Tendon injuries form some of the more common injuries that runners sustain including the Achilles, patellar tendon and the plantarfascia (which acts in a similar manner to a tendon). Tendon injuries can be stubborn, and they can completely unravel the best of build ups for a major event. Here are a couple of key management tips.
1. Avoid complete rest.
Unless the injury has come about from an acute injury (partial or complete tear), pain that has just come on slowly over time tends to be better managed with relative rest. Complete rest will rarely if ever resolve the issue because the problem is in the tendon’s ability to tolerate load.
2. Offload then slowly build back up.
Give the tendon a break from the aggravating load (running) but continue to bike or swim as a form of cross-training. Most of the science tells us that tendon’s only have so much capacity to adapt to changes in load (think mileage, intensity, frequency of your runs). When ready to build back into running the rule of thumb is never increase by more than 15% per week (mileage,intensity and frequency).
3. Establish the cause.
The majority of tendon conditions that have developed over time can be attributed to a rapid change in load, changes in footwear or poor biomechanics. It is worth consulting with a physio with an interest in running so they can look for these causes and help prevent the problem from returning.
4. Scans and other diagnostic measures don’t often change management.
Leading tendon guru’s worldwide agree that ultrasound scans or even an MRI of a tendon often doesn’t change the treatment protocol. Trust the judgement of your physio and follow what we know is a tried and tested rehab process.
Finally, if you have an Achilles problem then you have something in common with one of the leading researchers in the field of tendon injuries. Mr Hakan Alfredson, an orthopaedic surgeon after whom Achilles rehab protocols were named was a runner who himself struggled with his Achilles. By performing a progressive strength programme he resolved his issue and was able to avoid surgery.