Thursday, May 28, 2009

Classic Overuse Case

Today was my much anticipated meeting with an orthopedic specialist. It is Achilles tendinosis as I had thought. The tendon is fine and intact and will not require surgery or even a temporary boot. That's the good news.

The bad is that cases of tendinosis are resolved in terms of months. Not days. Not weeks.

The condition is actual degeneration of the tendon in which the tendon itself becomes thicker and blood supply is reduced. The decreased blood supply stops the tendon healing, creating a vicious circle that is tricky to break. It is caused by overuse.

I think the stress I put over the winter months on the calf muscle may have been the culprit here. In 2008, I had issue with my calves and set a goal over the winter to strengthen the calf muscles. This lead to stress on the Achilles and may have introduced some microtears as well...which when I started to incorporate my speed work in early March led to the Achilles essentially saying, "enough is enough".

Treatment will include rest, over-the-counter inflammatories, and ice. It can take weeks to months of rest for the tendon to repair itself. My hardest task will be to be patient and not return too soon to the run.

The doc even brought up the "have you considered giving up running", to which I most have given him a Stare of Death as he quickly moved on.

Last resort, should my Achilles be in the same state after a few months is to try a splint, brace, walking boot, or other device that keeps the lower leg from moving.

Best thing is that although treatment for Achilles tendon problems takes time, it usually works. Most people can return to their beloved activity and get on with life.

My current plan will be to do no running for at least the next five weeks. I then hope to start with very slow and very low mileage. That plus the two weeks I've already not run since my last event will give me almost two full months of rest for the Achilles. I leave open the possibility of competing in the Lake Waconia Triathlon on June 28 with me not forcing the run at all.

We'll see.


Anonymous said...

Brian -

I feel your pain - figuratively and literally. My running is "on hold" for several weeks due to Medial Anterior Tibial Syndrome, aka shin splint, on the right. It had been coming on gradually for several weeks. I'd been to PT, as well as using ice and NSAIDs. It was really hurting on my planned long run on Memorial Day. I just figured that I could run through the pain. I knew that, this close to Kansas, it was do-or-die. My blisters actually ended my run, but but Tuesday, I was really hobbling. On Wednesday, I saw one of my Orthopedic partners and had a bone scan, which confirmed MATS. It is actually a lot better today, and I got in a 25 mile ride after work. One of my friends who is registered for Kansas is having shoulder problems to the point of questioning her race. I'm stronger on the bike leg, so I may swim and run, while she does the run. It's kind of like kissing your sister, but it's better than not racing or DNFing at T2. I'll keep you posted.

Steve (aka "agegrouper")

Chad in the AZ Desert said...

Best of luck with the rehab. The good news is that it is something that can be fixed. I guess this will also give you the chance to evaluate your training so that it doesn't happen again. I had to go through that with my knee and wasn't sure if I could run anymore. Here I am two years later about to finish off the highest mileage month of my life - with no pain! It can be done!

Adam Beston said...

Hope it gets feeling better. Now is a great chance to catch up on that swimming and biking. I want to see a sub 7 min 500 by the time you are back running. Good chance to also get your biking in shape. You prolly won't loose that much on the running if you stay focused on the other two. You might also try an ace bandage or some tape more for the reminder to take it easy. Maybe the Waconia Tri you can just to the bike and see how you stack up. Remember, months and I would think racing especially. Plenty of pros go through this too remember

Vagabond said...

Good luck on your recovery. It really sucks that when you love something so much, and you already make yourself suffer enough trying to do it well that things like this happen.