Building up to a half marathon after rupturing your Achilles.

In five weeks I will be doing the Brighton Half Marathon. This will be my first half since rupturing my Achilles in June 2015, almost three years ago. I used to do races like this all the time, mixed in with an occasional marathon. If you’re a regular reader of this blog (don’t worry, I’m not offended) you will know that I have gradually been building up the strength in my Achilles along with pace and distance in my runs. It’s been a long and exhausting journey, and there have been a few things I have learnt along the way.

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The usual half marathon programmes recommend progressively longer runs once a week interspersed with tempo and easier runs. My first piece of advice is to focus most of your efforts on the distance runs. These are important in building strength in your tendon and confidence in yourself that your Achilles can handle 21km. I have been building up distance over the past year and this is an important aspect of with this type of rehab – ensuring you have the time to build up healthily. Rushing to build up distance too soon is dangerous, so pick a race that gives you more time to increase distance gradually.

Running every other day is a good rule to stick to in order to give your tendon time to rest. Often though it is best to take several days off in between runs, particularly if you feel any discomfort in your Achilles. This is time that can be used to cross-train or focus on sports which still build your aerobic fitness whilst allowing your tendon to recuperate.

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A problem I have found post-rupture is that my hips and knees have developed more niggling injuries due to the imbalance that exists between my good and bad leg. I’d also recommend Pilates, which has been good at building my core strength and has had a noticeable impact on reducing the niggling injuries. It provides focus on days off from running and has taught me exercises which activate long forgotten muscles which, like the rest of your affected leg, have fallen victim to wastage.

Tempo runs are important for building pace and can be done for as long as your tendon responds well to them. The flatter the route the better, to ensure you aren’t putting unnecessary strain on your ankle on the climbs (something to remember when picking which race to do). Having a faster running partners for these are immeasurably useful as they push you out of your comfort zone (see my earlier article). Be careful not to do too many tempo-runs – it’s important to remember that completing the race healthily is the most important thing. Faster half-marathons can come in time. At least that’s what I keep having to remind myself.

I continue to be mildly amazed at the ability of my tendon to respond to the increasing demands I put on it when for so long running seemed a far-off dream. It has been the ingredient of time which, fingers crossed, should see me over the line. If, like me, you have suffered a ruptured Achilles, I hope articles like these offer some useful advice. I would love to hear from you and how your rehab is going.

Finding a good running partner is tricky, but worth the wait.

Much like finding true love, finding a good running partner can be tricky business. Much like finding that special someone, it often starts with excitement before nagging and awkward long silences kick in.

People often talk of their ‘get-rich-quick schemes’ and mine would be a plutonic tinder-esk app for running partners. Instead of swiping through pictures, you’d have split times and favourite running routes… I think the idea needs a bit more work…

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Over the last few months I have begun running again regularly following a ruptured Achilles heel a couple of years ago. Despite the overwhelming joy of this, as I have mentioned in some of my earlier blogs, I have found it particularly hard to regain the pace I was capable of pre-snap. I have found a few things that have helped (see previous blog), but none have been as a good as running regularly with my older brother, Tim. We had often run together many, many years ago and back then were roughly the same standard. Since then it’s fair to say that he has become a lot faster whilst I, well, I haven’t. As a result, running with him over the last couple of months has been a revelation for several reasons:

Firstly, because we are brothers there is no need for any of that tricky running small-talk. You know where one of you of is struggling to stay alive and the other is merrily chatting along. Because we know each other so well we know the tell-tell signs of someone not wanting to talk – all it takes is a single look and the other person knows now’s not a good time.

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Secondly, and rather selfishly, running with someone faster (but not too much faster) than you is great for improving your pace. We often run routes along London’s roads and the narrow pavements mean one of us runs in front. I often find myself desperately hanging on as Tim happily jogs along and am surprised that whilst I am in large amounts of pain I do manage to keep up with him longer than I expect. In football people often talk about a player being ‘match fit’, and this is the same thing – by running with someone faster it creates an experience you cannot create on your own. Rather than slipping back to your basic pace you are forced to run faster. You could argue that you can create this pace on a running machine, but I would say that if you are a competitive person then the sight of someone just ahead of you provides far more motivation than a bleeping screen with slowly moving numbers and your sweaty, miserable reflection looking back at you.

