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On this page, we'll try to answer your questions
and provide some nuggets of wisdom. Keep in mind that diagnosis of injury is the responsibility of your physician. Comments
posted here should not be misconstrued as medical advice! Please refer to the
publications page of this web site for informative articles on flexibility and strength exercises, common injuries, and other
useful tips.
Ask the Coach
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Friday, June 30, 2006
Achilles Tendinosis - injured runner
For the last couple years, I have had episodes of right achilles pain without swelling, which I've been told is achilles
tendinosis. When this occurs, it seems like I can take several weeks off from running with no improvement, and then if I get
fed up with the time off and return to running, it eventually resolves on its own. I haven't really found an effective way
to prevent/treat these episodes. I try to do eccentric calf strengthening exercises during the nonpainful intervals, but this
apparently is not really helping much since I continue to have the problem. Also, during the painful episodes, I haven't found
anything that helps. In fact, I think ice might make it worse! Do you have any advice on treating achilles tendinosis? Thanks!
Reply: Janet
If you've not had a gait analysis done, that might be one avenue to pursue. If your
foot is pronating too far or too fast or too late... this can place additional stress on the Achilles tendon. Also keep in
mind that the terrain you run on, the pace you run and the shoes you run in... as well as flexibility in your hamstrings and
strength in your core muscles may all play a role as well. Good strong hips, flexible hamstrings, the right amount of support
from your shoe or shoe/orthotic, and careful training are about all you can do. The eccentric exercise is valuable -- but
you may want to talk to your PT about whether or not you're doing the right ones and at the right level of intensity. Hope
this helps. Janet Hamilton, MEd, RCEP, CSCS, Running Strong coach
Thanks -- from Maureen
Janet, I began posting back in the summer of 2004 when after I was diagnosed with a hip stress fracture. When I got off
crutches and was cleared to try running again, I had a lot of trouble. I eventually got your book and began doing the exercises.
Still no luck running regularly. Got your video gait analysis, changed shoes, found a new doctor to prescribe PT. Found a
PT who helped me with lateral hip strength. All the while continued with your exercises. Well, Janet, my glass is raised to
you. I just completed my first marathon this weekend. Made it through the training (peaked at 51.5 miles)in one piece, and
ran a 4:45 race (way slower than I had hoped, but it was in a pouring tropical rain and I think I got dehydrated). And I'm
still feeling good! I can't wait to try another one. I love to run. Janet, you are my hero. BTW, to all reading: no one paid
me to write this! It's all true!
Reply: Janet
Maureen, congrats on finishing your marathon injury-free. Thats a testament to your diligent
attention to the details when training. I'm glad to have helped in a small way. Here's wishing you many more years of healthy
running! Janet
Femoral Neck Stress Fracture - Mike
After 8 long months, my doctor has finally said that I am ready to begin a running program after a femoral neck stress
fracture. My doctor said that I probably did too much too soon. I am starting a walk/run program and I'm also going to a foot
specialist to be sure I have the proper shoes. In your opinion, what are the chances of this injury recurring? I plan on taking
things very slow this time. Thanks
Reply: Janet
If you deal with the factors that lead to the injury in the first place, and if you're
systematic in your training -- your risk of re-injury is low. I would recommend doing a walking program only for a few weeks
before adding in segments of running. It just makes more sense to be conservative and reduce your risk of injury as far as
possible. Hope that helps. Janet Hamilton, MEd, RCEP, CSCS, Running Strong Coach
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Running Strong* 191 Crossing Dr* Stockbridge, GA * 30281 Phone/Fax: (770) 957-0986 Or 678-357-6406
Contact coach Mike Broderick in Gaithersburg MD * (240) 338-2210
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