The Tragedy of Achilles

Thetis immerses Achilles in the Styx

Anyone who’s ever watched a soap opera like Coronation Street or, especially, Eastenders will know that if everyone’s happy and having a good time, sitting down the pub on Christmas eve with a pint singing something jolly and looking forward to the New Year, then something terrible is just about to happen. It’s inevitable. Uncle Shithead turns up out of the blue. A cheap electric blanket catches fire. Someone falls off a ladder while hanging a particularly heavy ceramic duck. Or someone sprains their Achilles tendon.

The Achilles tendon is named after a Greek hero who, as a baby, was dipped in the river Styx to make him immortal by a goddess who was afraid of getting her hands wet. It takes a long time for injuries to the Achilles tendon to heal because of the restricted blood flow, and it’s possible for it to snap altogether which means surgery and crutches. Everything was going so well back in March too. My times were going down and my shins weren’t bothering me. I’d just blitzed a long run along the waterfront, on a warm windy night with a new Surgeon mix in my headphones. It was great, but then I noticed my heel was a bit painful. Usually when I notice something’s wrong, like an odd twinge in the knee or hurty shins, I stop running for a few days, do regular stretches and everything sorts itself out. Not so this time around. I tried running again a few days later and it felt just as bad, a tender weak spot about half way up the tendon that hurt when I ran. In the mornings and for most of the day I was limping. A week later and it was the same. Then it dawned on me that this was going to be a matter of months rather than days. The curse of the soap opera had struck.

For the whole of April I didn’t do any running at all in favour of rest, and stretching (which if I’m honest, I didn’t do all that regularly). You’d think that would be long enough, but it didn’t get any better at all. I was still limping in the mornings. In fact, the less I did the worse it seemed to get! I really missed being able to run. Whenever I saw people out running I would crane my neck to watch, wondering if I could keep up with them. I also found myself wondering if I’d be up for the Adidas 10k in June. My goal was to nail it in 45 minutes. That was still a couple of months away, but from what I’d read it’s usually 8-12 weeks to get back on your pins and I’d have missed a lot of running by then. So I rested, and hoped.

Running with the librarians

However, one of the upsides about not running was that it got me reading about running (I think Unity Books have done pretty well out of my sore Achilles). For starters, I finally got around to reading Born to Run by Christopher McDougall. An old friend had recommended it to me over a year beforehand, but at the time I remember having a slightly superstitious (and silly) fear of running books. Isn’t it just over thinking something that should be really simple? Aren’t running books for serious runners who can run faster than me? Aren’t I just going to find out I’m doing it wrong? But Born to Run grabbed me from the very first chapter and it’s a truly rollicking book; a great story, with incredible characters. I had no idea human beans were capable of such endurance, but of course that’s the point of the whole book. According to Born to Run humans evolved the capability to run all day to chase down antelopes on the savannah, except in the modern world we’re lazy, eat too many burgers (which don’t run very fast), and wear bad shoes.

Running booksBorn to Run lead naturally to Scott Jurek’s book Eat and Run. Scott is one of the many characters in McDougall’s book, and is an exceptional endurance runner from North America. I didn’t know much about the ultramarathon world until reading Jurek’s book and I found the whole thing fascinating. How on earth does someone run 100 miles in a day? Can’t say I’ve tried any of his vegan recipes yet, but after finishing the book I did cook a vegetarian lasagne as a half arsed tribute (amazingly, the kids didn’t notice it was lentils and not mince). Jurek’s book also prompted me to track down a copy of “The Marathon Monks of Mount Hiei“, which I was lucky enough to find on Abebooks. The monks of Mount Hiei have a long long history of endurance feats, some of which involve running ultramarathons every day for a hundred consecutive days. Both of these books underscored the feeling that I had barely scratched the surface with my running, and that running need not be about getting faster. It can be about going further. I may not get very fast, but how far can I run? What trails could I explore? I suddenly felt very bored of running in circles around Johnsonville and up and down the waterfront. I have a great view of Mount Kaukau from my house. That was going to be my next goal.

I also gobbled up Murakami’s book “What I talk about when I talk about running“, Adharanand Finn’s “Running with the Kenyans” and Mark Rowland’s “Running with the pack“, and just recently started reading what I think is the best book about running I’ve come across, “Run to the top” by New Zealand coaching legend Arthur Lydiard. However, I’ll save more on all that for another post.

The Tour de Spare Room

Far from over-thinking things or finding out I was doing it wrong, all these books reaffirmed my own enjoyment of running and widened my outlook. I have to say I really enjoyed following Scott Jurek on ultramarathons through the mountains, chasing down competitors with a torn ligament and scaring away bears.  However, it wasn’t me out there doing the running. It was someone else. I didn’t feel like I was getting any closer to hitting the road again, so in order to keep up some sort of fitness I decided to do something I’d been mulling over for ages. Get an exercise bike.

Spin BikeWhy not get a real bike? I wanted to expand my options for exercise at home, so I could still keep fit while I was looking after the kids, or during a spell of filthy weather. I was also put off buying a road bike because most of the cyclists I know have had a near death experience on the road at some point, and I don’t want to risk my neck just for the sake of some exercise. So I got an indoor ‘spin’ bike, which is somewhat like a real bike with a big heavy flywheel. I’m very glad I got it. I’ve used it several times a week for the past couple of months, and it’s a very nice option for cross training (along with swimming or a basic home workout). It sits in the spare room with the old PC so I play music, and random Youtube vids for a bit of eye candy, and blast away for about 40 mins while keeping above some sort of set speed. It’s the sweatiest workout ever,  but I still don’t end up as tired as I would after a run. Perhaps that’s just as well. I can save my energy for what I love most.

