THIS week I offer some help for runners aged 40-plus.
If you’re a footballer whose season has ended and are looking to keep fit throughout the summer, I hope you never have to need this advice, but chances are you will.
See, something happens to Achilles tendons when you run on hard surfaces. More so if you’re over 40 and have gone from playing on soft grass to harsh concrete surfaces or treadmills.
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The symptoms of an Achilles injury will be immediate sharp pain in the back and bottom of your leg right above the ankle joint. It often happens when running or jumping and gets worse as you go on.
If the inevitable happens, here’s a step-by -step guide on how to recover from an Achilles injury that the professional athletes know and use:
Complete rest and apply lots of ice. Swap footwear to soft, comfy shoes with a raised heel. There is no need for strapping or supports other than to apply ice. Every hour for ten minutes is recommended. Typically, a pro athlete suffering with an Achilles tendon issue would be advised to go swimming, take one or two gentle flat walks and when possible, work on core stability exercises with a balance ball.
The right selection of footwear is important - avoid plimsoles or sandals. Find and wear a pair of trainers with a nice thick ‘heel’ to prevent any tension on the tendon.
From a physio point of view, after about two or three days, I’d begin some deep massage and very gentle stretching and work on the ankle joint to prevent any stiffness or get rid of any swelling. I’d also massage the calf muscle and check the lower back for any stiffness to rule out any nerve problems that could create more long-term issues.
The ice continues - often until day ten depending on how much bleeding has taken place and how badly damaged the muscle tear is. Typically, one of my players would now be exercising on a bike, swimming would continue and towards the end of week two, I’d be aiming to have the athlete doing some very gentle jogging. The player or athlete can expect to feel some form of burning sensation, but as long as it isn’t ‘cramping’ or ‘biting’ this is fine - and a good thing.
From a physio point of view, massage is now vital.
It’s at this point that the scar tissue build up is dangerous and if the massage isn’t done, it’s the number one reason for an Achilles tearing again in the first two weeks you are back running or playing.
Now, heat is being used rather than ice at this stage and stretching is now vital too. I’d be recommending that the athlete attends yoga classes and increases the amount of pilates exercises and that they should be working on their balance (using a ball).
Fitness levels are increased significantly. Swimming, cycling, gentle jogging is stepped up (still on flat surfaces), and by the end of this phase, the athlete may or may not be asked to run at three-quarter pace.
From a physio point of view - hands on treatment is vital. Massage on the Achilles, calf, hamstrings, gluteal muscles and lower back is essential to prevent future recurrence. Ankle joint and balance work is important too. stretching is also introduced.
The athlete should be 90 per cent fit by this stage. Cardio vascular work is increased and a return to practice and full drills is possible by the end of week four.
Athletes are put through drills that will include sprints, shuttles and plyometric work, including running backwards. Please note: running up hills and on sand is a no go for at least three more months.
From a physio point of view - massage continues, stretching is vital and passive and active stretching is stepped up.
The athlete can return to sport. Fitness and performance work increases. From a physio point of view - massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions.
Note: Daily hands-on massage is required for approximately another two-three weeks to prevent scar tissue tightening the muscles.
Take it very easy early on, stretch and mobilise the injury. No Achilles injury can recover fully without deep tissue massage.
Too much rest in the first few weeks will increase the likelihood of a recurrence. Don’t be fooled by the lack of pain after two weeks either. It does not mean you are fit to play or run and if you haven’t followed all of the protocol listed above, you will damage the muscle again sometime soon.