Articles, tips, miscellany
A Year And A Half Of Achilles Tendinitis
by Mike Wilensky, Frontrunners/Frontwalkers Chicago
You don’t want to get achilles tendinitis. A mild case will pull you off running, and a more severe case will make walking, and even standing, a painful experience. I’ll tell you my story and offer you some tips on avoiding and recovering from a.t.
My first bout came in 1992, right ankle. The details escape me, but a podiatrist diagnosed it and prescribed physical therapy. A clinic in Hyde Park treated me with massage, stretching, ice, electrical stimulation, ultrasound, iontophoresis (a topical analgesic driven in by low-voltage electrical current), and large doses of ibuprofen. After a month or two, it was cured, and I was running again.
Chapter two: other ankle, summer, 1998. This might have been triggered by running in a mountainous western Pennsylvania town, where the uphills particularly strained my achilles. Now let me confess that I’ve never stretched faithfully – it’s time-consuming, it’s boring, and I’d run for 35 years injury free without doing it, and saw no reason to start. At any rate, the tendon began to ache, so I again saw the podiatrist and went for physical therapy, but without success. In November, 1998 I sought relief from a chiropractor, whose treatments were almost identical to the physical therapist’s. The podiatrist, chiropractor and physical therapist probably told me to stop running, but I just didn’t hear them – with every slight improvement, I tied on my shoes and went out to the Lakefront again. It seemed almost impossible to stop -- after all, running had been an almost-daily part of my life for over a third of a century!
I didn’t get better. Tired of the inconvenience, time and cost of the therapy, I gave it up in frustration and alternately ran through the pain and rested. Finally, Labor Day, 1999 my partner lost his temper with me and asked, "When are you going to wake up and smell the coffee?" Taking his charge, I saw an orthopedist and found myself in treatments just like the earlier ones, but this time with clear and strict orders to forgo running until the achilles pain was entirely gone. It was hearing and obeying these crystal-clear instructions that led to my cure. I biked, swam and walked to maintain basic fitness. I got orthotics, too. And after a year and a half of achilles tendinitis, I’m running again, wiser for my experience.
One sidelight: Someone I met had good things to say about Flexall, a topical ointment like BenGay -- he claimed it had really helped him. A pharmacist, though, told me that these preparations (camphor, eucalyptus and methyl salicylate) are ineffective: no topically-applied medication can penetrate deeply enough to benefit a tendon. I decided to try it nonetheless, and do think it helped. Let me emphasize that the care I received from the podiatrist and chiropractor was excellent; their prescriptions were almost identical to the orthopedist’s. They are good doctors – I was a bad patient.
So what did I learn from all this?
First, an ounce of prevention is worth a pound of cure. The best way to avoid a.t. is stretching. A.T. is an overuse injury, and if you’ve been running, your odometer has been running, too. And if you haven’t been stretching before, and even more importantly, after you run, you’re increasing the likelihood of trouble, pari passu. I’m now in the habit of stretching while waiting for elevators and while riding on escalators. And, when climbing stairs, I always stop, rest the ball of my foot on the stair and let the heel "hang" – each foot for 30 seconds. "Stretch the hell out of that thing," said my physical therapist. I also apply ice for fifteen minutes after each run. It helps.
Second, you need to give yourself time to heal. You really do have to let a.t. cure totally before returning to running, and you do have to rebuild your mileage slowly. The orthopedist told me to run on soft surfaces, and by extension, it’s probably important to wear well-cushioned shoes and thick socks. There’s as much nobility in giving your body the rest it needs to heal as there is in pushing your fitness routine. I’ll never forget Jim Franzen’s seeing me and saying, "I’m glad to see you’re walking!" He was saying that he was happy to see me taking care of myself and obeying doctor’s orders. It was so inspiring to have him say that to me. Thank you, Jim.
Third, there’s no magic cure for a.t. The podiatrist, physical therapist, chiropractor and orthopedist all sang from the same hymnal. I checked the Internet for other ideas, and there weren’t any.
Fourth, I found that life without running is worth living. Walking, swimming, stationary biking (buy some good books!) and Nordic track really are o.k. You can work up a sweat and get your heart and lungs pumping with these activities.
Finally, do place some stock in advice people give you based on personal experience, provided it makes some sense and is not outright dangerous. Do a cost benefit analysis. Flexall? There wasn’t much to lose. And it turned out to be a big help.
Now of course none of this is to be construed as universally-applicable medical advice. Consult your health-care provider for care for all your health care problems. But if you can benefit from my experience, and the conclusions I’ve reached from them, I’ll be happy with insight I’ve provided to you. You ask a lot of your body when you run. You push it and abuse it. But when trouble arises, you need to rest and give yourself the time to heal.
Good luck and happy running.