Injury reframed

Following on from my previous post I thought I should give an update on my ongoing achilles injury. Last week I visited a new physio - Paul Coker at the Treatment Centre in Truro. What makes Paul different from previous physios is that he is also an ultra runner which has to be a good thing.

We spent a good bit of time going over my history and when we got to the part where I mentioned my climbing accident and subsequent smashed up Calcaneous on the other (left) leg, Paul seemed convinced that this was where the problem was.

So here's the theory, broken and deformed Calcaneous, lack of movement & flexibility in certain planes of motion, significantly less strength in the left leg overall (Paul measured my calfs and I was surprised how different they were); all adding up to a leg that was not pulling its weight. The right leg therefore has to do a lot more work and probably impacts the ground harder, especially as I tire on longer runs, eventually causing the injury to my achilles.

There followed some massage to my injured leg performed with a kind of metal knuckle duster and without doubt the most painful massage I have ever received! What was really positive though was that in fact I should not be resting but continuing to run, albeit at reduced intensity for now. I have had a feeling, and Paul confirmed this, that the weeks off had made things worse, not better.  I am to continue with the eccentric heel drops but adding weight to make them harder.

For my left leg I need to work on the part of the muscle that prevents me standing right up on tip toe, currently I can only get up about half way as far on my left leg as my right. This I had assumed was a mechanical limitation I was stuck with but Paul thinks I can improve it: I have to hold myself in position for as long as I can, using as much assistance as necessary to stop my heel from dropping. Eventually once I can do this I will extend the exercise to full calf lifts but I'm a way off that right now.  Paul also thinks I can get some of the range of motion back - I currently can't turn my foot in fully. He thinks rather than a bone on bone limitation post-op this is all down to tightened tendons running down the front of my leg so I have some instructions - including a foam roller and pushing my foot into position - to get this mobility back.

And as for running, its ok for it to hurt! Paul asked me to judge my efforts on how sore I am after rather than during my runs, and this is the best news I could have! Its funny how a little confidence boost like this can make so much difference. I was running previously and wincing at every twinge I felt in my achilles. This weekend I ran free of the fear that I was damaging my foot, happy that in fact I was doing it some good - and the next day: no pain. So next weekend my long run will be just that little bit longer!

Its going to be a while before I am fully fit but mentally I am in a much better place and I'm sure I'm on the right track. Watch this space.