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Saturday, October 17, 2015

Achilles Tendinitis: Yes it can get better!!!

This email is from one of my favorite long distance patients. I treated her for achilles tendonitis last year with activity modification, icing, stretching and strengthening. The email shows that this basic approach was successful. She also found a wonderful video on self deep tissue mobilization of the calf, but not to be done if your knee cartilage is suspect at all. The technique requires your knee to be too bent forcifully for too long. But, given good knees, and given a calf or achilles problem, you may want to add this to your regimen. Another example of how I learn more from my patients than medical seminars some times. Rich

Hi Rich;

I meant to make a follow-up appointment with you for earlier this spring, and I got caught up with stuff and never did. Part of the problem (if you want to call it that) is that my Achilles was feeling much better... which meant I wound up putting off making an appointment to see you.

I think I don't need to make another appointment at this time, but I thought it would be good to send you an update.

I kept up with my calf stretches regularly (and heel lift exercises not-as-regularly but still every so often), to where my Achilles no longer bothered me. I stopped wearing the support boot at night. I also felt like I could finally start pushing off with my left foot and I didn't feel any sort of strain.

The big news is that I ran the Mountains 2 Beach Marathon (from Ojai to Ventura) this past May, and qualified for the Boston Marathon! Not only did I BQ; I did so with 5 minutes 12 seconds to spare, essentially guaranteeing a race spot by being able to register during Week 1 (with the rest of the "fast runners"). I have a friend of mine who only made her qualifying time with a spare 100 seconds, who was shut out for the 2016 race because the cutoff was 2 minutes 38 seconds (I assume you know how that two-step process works for Boston).

I have registered and been confirmed to run Boston next April. I also won the "Boston 2 Big Sur" lottery so I will be running the Big Sur International Marathon down in Monterey a week after that.

Things got a little dicey after the marathon. Just a few weeks later, we took a vacation to Grand Teton and Yellowstone, where we ran two half marathons. Since we were doing a lot of hiking and also some camping, I actually didn't stretch as much as I should have... and so June/July was a little concerning because my Achilles tightness came back. I restarted working on them with diligence, and the issue has resolved itself now.

Now that I no longer feel gimped, I find that being able to push off with healthy feet/legs has made a tremendous help in my speed. This past weekend, I ran the inaugural Yosemite Half Marathon, and had I been suffering from Achilles tendinitis that course would have had me howling in pain; the course is 10 miles of downhill, with a leveling off/rolling streets for the last three miles.

However with my healthy Achilles, I was able to just remove my brakes altogether. I finished with a time of 1:40:51.9 and broke my previous PR by 10 minutes. My husband joked that I should put an asterisk on it because it was a gravity-assisted course, but I also came in first in my age group... THAT's legit, since everyone else in my age group also ran the exact same downhill course.

One quick question. A friend of mine forwarded me this video, and I'm wondering what you think. It makes sense; it's essentially like having someone press down on your knots while you try to work them out.


PS: Sorry about the Giants. The A's sucked this year, too.

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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.