When your "Achilles Heel" really is your Achilles Heel!

People frequently use the term "Achilles heel" to describe a personal weakness or vulnerability.

The phrase originates from the mythological Achilles being dipped into the river Styx by his mother Thetis. The river's waters could protect Achilles and provide immortality. Since Thetis held Achilles by the heel, his heel was not immersed and Achilles was vulnerable there. He eventually died after an arrow was shot through his heel ("Gee, Thanks Mom...").

For many runners, the "Achilles heel" carries a literal importance. Achilles tendonitis is a common problem and can cause a variety of performance and health problems.

An Achilles rupture is even worse-the running "death penalty"! A rupture requires surgical repair, a variety of progressive casts for up to 12 weeks, and many more months of rehabilitation. Complete rupture recovery may take up to one year!

Can you deal with that, runners??????

If no and you are experiencing Achilles pain, you need to take immediate steps to prevent this debilitating injury.

I personally experienced a serious Achilles tendon strain ten years ago. It took many months to resume a regular running schedule. If the tendon had ruptured, it would have been significantly worse.

A few important technical points about the Achilles tendon:

-The Achilles tendon is often called the Calcaneal tendon;
-The Achilles tendon joins the two heads of the gastroc and the soleus (muscles of the calf);
-The tendon inserts into the posterior calcaneus (heel bone) and is the longest tendon in the body;
-Blood supply is limited for the Achilles tendon.

How do you know you might be facing a potential Achilles tendon injury?

Most feel gradual Achilles tendon pain increase when running. Sometimes pain persists even when not running. Whatever you do, do not ignore the pain. If you do, you are probably going down like our old friend Achilles!

What can be done to treat Achilles problems?

Like most injuries, Achilles tendon problems are often multi-factorial and merit personal examination by an appropriate sports medicine professional. However, certain common issues often exist.

Most importantly, runners must modify training volume and intensity. Achilles issues are usually related to sudden increases in training intensity or training volume. Therefore, the old adage "cease the offending activity" is correct. The "offending activity" here is excessive running volume or intensity.

Runners should not necessarily cease running when facing Achilles pain. However, reducing volume and intensity greatly reduces Achilles rupture risk. Incorporating alternative exercise choices such as swimming or biking may also lessen serious injury risk. I re-discovered weight-lifting after my Achilles injury. Weight-lifting opened an entirely new world of fitness and athletic performance.

Standing on the ball of the foot and slowly lowering the heel to parallel with the step is the most common resistance exercise to treat Achilles heel problems. Do 2 sets of 15 twice per day. And keep doing it! You need to do this consistently for weeks to see good results.

As with any lower extremity injury, athletes should evaluate whether shoes are appropriate and well-fitting.

A slight heel lift may help alleviate Achilles injury risk.

Mild stretching of the calves is also recommended. Those experiencing Achilles pain should be not be overly aggressive with calf stretching as this may contribute to the problem. The calf wall stretch is a moderate calf stretch and is usually a good choice.

Runners experiencing Achilles pain should avoid speed work and excessive hill training as Achilles stress increases with these choices.

Sources:

Cosco DD, Navazio F, Common Problems in Endurance Athletes,
American Family Physician - Volume 76, Issue 2 (July 2007).

Dr. Stephen Pribut's Sport Pages, http://www.drpribut.com/sports/spachil.html, accessed June 22, 2009.

Sauna=Better Running Performance?

You hit the track early on Saturday morning. You grab a post-workout shake and savor the good feelings produced by the run. After the training session, you head to the sauna to relax. You know the sauna feels good. But do you ever wonder if it actually helps you run faster?

According to at least one study, the answer is yes.

A 2007 study examined whether competitive runners could increase running speed by sitting in a sauna for 30 minutes 4 times per week for three weeks. After a training run, the runners literally ran to the sauna building. Blood pressure, heart rate, hydration levels and other physiological variables were monitored closely to ensure safety.

After three weeks of post-running sauna sessions, endurance performance was enhanced by about 2%.

Although this was a small study, saunas may promote recovery and thereby increase running performance.

Runners should be careful with the sauna and completely rehydrate after all sauna sessions. Blood pressure and heart rate should be monitored. Some athletes may have conditions which would prohibit sauna use. As with all new physical activity, a doctor should be consulted prior to beginning.

Scoon GS et al, Effect of Post-Exercise Sauna Bathing on the
Endurance Performance of Competitive Male Runners, Journal of Science and Medicine in Sport (2007) 10, 259—262.

Running and Your Skin

It's race day, and you awake early. You need to double-check your race-day checklist before you head out the door:

Good breakfast: Check!

Running bib: Check!

Adequate fluids: Check!

Petroleum Jelly: Check????

Many newbie (and sometimes not so new) runners experience some serious and unexpected skin discomfort after racing. But do not be afraid, new runner! A recent European running review analyzed the most common dermatological running injuries and offered some simple avoidance strategies.

The most common skin injury? Blisters... Most runners experience blisters at some point. Heat, excessive moisture, ill-fitting shoes, and excessive training can all produce blisters. Using dry socks, wearing appropriate-fitting shoes and wicking socks, and applying petroleum jelly reduce blister risk.

Jogger's nipples (OOOUCCHHH!) are another common running injury and occur when clothing repetitively chafes against the nipples. I can personally attest JN are quite painful! I experienced JN after my first half-marathon and experienced pain several days afterward. Applying petroleum jelly, using commercial patches or placing adhesive tape on the nipples can help avoid this most painful condition. Women should also utilize soft bras, and men should wear synthetic, wicking shirts.

Chafing can be another runner's regret. Always wearing dry, well-fitting clothes and completely drying after showering can minimize chafing risk. Applying petroleum jelly to the inside of the upper thigh can also help. Larger people are particularly susceptible to chafing and should take appropriate caution.

Whether you are running your first or your fiftieth race, taking simple steps can let you avoid these highly unwelcome visitors.

E A Mailler, B B Adams, The wear and tear of 26.2: Dermatological Injuries Reported
on Marathon Day, Br J Sports Med 2004;38:498–501.