You've probably heard the warnings about seeking medical advice before starting an exercise programme. It turns out it's for a good reason... Because people are idiots. There is a significant number of us who decide to go too hard too soon... and then blow up. I should know as this has been me.
Especially after time out through injury, where you KNOW what you were capable of, and you aim to get back there in the shortest time possible. And then something breaks again. It's hugely frustrating, and patience has never really been my strong-suit. I genuinely think that my recent tribulations have been the universe knocking hard on my head, trying to wake me up to that fact...
A fact that was confirmed to me the other day in my Physio appointment with Olympic Team GB's Chief Physiotherapist - Nicki Combarro.
Nicki gave me a full assessment of the problems I've been having. She could see clearly that the problem is definitely insertional tendinopathy in the Achilles and Heel Bursa. A problem made worse by a calcification in my heel (Haglund's Deformity). But that the true culprit that was causing a large amount of pain is in an incredibly weak Soleus in the left leg as a result of the previous calf, Achilles and ankle injuries I sustained over the last number of years.
My Calves are strong in the Gastrocnemius (the big calf muscle) but the strength to 'toe-'ff' when running just wasn't there in my left leg, which is driven by the soleus. She showed me how much less developed the soleus is in my left leg compared to my right.
While we can look at shockwave therapy in a few weeks to accelerate the tendinopathy healing, Nicki said that we need to strip it all right back and start with basic strengthening of the Soleus 1st. Having demonstrated to her single floor standing calf raises, the moment she asked me to preform the same calf raise with a bent need I was in trouble...
I couldn't do a single one. Not one! I could do 20 with a straight leg. I could do 20 with a bent leg on my right side. But the moment I tried with my left I was f*cked.
Not good..
It was insanely painful and she already knew that the full bodyweight load would be way too much for that leg at this time.... and she had a solution to that. A solution that would add load to the soleus, and allow me to build on that progressively. A simple matter of sitting on a bench and adding some weight plates to my seated thigh and performing the raise there.
Insanely simple, and could knock out 20 reps with 20kgs on my knee pretty easily. Not only that, but in less than an hour after, my heel pain was notably less! I was given strict instructions to do NO RUNNING for the next 2 weeks, and to perform these knee raises 3x 20 reps twice a day.. When I could do a comfortable 20 reps in each set, then to add more weight to my knee.
Nicki also gave me straight leg bridges to do on a bench/box daily for the next fortnight to strengthen the weakened left leg posterior chain.
In 2 weeks time we are then looking at starting the shockwave therapy to help deal with calcification in the tendon insertion while also looking a new exercises to build on these next two weeks.
Right now, I'm feeling a damn sight more positive about the troubles with my heel. I have a solution that requires patience. I need to take it slowly. I was cautioned that even if the pain drops, do not run! Nicki was adamant that running too soon will only set things back. She wants to rewind everything back to the very start with what she thinks is the main culprit triggering these problems. Slowly slowly catchy monkey... Fix that first. She was very relieved that I have built in these next few months to rehab properly, commenting that endurance runners are a nightmare for pushing the moment they feel the pain has eased (something for which I am also guilty LOL).
I also learned that despite wrecking my ankle a few times over the years, that the bones were moving as they should be and that that the ankle mobility issues were being significantly impacted due to the weakness and tightness in the soleus. Overall I'm happy and relieved we look to have a solution. It's the worst thing to simply not know, despite trying so many different approaches. The main thing here is to be patient. Do the exercises set, concentrate on perfect form while doing them, and getting on top of my natural urges to push it too quickly. At this moment in time I'm feeling better about this, but there is a VERY long way to go... but at least, I am going. Thanks for reading.
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