May 28, 2024

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Getting Back to Running After Achilles Tendonitis or Achilles Tendinosis

Getting Back to Running After Achilles Tendonitis or Achilles Tendinosis

[00:00:00] As I’m filming this, it’s a new year and hopefully ready for a new you. But if you’re like me and what we’re going to talk about in this video is coming back from injury. No, this could be any injury. But in our case in particular, in my case in particular, this last year is coming back from Achilles tendinitis or Achilles tendinosis, depending on what your particular situation was. So I’ll talk about what I’ve been doing to get back into running and how you should approach getting back into running after an injury and specifically this one.

[00:00:43] I’m Jesse Funk, the founder of and the host of this show, Runner’s High where we talk about everything running, unfortunately, today, getting back into running after an injury. And I say unfortunately, because we never want to be injured, it’s a terrible thing. And it really I mean, it sucks just to put it in the pejorative. It sucks. We don’t want to do it. We want to avoid it at all costs. But sometimes it happens.

[00:01:08] If you haven’t been around basically for this last entire year, I’ve been dealing with this injury, depending on how you want to count it. Somewhere between nine and 13 months I’ve been dealing with this injury. I raced once and that kind of blew it up and I have to start my rehab over again for my particular case, Achilles tendinosis, because it is something that is not acute, meaning it’s not a short, sharp kind of situation.

[00:01:35] It is a degenerative long-term condition for most people. You can be looking at 3 to 6 months for recovery, longer For me and the physical therapist person I’ve been seeing says I’m one of a handful of people that have ever taken this long to recover from this injury. Lucky me, but that also means I’ve had to really pay attention to being on top of my rehab and coming back into running a kind of conservative clip, but also having a solid plan in place. And that’s why I think the purpose person is to talk about this, because I’ve experienced the really bad side of it.

[00:02:17] So let’s get into what I’ve been doing and then what I think you should do based on the lessons that I’ve learned. Number one is simply, you don’t have to stop running. Now, this is going to depend. My general rule of thumb is if an injury changes the way you run, to stop. Now with Achilles tendinitis or Achilles tendinosis, in that acute phase, when you initially get that injury, sometimes stopping for a short period of time, a couple of weeks can help the healing process begin without causing more injury.

[00:02:56] But it’s a generally it’s a general consensus that you can continue to run with Achilles tendinosis, or Achilles tendonitis, assuming that pain remains low enough to continue to progress. So I continue to run basically this entire period, but I really reduce my mileage.

[00:03:20] So we have been doing previously the last couple of years, four days a week of running, one day of swimming, another day of lifting by itself, and then one day off. 

[00:03:32] This year, because of the injury, we reduce my mileage to three days of running where I was only doing five or six-mile runs because that seemed to be the threshold for me. We had been building up. I got up to doing this like ten-mile run and I came back and I was like limping. I just said, “Coach, this is, It’s too much. We got to back off.”

[00:03:53] So then basically the last nine months I’ve been stuck at this like 18-mile period doing my rehab stuff. Now I’ve done another video on the rehab you should be doing if you have Achilles tendonitis. We’ll link to that at the end of this video. But subscribe because I come out with videos like this all the time and so check it out at the end of the video if you haven’t seen the rehab.

[00:04:18] But doing that rehab was just extra slow and the markers you’re looking for are pain-free at each level of that rehab, you’re looking for pain-free. So then similarly, when you’re looking to return to running, in my case, I continued to run the whole time, but we were looking for a marker of when can we increase mileage. And I was really looking for entirely pain-free.

[00:04:45] Now, I’ll say I’m at the point where I’m basically hitting my first pain-free runs. But we did start up mileage a little before then because I was coming back from runs where I actually felt better after the run and for the rest of the day than I did prior to the run. So the run wasn’t actually causing any more deterioration. So that kind of situation or again, pain-free and you want to continue that.

[00:05:14] Our progression plan this year has several steps to get me returning to racing and I want to talk about what those are going to look like. So this is a plan that my coach and I have kind of come up with. It’s pretty conservative. And again, that’s because it took me so long to get back to running “normally.” 

[00:05:37] And we don’t want to go backwards, basically, in my particular case, what we think we figured out is that it seemed like if you looked at my heel, it seemed like I had like a Haglund deformity, which is a calcification of the bone there, the calcaneus use that bone where your Achilles sits. But it actually wasn’t.

[00:05:58] I had a buildup of, like, fibrous tissue in that tendon and around that area that we had to basically break up over time. And as far as my memory goes, it’s been there since college.

