Achilles tendon pain and swelling training for the Oxfam Trailwalker

Over-engineered shoes with high heel-counter
that digs into the Achilles tendon when
stepping downhill, or into depressions.  Fine
for flat running - terrible for running or walking
over rough terrain.

Hi Gary,
I am training for my first Oxfam challenge but am having a lot of trouble with my left archilles.  I have read previous posts where you have suggested it may be the smaller muscles around the tendon but am finding discomfort at touching the tendon and swelling after walking on it.

I am currently travelling around south east Asia and should probably be walking a little less but I took it very easy before my trip and it still didn't seem to heal.  It gets worse the more I walk and sometime goes so tight that I have to stop I pain and give it a few minutes. Is there something I can do to strap or support it as the oxfam teailwalker is only a few months away.

I have been to a physio but he was only massaging it and then strapping it which he advised me to leave on for 24 hours and it wasn't helping only while the strapping was on.

Thank you for any advice you can give.

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Gary:
There has been an upsurge in Achilles tendon injuries in the last year.  In fact last year was a record for me.  There are a number of causes but there is one causation that stands out above all else: Footwear.  But why now?

I think the problem is in the shoe design which has high, hard heel counters (refer photo above).  Running shoes are designed in places like California where their idea of off-road is a manicured track - nothing like the rough stuff you find in New Zealand!  The real damage happens when walking or running down very steep slopes or stepping into depressions like pot holes where the foot is forced into extreme plantar flexion while the Achilles tendon has to snap taught.  This causes a guillotine chopping of the Achilles tendon.  This action can be repeated a thousand times during an hour or so of walking or running.

It is therefore hardly a surprise that Achilles tendon injuries are on the increase in New Zealand.

Check to see if your most tender spot on the Achilles fits with where your shoes bite into the tendon.  If this appears to be the case then it is best to biff your shoes and get a new pair that has a low-cut heel counter.  If you can't bear to do this, you could resort to partly cutting away the heel counter of your $220 pair of shoes!

Please take time to read the string of articles about Achilles tendon injuries here.

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The advice in these articles is given freely without promise or obligation.  Its all about giving you and your family the tools and information to take control of your health and fitness.

Running Shoe construction - Have we sould out to the shoe companies?

"Recalling that your sister was a barefoot runner early in her career, I wonder about your thoughts on minimal running shoes. I can see valid points on both sides of the argument."


Photo: Lorraine and our late father, Gordon Moller, circa 1976, training in the Central North Island forests (Pinedale).

Note the rough terrain. The light shoes are conducive to nimble footwork. This terrain meant every foot strike gave varied stress on the feet and ankles and was quite soft on the knees and hips.

Heavy, over-constructed shoes would only lead to clumsy footwork and consequent injury - mostly from falls and ankle sprains.


"I had hip surgery July 2008 for labral tear induced by a well meaning therapist, on a totally fine hip, to impress me with her work and refer patients! Ouch. I have to vary my activity widely. The greatest bulk of my exercise time is in the twice weekly 2.5 hour strength training sessions. With one more shorter strength session, a couple hour hike in the mountains one day and a long stationary bike ride other days.

One day a week I allow myself the luxury of running for an hour. I don't want to lose that last bit of my running soul and have to be very careful given the hip surgery and the 3 preceding knee surgeries.

Occasionally I set aside my Asics Gel Nimbus in favor of my old Nike Free 5. Today I felt lousy before my run but once again I was surprised when I ran my usual course in just over 56 minutes - a minute faster than my last couple of year PR and 2-3 minutes faster than usual.

Have we sold out to the shoe companies? Have they stolen our running souls? (all inherent puns and double entendres intended)"
Michael

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Gary responds:

(Readers might gather that Michael is a doctor who loves to run).

"The human foot is the result of millions of years of evolution. The shoe companies want to change the design of the foot straightaway. Running in the cumbersome boots that jam the display shelves of the typical running shoe store is akin to John McEnroe trying to play tennis with a baseball bat"

Gordon Pirie

I weighed a pair of Lorraine's Mizuno Run Bird shoes which helped her win the Osaka Marathon circa 1987 and a pair of heavier modern running shoes. The Run Birds are of absolute minimal construction and weighed in at just over 100 grams per shoe. That is really light for running a marathon on hard pavement! A pair of my modern Asics off road shoes were almost three times that weight.

If you are running for an hour, you are probably raising and lowering a shoe about 30cm or more for each meter run. That's about 10,000 times. Which means you are raising the shoe 3,000 meters in height. According to my calculations: The total weight being lifted and lowered one meter in height is about 300Kg worth for the 100 gram shoe or about 900 Kg for the heavier shoes. These calculations do not include the energy cost of accelerating and decelerating the shoes. (PS: I rushed these calculations, so my apologies if there are any errors).

Now, try this:

• Get a 10 Kg weight, a bench one meter in height and set yourself up with a heart rate monitor. Then:
• Measure resting heart rate standing still. Then:
• Lift the 10 kg weight from the ground onto the bench and then lower. Repeat this non-stop for 30 repetitions.
• How much did your heart rate go up and how long did it take to do the 30 repetitions?
• Work out how far you could run in that time at that heart rate.
• Rest for 5 minutes and then repeat the exercise, this time doing 90 repetitions.
• Now extrapolate these results to running a marathon.

Phew! Give me the light shoes any day!

Heavy shoes, or any extra weight, including a water bottle, back pack, watch or heavy clothing all energy-sappers.

So, the message here is to run light and that definitely includes your shoes.

My favourite running shoes are a pair of super light Addidas racing flats. I have removed the inner soles and replaced these with a pair of heat moulded Formthotics Shock Stop inner soles.

But what about injury risk? Very little of my running is on hard and boring pavement nowadays - I run over tracks that are generally rough and often very steep (That's Wellington for you!). I seldom run longer than an hour and do my longer exercise sessions on a mountain bike.

This works well allowing me to compete in a number of sports injury free at 56 years of age.

I hope this kind of answers your question - I am sure you can gather where I stand on this matter. Minimalist.

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