Achilles tendinitis

by Geir, answer by Marius

Achilles tendinitis problems before the marathon, what should one do ?

" New York City Marathon 2009 is only 5 weeks away and my achilles hurts. This will be my debut in marathon and I really would like to run. The doctor ordered rest and gave me naproxen. After a week it seemed better and I had a run. Then I was almost back to start.

I have now waited almost 2 new weeks, but I can still feel some pain. I have been doing some swimming and water jogging to keep myself fit, but haven't been able to build up the milages that I planned. I had not been on the 100 day marathon plan before I got injured either (proberly the reason for my injury. I started to hard with running on aspalt and concrete up to 5 days a week).

Question:
1)Should I start with the Eccentric strengthening program for Achilles tendionopathy, while "in pain" or wait until I feel no pain ?
2)Do you have any experience with water jogging as substitute training (It is very boring!)?
3) Is there any hope for my NYCM run. I have reduce my ambitions from sub 4 hour, to just finishing in such a manner that I have had a positive experience, and still have the urge for another maraton (following the 100 Day Plan all the way).

Geir

Answer: Geir, this is how you can go this and this is a special solution in your situation and still get there before New York:

1. Start to walk gradually more and more. You have to get into mechanical movement now and not just water jogging etc. I recommend walking 30 minutes daily first, increase with about 5-10 minutes daily. Once you hit 1 hour of walking, go into running 10 %, walking 90 %. You run 1 minute, walk 9 minutes, run 2 minutes, walk 20 minutes etc. Gradually increase this ratio up until 70 % running and 30 % walking. At that point, the walk/runs should be a duration of about 2-3 hours. This will get the achilles into gradual movement again and at the same time train some duration.

2. In your shoes, insert a heel raise of about 1 cm (pads, you get in sports stores) This will lower the tension in the achilles.

3. At night, rub your achilles in with anti-inflammatory cream and have plastic wraps going over it (usually used to wrap in food) so that the gel will stay there during the night.

4. Go to a massage therapist and have your calf muscles massaged every other day to release tension going to the achilles tendon. With such a close time to NYC cross friction massage of the achilles itself will only irritate it too much.

Also, wait with eccentric exercises until after NYC - there is too little time and the risk of just aggrevating it is too big at this stage.

Good luck !!

Kind regards,
Marius

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