A couple of years ago, I wrote down my experience concerning my long-lasting achilles tendon injury. The purpose was for me to put my thoughts down in a place where I could review them later on and see how I experienced the problem first-hand and not just what I remembered experiencing, which tends to be over-exagerrated in the end if you want a good story out of your misery. I posted those thoughts here in July 2015.
I haven't kept a journal over my injuries per say, other than my training log. Such as it is, the analyses aren't that deep when it comes to the entries concerning my achilles tendon. If it works, it works, and when it doesn't, a rest day usually sorts it out. Until that doesn't work either.
In hindsight, I feel like I've been very naive when it comes to my rehabilitation. There is comedy in the fact that I thought two weeks were a reasonable period to rest and rehab an achilles tendon. I kid you not...
Honestly, I should have seen reason and sought more guidance in rehabilitating my injury. I should have nagged properly to meet expertise on running injuries and dealing with over-eager athletes. My experience, however, is that most physiotherapists have very little knowledge about athlete's injuries, especially if you meet a generic representative in the field working in Swedish health care. Once, when I wanted to discuss aqua-jogging as a relevant alternative training form to running, the physio I met at the time thought that it wasn't a good idea to run in a kids pool... The poor fool had no idea about aqua belts or aqua vests. I didn't see that physio again, but I feel like there are a lot of them around, whose only concept of dealing with an injury caused by running - is simply not to run.
So, without further ado, here are my recent experiences with setbacks in my running caused by my inability to treat my achilles tendons correctly over the last few years. The lesson being, if you're reading this and dealing with your own issues, to listen to your physio and rehab your tendons properly!
In the fall of 2015, I started running again on my way back from injury. I had stopped running in May to rest my achilles yet again. Here's a fun fact: did you know that you can have two types of achilles tendinopathy? Midportion and insertional. Most people get the midportion variety which is pain located a few centimeters above the heel. In my case, that was the first injury I failed to rehab properly. It is the easiest one to deal with, so if you have midportion achilles tendinopathy, be glad that at least it isn't insertional, which is the variety I am dealing with now, due to being a fucking idiot. I started feeling pain on the back of the heel, instead of over it and I did what I had done in my previous dealings with my achilles tendon: rest from running and eccentric heel raises. It allowed me to start running again, and I stopped doing the rehab exercises, because I'm a moron, and ran on.
In 2016 and 2017, I enjoyed a few years of being able to run quite much and quite well. There was pain, for sure, but never when I ran. I usually got quite sore in the mornings and after being still for a while. After days of hard running, I usually had more pain, but the rest of the body also needed to rest on those days.
Coming in to 2018, however, the problems spiked again. I got sore, not only in my left heel, which is were I originally had problems, but also in my right heel. Much like in the previous years, I didn't deal with the problem right away, but waited until after an important race, prolonging my pain and the rehab period for sure.
I stopped running in May, yet again, but ran sporadically to "test" and stress the heels somewhat. It felt OK, and I met a physio because I felt like I needed some guidance. The physio wanted me to stay off running for four to five weeks, which I did. The lesson from that time was that I got bored and the road back to running when I eventually got better was longer and slower than it needed to be.
The best experience I've had in talking to doctors or physios concerning my heel pain is a doctor I met who actually wanted to look at an X-ray of my heel and not just touch it and squeeze it or see if I could do a heel raise. After establishing that my achilles tendon didn't have a tear anywhere, and that the heel bone was intact, this bit of knowledge was passed on to me: "it is just pain. It's not dangerous to run with pain. The tendon will not tear, so it's just a matter of how much pain you can handle."
Some might think that this was bad advice, but this is actually the best piece of wisdom I have come across when it comes to chronic heel pain. There are a lot of things I should have done early on to avoid this injury to be prevalent. I didn't. Now, all I can do is deal with the fact that surgery, as a last resort, wouldn't even be a guarantee to get rid of the pain. Just a guarantee of weakening the tendon and the insertion, which increases the risk of tears or even ruptures in the future.
So I ran on. I started slow, and increased with minor steps. Pain was there, but I never ran so that the pain got worse. I had a few weeks of devoting some time to eccentric heel raises and heavy, slow strength training, but after a few weeks, that type of training ebbed away.
Cut to 2021. In June, I ran an intense orienteering interval session after a week of hard running and a distance training with zero drop-shoes. The day after, the back of my left heel was seriously sore. I didn't rest though, because there was a training session on a map that I didn't want to pass on. Then I wanted to attend a training weekend in Ärla. Then I wanted to run the World Cup test races and have a training week in Idre. And then I wanted to run this and then that, and when it actually came to the most important competition of the year, the Jukola relay, my left heel was so sore that I needed to avoid wearing shoes.
I managed to run the Jukola relay, and after that I didn't run for three weeks because I had ignored the pain for too long. Pain that got worse after each training session. Now, I'm trying to be more systematic in my progress to come back to running. I don't believe in staying off running for too long, simply because you need to load the tendon so that it doesn't get weaker. And what better way to load it than running? I keep it short, not more than 5K, and I only run every other day because I also do a lot of strength training at the moment, focusing on the calf area. One big change from earlier is that I do them flat on the floor and not in stairs, to avoid a sharp angle for the heel. I believe that this time, my injury has come from the bursa getting too much pressure, so I want to allow some relief in that area for a while.
I don't know why, but for some reason I wanted to write this blog post in English. I feel like there are more people who understand this problem in English speaking areas. When I have searched for other athletes' experiences it has been easier to find in English. If you have similar problems, or maybe even some input that I haven't thought about, feel free to comment.
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