In my most recent blog update, I talk about my achilles challenges, searching high and low for the best approaches, and taking a measured, intentional approach to returning to health and competition. Not everyone can fly across the country to get access to the top sports doctors, so I want to share a few of my resources from top Doctors, Coaches, and scientists that you can consider if you have an achilles injury. A lot of this applies to other injuries as well.
It’s always good to see a doctor first when you have an achilles problem, and more than likely they will prescribe physical therapy, or send you out the door with a few exercises proven to work. Much of the leading research comes out of Sweden by Dr. Håkan Alfredson, and it focuses on specific eccentric loading protocols. It hasn’t solved the problem for me because I have an issue with the bone the tendon connects to, but it works for most achilles issues, and is non-invasive, and free! Here is a link to his scholarly articles, and others along the same topic. You can always start these on your own.
Often there is more going on than just the achilles. Ideally, a physical therapist is best equipped to evaluate your injury and get to the bottom of why it occurred in the first place. While as an athlete you can tend to focus on the spot the causes pain, they will take a look at the problem more globally and give you a strength program to create more symmetry, and bring you back to health.
Compliance is the biggest obstacle to physical therapy working. You are much more likely to be motivated to do the exercises if you understand “why.” Read Jay Dicharry’s book “Anatomy for Runners” to develop a global view of your body, and to trouble shoot specific problems on your own. The book helps you help yourself and is a tool all runners should have on hand.
When in Doubt, Get Imaging:
One thing I’ve learned is that if a seemingly straightforward injury doesn’t respond as expected, there might actually be something unusual going on. My MRI showed a bone deformity that made many of the traditional PT exercises and a lot of what I was doing in the gym counterproductive. Yes, it was extremely frustrating to learn that for over a year I was making things worse by trying to make things better, but now this new knowledge changed my course of direction toward working around my problem with an orthotic that will minimize the effects of this structural abnormality. Currently I’m using green SuperFeet with a special pad under the first metatarsal per Dr. Saxena’s recommendation, and if it continues to work, I’ll get a proper orthotic. I know orthotics are not in fashion at the moment, with everyone being into natural motion, but at a certain point you have to work with the body you’ve got, and if you need a bandaid, you need a bandaid. Don’t freak out about it.
Return to Running Protocol:
Dr. Amol Saxena made his guidelines for Achilles recovery available on his website for anyone, which is what I am using. Check it out. It is gradual, and based on research and years of experience. There is a lot of other great info on there as well.
Injury specific nutrition isn’t really different from what you’d normally do to train/compete your best. You know the deal: fruits and vegetables, reduce intake of inflammatory foods like sugar and alcohol, good healthy proteins and proper hydration. Short-term injuries are easier to get on the horse for, but the long term ones can be brutal. Some recent research shows there are other helpful tools to help tendons heal, and also to prevent something like this from happening again, namely this interesting and groundbreaking work coming out of the UC Davis Functional Biology Lab by Dr. Keith Barr around the role of connective tissue.
According to the article, we are now learning that ligaments, tendons, and other connective tissues are more than just a way of connecting muscle (power) to bone (structure). Connective tissue is what does most of the tearing down and rebuilding when we exercise, not just muscle, and it makes the heavy lifting possible by diffusing the load. While there is still a lot of research that needs to be done to support the theory, early lab work shows that collagen rich gelatin is extremely effective in supporting the rebuilding of connective tissue. Ingesting something and processing it through your body is a lot different than soaking a tendon in a gelatin bath in a petri dish, but this early work is exciting enough that many elite athletes are giving gelatin supplementation a try. It is natural, low risk, and certainly can’t hurt. Staying hydrated, and stimulating the tissues for as little as 5 minutes, twice a day, 6 hours apart are also part of my strategy. There is more detail on that in the article as well.
Here’s a recipe for a way to supplement gelatin. The main ingredients are fruit juice and gelatin. You can use any juice but my recipe uses tart cherry juice because I want to double dip into it’s anti-inflammatory and recovery properties. I’m sponsored by CMI, and have lots of juice on hand, so I’m always looking for creative ways to incorporate it. There’s tons of info about tart cherries, research, and recipes here if you want to know more.
Basic Cherry Blocks Recipe
- 4 cups of tart cherry juice (make sure it’s 100% juice, get at any grocery store)
- 4 small packets of gelatin (baking isle)
- 2 TB of honey
- 1 packet of Emergen-C. (any flavor you like)
In a medium saucepan, heat 3 cups of tart cherry juice and 2 TB honey.
In a separate bowl mix one cup of tart cherry juice with 4 packets of gelatin, and one packet of Emergen-C until it is smooth.
When the contents of the pan begin to boil, immediately pour the contents into the bowl with mixture and stir with a whisk or fork until evenly mixed. Over-heating juice reduces the health benefits so I try to pull it off when I see the early bubbles right before the boil. It’s hot enough to do the job, which is to be a solvent for the gelatin mix.
Allow it to cool on your countertop for half an hour or so, cover, and then put it in the refrigerator for 3-4 hours. Slice into 1 inch cubes.
Consume 2 cubes 30-60 minutes prior to exercise. I also have two more before bed.
Variation: For more nutritionally dense blocks, follow the same general instructions, but in the initial mixture, mix one cup of tart cherry juice with 5 packets of gelatin, 4 2oz shots of tart cherry juice concentrate, and 1 packet of emergenC. Then proceed with the rest of the instructions.
Got Something to Add?
If you have any tips that help with tendon health, strategies that have worked for you, feel free to share them below in the comments. I’ll add more in the future if I come across anything else helpful too.