Tuesday 12 December 2017

Common injuries include Achilles tendon overuse

The Achilles tendon is the longest and strongest tendon in the body
The Achilles tendon is the longest and strongest tendon in the body

Mark McCabe

One of the most common forms of overuse injuries we see in our clinic is damage to the Achilles tendon. It is best to take precautions to prevent injuries here in the first place, so be diligent in completing your strength and conditioning sessions.

Tendons consist of collagen tissue and while this is elastic and capable of developing high-tensile loads, it has a very poor blood supply. Because of this, if tendons are damaged, their healing time is prolonged. Tendons attach muscles to bones and transfer the forces developed by the muscles to the bone, causing movement to happen. Owing to their elastic nature, they can act as springs, enabling you to get "free energy" by bouncing along if they are very strong and well-conditioned.

It has been shown that many tendon over-use injuries show degenerative micro tears called tendinopathy, which, once they reach a certain threshold, cause pain with activity in that tendon. This leads to further weakening of the tendon and, if activity is continued, damage occurs due to the reduced tensile load the tendon can bear.

The Achilles tendon is the longest and strongest tendon in the body. Causes of injury include weakness or lack of muscular endurance in the muscles that coordinate lumbo/pelvic control surrounding the hip and trunk, or in the driving muscles of the legs, such as the gluteal, hamstring or calf complex.

If Achilles' tendinopathy is diagnosed, then any of the relevant mechanical or training factors mentioned above need to be addressed in your rehab plan, coupled with therapeutic exercises to regain the ability of the Achilles' to withstand tensile load. Loading the tendon through resistance training encourages the stimulation of new tendon tissue repair - a formation of micro massage occurs which, through irritating the injury site, facilitates faster repair. Doing calf raises, progressively increasing the load, is a key way to do this.

Other conditions can mimic Achilles' tendinopathy so consult a medical professional with a background in sports medicine to make a proper diagnosis if you are experiencing pain in this area.

Q: My thighs are killing me when running and my legs feel very heavy during the day. I’ve stuck to the programme so far and don’t want to stop now. What should I do?

A: Excessive muscle soreness after runs that persists longer than 48-72 hours after sessions is typically an indication of inadequate recovery between sessions. Your body is struggling to adapt to the combination of training stress and life stressors that you are encountering on a daily and weekly basis.

If you have been hitting your sessions harder than you should have been, or if your nutritional habits have been bad, you may have build up too much training stress that now needs additional recovery to allow you to make fitness gains. Similarly, following the programme to a ‘T’, despite increased work or personal stressors (longer work hours, deadlines, sick children etc) may push your body to much and mean that you need to go easier on the workout plan until your personal situation settles. Either way, you should look to reduce the intensity of the sessions to allow increased recovery time.

Continuing to push through pain or discomfort in these cases typically results in loss of fitness rather than any significant gains. Elite athletes, with years of training history, may be an exception to this. So, change out your next run and substitute  it for a recovery swim or an easy walk or cycle to encourage muscle recovery. Similarly, cut down the total number of sets and repetitions on your gym programme. Until your legs return back to normal, sessions should be energising and light.

After a few days, use a foam roller on all the major muscles of your legs or if possible consider a sports massage to bring back some freshness to your legs.

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