighted the possible differences\u00a0(source)<\/a>. With that come different loading strategies.<\/p>\n Three mile into a ten mile race and I begin to feel a niggle in my right lower calf\/upper achilles tendon. I told myself its nothing and will go away. It doesn\u2019t really but doesn\u2019t affect my performance yet. Another mile and I\u2019m running in the middle of the road as the cambers on the sides of the road makes the niggle worse. Another half mile on I round a corner and up my pace slightly. A sudden dart of pain splits my calf down the middle and lingers into my Achilles tendon. I pull up immediately and begin the long walk\/hobble back to the start line!<\/p>\n Initially I believed it to be a tear of some description. After thinking about it, doing some tests, but most importantly looking through my training diary, a clearer picture began to appear. I had noted minor calf pain within the previous two\u00a0weeks on two separate occasions. You would have thought this would have been high on my radar going into the race. However it wasn\u2019t. Its a fine line which niggle to pay attention to and which to ignore. If we stopped training for every ache and pain we got we would never run a mile.<\/p>\n This now looked a classic midportion tendinopathy in a\u00a0reactive stage<\/a>. With tendinopathy, unloading initially is paramount. Unless we unload the tendon will stay reactive. However unloading doesn\u2019t mean total rest. A tendon will not change if you rest. It needs to be stimulated by adequatedly loading it. For me, initially\u00a0this translated to\u00a0isometric exercises<\/a>.\u00a0To achieve the adaptions needed I progressed to concentric heel raises. Further progression required concentric-eccentric exercises (heel raises over a step). From this point I introduced some skipping. This was a good test to see if the tendon could store and release energy without setting off the pain receptors. After a few days skipping with rest days interspersed, I was ready for a test run. Everything went well and I progressed slowly.<\/p>\nMy Incident<\/h3>\n
My Recovery Approach<\/h3>\n