[00:06:12] So this is for me my particularly weird situation. This has been something kind of a ticking time bomb for the last decade that really just hit me now that we’ve had to deal with. So that lump, kind of small lump that was there on that Achilles is almost entirely gone now that we’ve continued to do muscle scraping and break it up.

[00:06:33] My situation aside, what we’re going to be looking at is, number one, building mileage without pain. So like this week, I’ve been doing 17, 18 mile weeks for the last nine plus months. This week we’re back up to 20 that we didn’t jump to 20, but we’ve built up a couple of weeks. This week it’s 20 as I’m filming. Everything’s fine, you know, I’ve done 8-mile runs 7-mile runs we’re continuing to build.

[00:07:00] So the first step is to me, we’re going to be getting to about 25 miles a week, again, continuing to be pain free and continuing that rehab program. Again, I’ll link to that video at the end. You want to continue that because you want to make sure your strength in that Achilles tendon continues. We’re going to get to 25 miles a week, then we’re going to add strides.

[00:07:23] Why are we going to add strides?

[00:07:25] Because strides are extra, extra tension on that tendon and on your legs. I’ve also had to deal with hamstring tendinopathy and that’s complicated things. Same leg, but they’re connected.

[00:07:39] And so we want to add strides because you don’t want to go from building mileage to, “Hey, let’s go do like a three mile tempo run.” That’s a lot of stress. Strides are 10 to 15 seconds of build up acceleration and deceleration. So you’re kind of in some ways you’re like testing the waters, but you want to remain pain free through the strides.

[00:08:05] What we’ll do to start with is simply just do like one or two after the end of a run. And then my kind of norm for doing strides after a long run is like 4 to 6. So we’ll build up to that again, assuming we remain pain free. And you want to be conservative, don’t try to do this every single time you run. Maybe once a week. See, “Hey, did it work?” Try again next week.

[00:08:29] Then from there, then we can think about, “Hey, let’s do some tempo run.” We’re probably actually continuing to build mileage through this time. For me, I’d love to get back into the like 35 to 40 miles a week, kind of range for you. That may be higher, It may be lower. Whatever your norm is, this is kind of what I can fit in my schedule at this point in my life. Then at that point, when mileage is built up, you can do strides. Then you go back in your tempo work and you’re going to do it any kind of normal, I’ll say normal progression.

[00:09:03] It all depends on where you are and what you do for your training. But for this particular case, we want to go through each step in terms of intensity. So you’re going to go tempo, which is like zone three, also known as like 10K or slow 10K pace or maybe half marathon pace. Then you’re going to go workouts a little bit faster, a little bit faster, a little faster.

[00:09:26] Again, this is over a period of time. That period of time depends on you, but the indicator that you can progress on to the next thing is pain-free.

[00:09:38] The toughest thing for you to do as you return to running is continuing that rehab program. And this is something I talked about with Mark Gallagher on the Smart Athlete Podcast. It’s another show that I used to do on this channel, discontinued at least for now.

[00:09:54] He’s a podiatrist in the UK and we talked about how preventive maintenance or ongoing maintenance of injuries is like the Achilles heel, pun intended, of people coming back from injuries because we get back to the point where we’re pain free and we go, “Yeah, we’re good.” Like when we have pain, we’re motivated. We go, I’ve got to do something about this. I want to get back to running. I want to do the thing that I need to do to get back to the activity that I love.

[00:10:21] But once you’re back at that activity, you go, “Yeah, I don’t need to do the extra stuff,” but you do because the recurrence of injury is much higher for people who don’t continue their maintenance programs. I have personally made it just a part of my warmup routine or I get to say my pre run warmup warmup I talked about that in another videos, again, subscribe to the channel. Stick around. Check out some of the other videos from previous seasons.

[00:10:50] It is essential that you do that pre warm up, but it’s also a part of your routine because you know that’s now part of your history. It’s not going to hurt you to continue that kind of maintenance on your Achilles. You need to have strong tendons, strong tight tendons to perform at your best. And when they get injured, obviously that sidelined you.

[00:11:11] So if you put it as a part of your warmup, even if it’s a set of ten or two sets of ten, not the whole blown like we’re doing three sets of ten twice a day or whatever you were doing with your physical therapist, that is going to be a crucial preventive key to keep you running and keep you healthy into the future.

[00:11:31] So do you have any questions for me about running? Anything you’d like to see here on this channel, leave them down in the comments below. I hope to see you next time on the next episode of Runner’s High.