Sunday, January 28, 2018

Achilles Strain - it's not as trivial as I thought

This is sort of an unloading, a confession of sorts, a realization of reality...  I injured my Achilles and I've had a difficult time recovering. This is coupled with the final realization that I clearly am not bullet proof and am not resilient to injury.  I've had running related running injuries before and somehow I rumbled through them.  And now I'm finding that I am unable to simply rumble through my current injury as easily or smoothly as before.

I yanked my Achilles in mid September and, now January, I am still working towards healing.  And this is really, really, annoying.  Annoying because of the time it has taken and my body's seeming unwillingness to fix itself quickly.  And annoying because my ankle / Achilles still hurts 4 months later.

Having said the above, I realize that I carry 90% of the responsibility, the remaining 10% being my gene's.  I was a late starting running, having just picked up the concept of running when I was 52.  I didn't join any groups, I didn't have a trainer, I just started trying to run - and I sucked at it.  I read a lot about running, read blogs, forums, and so on, and sort of figured out what I was supposed to do and some of what I was not supposed to do, which, much to my detriment, I probably did anyway. But one of the things that I ignored was my overall fitness and conditioning.  Being already fairly naturally "fit", I didn't really think about it much, and felt that getting my miles in was *the* most important thing. How many miles did I log this week, became my mantra. So ultimately, if I had an hour to exercise, I would use that time to run instead of maybe spending 20 minutes doing core exercises and leg strengthening and then running a productive 40 minutes. No, no, no...  I preferred to just run.  That 20 minutes was an extra 2-3 miles that I could log!  Besides, those core and leg exercises were, well, boring. I'd rather run in the rain...

This (kind of) worked for a number of years. I suspect now that many of my various previous injuries could have been avoided or reduced if I had spent more time conditioning and strengthening my core and legs. And now age has really caught up with me (I'm 61...) and I've become prone to more and more "little" injuries and it is taking longer and longer to recover from these "little" injuries.

And then I did this thing to my Achilles while taking down my hurricane shutters after Hurricane Irma.  I knew that something didn't feel right when I stepped off the ladder but of course, I kept going.  I even went for a run later.  And that's when the lump on my Achilles grew to the size of a small key-lime.  And it hurt.  It hurt enough that I could barely walk.  I did all the necessary things: ice, elevate, heat, massage, repeat.... and the lump eventually reduced to more the size of a small walnut, but I still could not run without it being noticeably painful.

Yes, I went to my Doc, who did an ultrasound to make sure that I hadn't done anything super-serious to the Achilles, such as tear or rupture, and after confirming that I hadn't, gave me a script for physical therapy.  And the PT is working, my ankle is feeling better, and yes I can see that I will be running again soon (I haven't run in 4 months).

But here's the crux of the challenge: Measuring only 6 inches long, the Achilles tendon is thickest and strongest tendon in our body. It can handle almost 4 times your body weight while walking and almost 8 times your body weight when running. This tendon is responsible for manipulating the heel and thereby enabling walking, running, and jumping.  And it turns out that it is very susceptible to injury.  The health of the Achilles tendon depends on the health, strength, and conditioning of, guess what (?), all the various muscle groups in my lower extremities that I was basically ignoring.

I had anticipated that the PT work would be focused on my lower leg area, perhaps my lower calf, maybe some deep tissue massage, maybe some ultrasound therapy, heat, and some ankle specific exercises.   -- Wrong --

Yes, there has been some deep tissue massage, and yes it was uncomfortable. Ok, it hurt. But it helped.
But then, things went totally askew on me.  My PT has evolved into a broad effort to teach me how to strengthen and condition my lower extremities, from my hips down to my toes. The range of exercises and routines has been very broad, probably broader that it would be for a real runner (who knows to exercise and condition their entire body) because my lower body conditioning is so bad.  The number of exercises grows with every PT visit to the point that I mix up my daily routine to both incorporate them all throughout the week and induce some measure of muscle confusion, which I'm told is a good thing.

So far I do feel stronger, but I'm also kinda sore all the time because I'm constantly implementing a new exercise that is stressing out an area that I have previously neglected.

In hindsight, I'm amazed that I was able to run any of the distance events that I've run without out totally destroying myself... I now have a growing menu of routines that I run through every day in an effort to strengthen my core, hips, and legs and I can see that once I've been able to heal my Achilles injury that I will be a stronger and fitter runner. Maybe I will be able to run another marathon...!