You’ve developed the running bug…
Outdoor exercise is the new Netflix! If you have been down to the local parks or walking tracks, then you would know that Melbourne’s eastern suburbs are booming with keen runners and walkers soaking in the sunshine in a bid to curb their iso-boredom.
For those of you who are new to these types of exercise, you may be at risk of developing overuse injuries, in particular tendinopathy. In this blog, our physiotherapist Michael Scardamaglia will teach you about what tendinopathy is, the signs and symptoms and what this means for your new found love of running or walking. For the purpose of this blog, we are going to talk specifically about one of the most common kinds of tendon pain – Achilles Tendinopathy
Achilles tendinopathy presents itself as a localised pain in a specific point in the Achilles, it can cause stiffness in the affected area in the mornings and impact your ability to run, hop and jump. Up to 15% of runners will experience Achilles tendinopathy, but it can just as easily affect sedentary individuals who begin to exercise without the appropriate guidance of where to start.
Why does running recruit the Achilles tendon so much?
There are a few underlying concepts I want to explain to you for this whole blog to make a bit more sense going forward.
Firstly, the load going through your legs when your feet strike the ground during running is around 3-8 x your body weight and your calves take about 60% of that load! This means we need to have really strong structures to both absorb and release that kinetic energy to generate movement.
Secondly, our tendons are unique in that they can shorten and lengthen very quickly thanks to the large amount of elastic collagen fibres in them. In contrast, muscles lack these stiff collagen fibres and therefore contract much more slowly, causing tendons to become the primary driver when a fast contraction is required. This means when our foot strikes the ground during running, our tendons can quickly absorb and release that force as kinetic energy to propel us forward.
Sounds really scientific right? More simply put; our tendons are like springs, and just like springs they can lose their spring-like quality if we don’t treat them right with the appropriate amount of running, coupled with strength training and adequate recovery!
What causes Achilles tendinopathy?
Tendons in general really don’t like change. When we talk about ‘change’ we are referring to the amount of load the tendon is exposed to across a period of time.
Let’s use our regular gym go-er for our example. Our gym go-er is a generally active person, who has recently taken up running to fill the exercise void during the covid times. Previously this individual has done little to no running and has decided to start running 4-5 times per week to replace their gym routine. They start off running 5kms, they are finding it very difficult and tend to pull up quite sore afterwards. After about 3 weeks of this same routine they start to notice some Achilles tendon stiffness in the morning when they wake up, some pain at the beginning of their run and as they cool down their Achilles starts to ache even more. This is a textbook example of Achilles tendon overload resulting in an Achilles Tendinopathy.