One of the more surprising joys of having a good partner has been changing routes. Like other runners I tend to stick to the tried and tested paths which can often become more of a mental challenge than a physical one as the boredom kicks in. I have my 5km, 10km and ‘progressively longer’ route so engrained in my head that I can’t bring myself to come up with anything new. When you have a regular running partner you naturally start trying their routes too which makes the whole process more stimulating. This is particularly true in urban running where I am always surprised at what can be found if you look hard enough or even better, have a partner who knows them already.

Lastly, and arguably the most important reason, is the motivation a good partner provides. Like all of us, I find it tough to find the enthusiasm to run on cold, dark week-nights and having someone texting to say they are already on their way over pushes you out of the door. More often than not the ‘let’s do 5km’ run turns in to far longer as, for Tim, 5km isn’t worth it. At the same time, because he’s my brother I feel no shame in saying that I can’t go that far and that I’ll do 7km with him and then head home.

Don’t get me wrong, running on my own is my something I cherish and look forward to. It is the one time of day when you are truly present and as a result I have always found it a meditative experience with as much benefit for my mental health as my physical. Having said that, if like me, you are keen to push yourself and be able to run faster and longer, I can thoroughly recommend finding a good partner. I have found that the best of these just happens to be in my own family.
Continue reading “Finding a good running partner is tricky, but worth the wait.”

Building pace and distance.

Since being able to run again I have desperately been searching for two things: pace and distance. Before the Achilles rupture I was clocking half marathons in 1:20hr and a marathon in about 3hrs. When I look back on this time I was running almost every day and playing basketball, football and tennis on an infrequent basis. I had built up a depth of endurance from this along with completing distance running events on a regular basis.

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Regaining the ability to run decent distance and a respectable pace is something which cannot be rushed. Starting at 1 minute running, 2 minutes walking for 10 minutes I am now at stage where I can run for 18km without stopping at 4.30km pace. Whether this is good progress or not I am not sure but there are a few things I would suggest to people about to go through the same process of seeking to regain a running standard somewhere near where they were before the Big Bang happened.

1. Don’t worry about pace.
When you first start again don’t worry about raising your pace too quickly. Pace is dangerous for your Achilles and I found that focusing on distance was far more rewarding. Distance could be increased more systematically over the first few weeks as you start you start to run for five, 10, 15, 20 minutes without having to walk. The joy of this was the realisation that you can run again and that your Achilles does work. Having spent so long on crutches and in a boot you forget the reassuring feel of sweat dripping down your face as your legs creak into gear. I spent the first weeks and months simply raising the distance a few kilometres each week, building my confidence in the tendon and making sure any pain felt in it was “good pain”.

2. Continue with your physio exercises.
When you start running again it is easy to forget about the heel lifts you have mastered over the last year or so. You think, “finally, I’m back to normal”. You’re not. I quickly learnt that whilst your Achilles may be “better” the rest of your core and leg muscles have diminished significantly. Hip, knees, glutes, calves, I’ve had more niggling injuries post Achilles rupture then ever before. My bad leg resembled an emaciated twiglet when I started running again so these injuries were no surprise. These injuries have stopped me from running frequently since I started again and are a source of persistent frustration. I spent more time with my physio dealing with these then looking at my Achilles. The exercises prescribed, along with continuing the heel lifts were and are crucial in building core strength and keeping my Achilles healthy. As I write this the arch of my bad foot has just started playing up – I’ll add it to the list. I continue doing heel lifts now, a year after I started running again and have exercises for my hips (which caused me months of pain that) which I do irregularly. People often ask me, “is your Achilles better now?” and it took me a while to come to terms with the fact that will never be truly better, just as good as it can be and to do this you must continue your exercises.

