We have another special guest post for you! Dr. Kelly Henry is the clinic director of our McLean location, in addition to being an amazing sports physical therapist and strength coach. Kelly was a successful collegiate swimmer at Virginia Tech and now spends much of her free time dominating triathlons (placing 2nd in her most recent race!). Enjoy!
Most runners know what I’m talking about – that dull, nagging pain at the back of your heel that does nothing more than get on your nerves. It’s usually not enough to stop you (or send you to physical therapy), but you spend a few miles during each run just waiting for the pain to subside or stretch before a run, hoping you don’t feel it.
This is how I felt for months while training for my first triathlon. I blew through the initial weeks of my training, adding mileage with no problem – until I started to feel pain in the back of my heel at the beginning of a long run. The pain disappeared during the run, so I thought, “no big deal.” Until the pain returned the next morning, and the morning after that, until it was interfering with my daily training schedule. I refused to change my volume or intensity of running because I was determined to complete my training program and hoped the problem would resolve itself. When it didn’t, I sought the advice of one of my physical therapist colleagues. Going from a provider to a patient was humbling, but here’s what worked for me:
1) I adjusted my volume
Many of my symptoms decreased once I admitted I needed a little rest. Combined with the two tricks below, I added running back in small chunks at a time. In general, I tried to increase my mileage by no more than 10% per week.
2) I gradually improved my calf and lower leg strength
Tendon injuries happen when a muscle isn’t ready for the physical demand being placed on it. Isolated calf and lower leg strengthening is crucial for improving the tolerance to load and decreasing the demand placed on the Achilles tendon. Exercises I added to my daily routine included bent knee heel raises and different split squat variations with my heel elevated.
3 I addressed the factors contributing to the cause of my injury
Besides strength and volume, there were specific mechanical changes I needed to make to optimize my running form and prevent this injury from happening again. I improved my ankle range of motion and learned to absorb the impact of the ground more effectively. Some drills to improve this included single leg box jumping and weighted single leg hopping.
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