Apr 252006

Today I went to the podiatrist to see what could be done about my supposed achilles tendonitis I’ve had in both heels for years now. In return, I learned more about the achilles tendon than I ever expected to know. I was really impressed with Dr. Tad Sprunger (Tad! *giggle*): he was pleasant, informative, and easy-going. Also, Dr. Benson knows his shit, because I do in fact have achilles tendonitis like he said.

By genetics, my tendons are shorter than normal and therefore tighter. They rub against the heel bone, which has caused the heel to lay down extra layers of bone over the years. Not a problem in and of itself, usually. He showed me how he knew this by trying to push my foot straight up while I kept my knee straight. I couldn’t get a full 90 degree angle at the foot unless I bent my knee.

It had been suggested by a previous doctor (who misdiagnosed me as having a heel spur) that cortisone shots in the heel would alleviate the inflammation. I never had it done because the idea of a needle in my heel gave me the screaming horrors. This turned out to be a good thing, as cortisone shots in the tendon can eventually cause it to rupture as the cortisone weakens the fibers. Doc said in 12 years he’d never given any and it would be an absolute last resort.

The achilles is the only tendon in the body that has no protective sheath, making it more susceptible to injury, in an area where it’s subjected to huge amounts of stress. So much for “intelligent design”. The human body, as great as it is, would never pass an engineering QA review. The tendon also has very little vascular flow, getting the blood it needs only from the calf muscle. This is why the Motrin I took for the pain had very little effect: it wasn’t really reaching the problem area.

I also learned that my shoes are shot. I bought a pair of Saucony running shoes two years ago from Hanson’s in Royal Oak and, while Doc said they’re a great brand and it was even better that I got them from Hanson’s to ensure proper fit, good running shoes only last for 6-7 months, even at the 5-6 miles per week (at most) I was putting on them. The materials used give great support, but the tradeoff is they can’t do it for long. He figured that the shoes had completely broken down, which is why the pain has been so much worse recently, and getting new ones is the number one priority.

Counterintuitively, using the treadmill or stairclimber actually puts almost as much strain on the tendon as running outside, and the only reason running on concrete was worse was because of the harder surface, which would have been mitigated by new shoes. Apparently even a “flat” treadmill still has a slight incline, which makes you shift your weight toward the balls of your feet, straining the tendon. More so for the stairclimber.

So my instructions are to stop running or stairs completely for 10 days, ice the heels at least ten minutes a day, and do several different stretching exercises. Once I get new shoes, stretch before and after running, then ice the heels afterward for ten minutes. I also have to start slowly, doing only a quarter of my usual distance. So it’s the stationary bike or rollerblades for me for awhile.

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