So I was feeding my mind, stretching, and staying fairly fit, but the Achilles refused to get better. I don’t think I noticed any improvement until I started doing calf raises off a step, after coming across many references to the benefits of calf raises in the treatment of Achilles problems. I did three reps of 15 raises off a step, three times a day. After a while the stiffness and discomfort eased, and I stopped limping. I still didn’t feel up for running, but it helped! What exactly does this exercise do? It’s not clear, but one idea is that extending the Achilles off the back of a step breaks down disordered collagen in the tendon, which is the cause of the soreness, and encourages it to grow back straighter. There is a very good, detailed essay on the subject here. This was a huge turning point for me. After feeling a bit despondent, I realised I was, after all, going to get over this injury. So I decided, heck, maybe it’s time I actually went to a physiotherapist. I could see there was light at the end of the tunnel, but what I really needed was a plan.

The professionals

Visiting a physio was a new thing for me, and in fact the first visit was quite bewildering. I explained what was wrong, told them my history, pointed to where it hurt and so on, but the physio didn’t examine my Achilles at all. Not even a quick prod! It was straight into an assessment of biomechanics and a recommendation to strengthen my glutes to stop my knees from buckling inwards. Then some tape came out, and before I knew what was going on I was walking back to the car with both feet wrapped up like brown paper parcels, thinking ‘what just happened?’ (however, that was better than a later visit to a podiatrist who only took 15 minutes to get to six hundred dollar orthotics. “I’ll think about it”…).

I felt like the physio went straight for the underlying cause without telling me what I could do about the immediate problem, which was the soreness in my Achilles. I was quite prepared to address the long term issues they’d raised, but, um, what about the bits that hurt right now? Can we get them working first? Perhaps I had played down the soreness, or wasn’t clear what I wanted. My second visit was a bit better though, and they had a prod at my Achilles which seemed to be in a state that didn’t worry them. By that stage I felt like my calf raises were doing some good, and after some encouragement from the physio I even got in a few short (3km) runs.

Yes! Running again! Although it was short and unpleasant, with the soreness getting a bit worse by the end, at least it was running! This was nearly two months since the initial injury, and despite the home workouts and the biking I was definitely out of shape. However, it was a great morale boost.

body runnerI had three visits to the physio in all. I think the calf raises helped a great deal to rehabilitate my Achilles, while the physio was rigorous about the biomechanical issues that had probably caused the injury, along with my old nemesis, shin splints. What was up? I stood on one leg and tried to do a squat. It was immediately obvious that my knee and foot buckled inwards. When I started doing glute exercises (leg raises, laying on my side) it was also obvious I had a weak butt. The idea was to strengthen the glutes so they would be strong enough to provide stability, so my knees wouldn’t buckle. So it was glute exercises first, then leg squats with my knee tracking over my foot, in a straight line. Then there was the issue of my foot rolling in. That was to do with the arch of my foot collapsing with each footfall, and a lot harder to correct. The idea of orthotics was thrown into the ring, but to her credit she didn’t push it and was willing to go along with my preference for strengthening and exercises instead. Whether my preference would yield results was another thing, of course. On my third and last visit she filmed me running and didn’t have much to quibble with. My knees and glutes were getting stronger and tracking straighter. I was running up to 7 or 8km at a time by then, although my shins were playing up. I think, after so little running, they were just not used to it. And there was still the issue of my feet rolling inwards. That was continuing to antagonise my Achilles, which was otherwise improving.

You can try to strengthen your arches by picking things up with your feet, and contracting the muscles under your foot to straighten it up, to lift the arch up so the Achilles is straight. I do that as part of my leg squats and and calf stretches. When my foot’s on the ground, I use the muscles under my foot to stop it rolling in. Also, when I run, I concentrate on pushing off with all of my forefoot, not just the ball of my foot (behind the big toe). The ball of the foot is where all the weight ends up when the foot rolls inwards.

Now then

So here I am about three and a half months later, and running regularly again. The calf raises helped, keeping active helped, and the gradual return to running helped too. At first my heel and Achilles felt progressively worse when I ran, but I stuck at it and got to the point where it would loosen up after about five minutes. By the end of a run it would feel pretty good, and the next day would be less stiff in the morning. When I want to go running now I always make sure I do five to ten minutes warming up first, some very light jogging. Then my Achilles loosens up nicely and I can enjoy the run. I also need to keep up the calf raises regularly. I stopped for a while because I thought I was back to running, but then the Achilles got noticeably stiffer again. So it’s important to stick at it. And the Adidias 10k? I made it. I even got close to nailing 45 minutes and my Achilles didn’t bother me at all during or after the run.

From here on it’s a matter of not doing anything stupid. Hills I am still a bit wary of, but I did get up Mt Kaukau, along the Skyline and into town a week back (I confess to walking up the really steep bits). I’ve done 20k a few times. My shins are easing up again. I do more cross training now, and love having the bike at home – The variety is good. I have a new passion for running books too. So in some ways the injury has done me some good. Moar diversity! My next race is the 5 Bridges half marathon in Petone in August. That I can even consider a half marathon after barely being able to run 3k two months ago is wonderful. I once doubted I would ever get back to that point. If you’re wondering the same thing then good luck, and stay positive! The story of your Achilles doesn’t have to be a tragedy ;)

Stay positive

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