Unfortunately I seem to have injured my Achilles just as the racing season starts to hot up in sunny Western Australia.  I knew I was in trouble about 14 hours into my last event, Birdy’s backyard Ultra.  ( https://ultraserieswa.com.au/event/birdys-backyard-2/ ) The looped course has a section on an uneven meadow with the option of running on an angle near the fence,  being the quicker option,  where as running on a flatter service was the more ‘runner friendly‘. Over time I had started to move towards the fence and because of that started to put my already tired Achilles under more pressure.  On one lap I was chasing Justin and as we came out of a gate I tried to accelerate off my left leg to catch him so we could run together for the next few kilometres. This proved to be my undoing as I felt that familiar tearing in my lower leg. I had felt a similar feeling when I blew my calf a few years ago,  so instantly knew I had a tear.

Luckily I hobbled about for a few steps but was then able to run with only small discomfort. This allowed me to get back to the start and tape up my Achilles with Rock Tape and neck a few more Voltaren tablets.  This was enough to get me through the event and I actually finished pain free.

Of course once the Voltaren wore off that evening my ankle swelled up and I knew I was in trouble.  Of course Dr.Google has the answer and I have self diagnosed, as every runner does,  with Achilles Tendonitis / Tendonosis.  I have decided to spend as much time as possible on my Bionic Runner and dose myself up with Voltaren for 7-10 days. After this we’ll see if I ‘m able to run albeit slowly and only for a short distance.

Of course my marathon a week Sunday (August 30th) is probably out the window unless I have a Lazarus like recovery , confidence is low. I am prepared to sacrifice this event for one of my goal races this year the Light Horse 12 hour. ( http://lighthorseultra.com.au/ ) This was my first DNF last year, ever, and I’m determined to put in a good effort this year to banish those DNF demons.  Before this injury I was confident of putting in a good total but now I’ll be happy just to run the full 12 hours.

Injuries are sent to test us and as we get older  they seem to come knocking on a more regular basis. I had a really good run of no injures initially but the last few years have torn a calf muscle, overcome a nasty case of Plantar Fasciitis , a Baker’s Cyst and now it looks like  Achilles Tendonitis. I get the injuries,  it’s the loss of fitness and starting again that really hurts. Lock down for me has been the prefect time to really concentrate on my training program and I was just getting back to 2016 fitness levels and,  with the help of my massage gun,  was loving my running again.  With a 12 hour event in September, a marathon in October, 100 miler in November, Ultra in December, 100k in January and finally the Delirious in February my race calendar is fully booked.  This bad boy of an injury could put paid to a few of those or worse. That’s running I suppose. Every time you put on your running shoes you roll the dice and eventually you get snake eyes.

On the bright side my injury allows me to post on the subject and if anybody,  reading this post,  has the symptoms below I have the article helps.

Common Disorders of the Achilles Tendon

What Is the Achilles Tendon?

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the “heel cord,” the Achilles tendon facilitates walking by helping to raise the heel off the ground.

Achilles Tendonitis and Achilles Tendonosis

 

Two common disorders that occur in the heel cord are Achilles tendonitis and Achilles tendonosis.

Achilles tendonitis is an inflammation of the Achilles tendon. This inflammation is typically short-lived. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears. Sometimes the degeneration involves the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

Causes
As “overuse” disorders, Achilles tendonitis and tendonosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain.

Athletes are at high risk for developing disorders of the Achilles tendon. Achilles tendonitis and tendonosis are also common in individuals whose work puts stress on their ankles and feet, such as laborers, as well as in “weekend warriors”—those who are less conditioned and participate in athletics only on weekends or infrequently.

In addition, people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking. If these individuals wear shoes without adequate stability, their over-pronation could further aggravate the Achilles tendon.

Symptoms
The symptoms associated with Achilles tendonitis and tendonosis include:

• Pain—aching, stiffness, soreness, or tenderness—within the tendon. This may occur anywhere along the tendon’s path, beginning with the tendon’s attachment directly above the heel upward to the region just below the calf muscle. Often pain appears upon arising in the morning or after periods of rest, then improves somewhat with motion but later worsens with increased activity.
• Tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. There is less tenderness, however, when pressing directly on the back of the tendon.
• When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.

Diagnosis
In diagnosing Achilles tendonitis or tendonosis, the surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.

Treatment
Treatment approaches for Achilles tendonitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon. In the early stage, when there is sudden (acute) inflammation, one or more of the following options may be recommended:

• Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon and promote healing.
• Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the condition.
• Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed.
• Night splints. Night splints help to maintain a stretch in the Achilles tendon during sleep.
• Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching, and ultrasound therapy.

When is Surgery Needed?
If non-surgical approaches fail to restore the tendon to its normal condition, surgery may be necessary. The foot and ankle surgeon will select the best procedure to repair the tendon, based upon the extent of the injury, the patient’s age and activity level, and other factors.

Prevention
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.

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