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Wednesday, December 19, 2007

Achilles - lower calf pain in a distance runner

Hi Gary,
I am a 49yo off road runner who having come off a reasonably robust year culminating in the 31.5km Kauri Run, am experiencing pain in my right Achilles/lower calf area. It used to appear only when road running but is now a constant on most off road surfaces as well apart from technical single track. I have read with interest your response to Tendonitis and am trying many things incl new shoes, orthotics etc. What supplement do you recommend and is there a range of exercises that can help?


Gary Moller advises:
What you describe is an almost unversal injury among runners. It is also one of the most annoying and limiting injuries. It is also one of the the easiest to fix if it is what I suspect it may be.

It is possible that you have strained or even torn a few fibres where the muscle and the tendon merge - what is called the "musculotendinous junction". The illustration to the right is pretty good but does not show how the muscle and tendon gradually merge. This is a vulnerable region for injury in the older hyperactive runner.

Another possibility is that you have bunching and inflammation of part or all of a muscle belly. The most commonly affected in runners and cyclists is the lateral head of the gastrocnemius. If a person was to press firmly on the belly of the muscle and it felt tender and hard, rather than soft and supple, then that is part or the whole of the problem.

The solution is simple and I usually have close to 100% resolution in most cases within 3-6 sessions. In a recent case just a week ago, it took just two sessions to have a runner completely pain-free following several weeks of painful hobbling from a calf muscle tear. The solution is deep tissue massage of the affected muscles/tendons and all of the surrounding structures, including the unaffected leg. Each session takes an hour and there can be some pain involved as knots and infalmmation are broken up and dispersed. This should be done by an experienced therapist who has the time to do a good job.

The end result is a pain-free, nimble-footed older runner.

There is a place for supplements during this process of restoring normal function because elimination of metabolic wastes and proper healing are all important and there are several supplements that can assist. These are available from my online store.

Vitamin C is at the top of the list along with the water soluble B vitamins. Vitamin E comes next for its healing and antioxidant qualities. There are several others that one can add, including minerals and fish oils; but these depend on individual need which I can assist with determining.

You could consider some of the assessments available here.

I am enthusiastic about Formthotics Active for running shoes. these are heat moulded to fit the contours of your feet, giving just that little bit of support needed as the feet tire and they reduce foot movement and consequent blistering. Formthotics Low Profile are designed for shoes like track shoes, golf shoes and cycling shoes. Although I have strong feet that never give trouble, all of my shoes, including work shoes are still kitted out with Formthotics.

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