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Monday, August 11, 2014

Achilles Tendinitis: Email Advice regarding strengthening and running

Hi Rich;
I'm not up to 100 stretch sessions yet but I'm getting close (at which point I will make another appointment with you).


In the meantime, I just wanted to keep you abreast of what's going on.

I've been running every other day and doing the stretching regularly and leg strengthening exercises faithfully. I am now up to 50 straight leg both legs/25 bent legs, as well as 50/25 on each leg separately. I do, however, break the individual legs into sets. 25 straight leg on my right, 25 on my left, second set of 25 on my right and left, the 25 bent knees on both. My calves really start to burn at about 21 but I have the strength to power through them. I feel like they're really helping me with some burst energy when I run,which is good news.
Dr Blake's comment: I am having this patient each evening do two sided calf raises both straight and bent knee to warm up, and then straight and bent knee single leg calf raises to tolerance (pain in the calf/achilles, or burning. She has slowly worked up to this level. Sounds like she is successfully squeaking in a few more after the burn. She is also doing more since she is breaking them up into 25s for the straight knee. The goal in rehabilitating achilles is to build up to 50 one side straight knee, and 25 one side bent knee. 

This past weekend, I deviated from the "run only every other day" by running two days back to back. I ran 7.5 miles on Saturday at a relatively fast click (for me) and then a little slower on Sunday for 6 miles. I found after yesterday's run that my achilles reminded me that I needed stretching (we sat in the car a while) so I made sure to stretch whenever I could.
This morning, I felt the normal tightness in my achilles, but after my regular morning calf stretch routine it feels completely fine.
Question: I have a half-marathon coming up in 7 weeks and I would like to start being able to incorporate two things:

Running 4 times a week rather than 3
Running longer runs.
I want to get a sense from you whether those would be OK. The 7.5-miler was a test; I felt fine afterwards but I made sure to ice and stretch afterwards.
No crazy big miles for any of the runs but I would like to be able to run at least a couple of 12 milers in the next 5 weeks. Do you think that's reasonable?
By the way, I have started taking a yoga class once a week and I find that it is very helpful.

Thanks.

Dr Blake's comment:

     Sounds great, but you can do the 1/2 marathon better with every other day runs when you are recovering from an injury. That gives you 4 times one week, and 3 the next. It will honor the recovery phase better, and when you are increasing mileage (especially the long runs), it makes a big difference. Hope it makes sense. Keep up the hard work. With 7 weeks to go, run 8 miles the first weekend, 9 miles the next, 10 the next, 11 the next, and 12 the next. You will be more than ready.  Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.