Running writings: Injury Series: Eccentric exercise and tendon remodeling, part I: Achilles tendonitis. Attention readers: I have published a significantly revised and updated article on midpoint Achilles tendonitis. The information below is incomplete and out of date! Click here to go to the updated Achilles tendonitis article. Note: if you are looking for information on insertional Achilles tendonitis, see this article. We're shifting gears a bit today. Its role in running is essential- -it allows the calf muscles (the gastrocnemius and soleus) to elastically store energy via the stretch- shortening cycle, which is released upon toe- off. Want to learn to throw a perfect spiral or how to hit a curve ball?
Unfortunately, this can't be answered yet. This brings me to John's First Maxim of Injury: injury- related pain is the result of real, physical damage to the musculoskeletal system. It may seem like a silly maxim, but you'd be surprised how many people fool themselves into think that the only reason something hurts is because there's . When Sam injured his Achilles, probably during his high- volume training in the past week or so, he actually caused a microsized rupture of the tendon. This cycle of injury and repair does not necessarily have to take place in rapid succession; several injuries to the same Achilles tendon over a period of months or years can also bring about the disordered collagen arrangement characteristic of chronic Achilles tendonitis. Because of the disrupted collagen arrangement. I've already established that tight calves are bad and predispose you to Achilles problems, and stretching loosens tight muscles, so why not stretch them out? Because stretching increases strain on the Achilles. Every time you stretch, it's like tugging on both ends of that knotted rope. Eccentric heel drops: a superior treatment method. In the past decade or so, using targeted eccentric exercise on injured areas has become a very important part of rehabilitation for several chronic overuse injuries. Fifteen were assigned a rigorous eccentric calf strengthening routine and fifteen were assigned surgical debridement of the Achilles tendon. They were only loading the calf muscle eccentrically, no following concentric loading was done. Instead, the noninjured leg was used to get back to the start position. The patients were told to go ahead with the exercise even if they experienced pain. However, they were told to stop the exercise if the pain became disabling. ![]() SOURCES: Stop Sports Injuries: "Running Injury Prevention." Sports Injury Clinic: "Running Injuries," "Blisters." American Orthopaedic Society for Sports Medicine. When they could perform the eccentric loading exercise without experiencing any minor pain or discomfort, they were instructed to increase the load by adding weight. This could easily be done by using a backpack that was successively loaded with weight. Recall that the root cause of chronic Achilles tendonitis is the disproportionate strain on the disordered collagen at the injury site- -the knot in the rope, per our analogy earlier. Next time, we'll look at a similar eccentric rehab protocol for another common chronic injury: patellar tendonitis.
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June 2017
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