3. Build pace gradually.
The dreaded Garmin. God, I hate that thing. I found mine at the bottom of the drawer a few months after starting to run again. There is no escaping the numbers on that thing. You think you’re flying along, on for a PB and then you take a look at the Garmin – nope, not even close. There is no escaping those dreaded digital numbers but they are crucial for building pace back into your runs. Much like with distance, small increments are important here to ensure allow your Achilles, and the rest of your body, to adapt to the new demands. One thing I have found that’s had a big impact on raising my pace has been 1km shuttle runs, repeated five times. Back in my glory days I could run 4.15 per km pace easily. That was just above jogging pace for me. After a few months building distance I decided to start focusing on pace. At the time I was able to run 4.45 per km pace just about comfortably but not for long. I decided to set 4.15 as my target for the shuttle runs. I found a flat, straight stretch near my home and quickly increased my pace until it read 4.15 on the Garmin. Get to 1km, stop, pant, kneel over, keep the vomit down. Repeat for 5km and you’ll quickly see the benefits but listen to your Achilles – if it’s not happy with the increased pace then ease off and find one that it is happy with.

Achilles Hell: tips for rehab.

Regular readers of this blog (my wife) will know that a couple of years ago I ruptured my Achilles heel in a typically below average five-a-side football match in east London. Over the past few months I have returned to running and am slowly regaining the fitness of yester year. For anyone going through the rehab process it can be a pretty nasty ordeal, testing your patience to breaking point. I often think back to my own rehab (which is still on-going) and think what I would/should have done differently and have come up with a few tips for those of you about to start the slog.

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1. To operate or not to operate.
The first key decision of your rehab and one of which I have no clear advice (great blog this, eh…) is whether to have operative or non-operative treatment. In my defence, this is because the medical world seems split. Rupturing my Achilles in east London meant I ended up at The Royal London Hospital in Whitechapel. The orthopaedic unit there advised against surgery on the basis that there is no clear evidence that surgery is better than non-operative treatment. Those of you who are Arsenal fans will know about Santi Cazorla’s terrible and gruesome Achilles woes which are due to infection as a result from surgery – something I was warned about. When I look back on my decision to have non-operative treatment I do question why all professional sports men and women (research them, it’s quite an impressive list) have surgery if there is no clear evidence and wonder if I did make the right decision.

2. Choosing the right physio.
This is the most important decision you will make in your rehab. A friend recommended her physio as she had been successful in treating my friend’s back injuries from ballet. In my naïve mind I thought, “a physio is a physio, right?” How wrong I was. In hindsight the exercises that she asked me to do were too much too soon which I think contributed to my partial re-rupture when walking “normally” down steps (something I should never have been doing so soon). When I returned to The Royal London after this my doctor was at a loss about what to do so asked his boss – an orthopaedic consultant called Nima Heidari who at once asked who my physio was. He advised that I see Adam Goode at Pure Sports Medicine which undoubtedly turned out to be the best decision of my rehab. Adam is a specialist in sports injuries and has extensive experience working with ruptured Achilles. His programme of exercises and crucially guidance on when to start doing more challenging exercises, when to start running and for how and at what pace, are the reason I am running today. It may cost a bit more but the right physio is money worth spending.

3. Having access to a running machine.
I’ve never been a fan of running machines. For me there is no reason to use one when you can simply, and for free, run outside. A lot of this is down to a PE lesson at school where a classmate who went by the name of “Mower,” was happily jogging along on a running machine. Mr Knight, our PE teacher, thought it would be funny to up the speed on Mower’s machine to the point where the poor lad’s initial smile turned to fear as his legs started rotating like Fred Flinstone’s. Young Mower couldn’t keep up and flew off the back of the machine like a cork out of bottle, skinning his back. I’ve never looked a running machine the same way since. I doubt Mower has either. Having said that, when it comes to rehabbing an Achilles rupture, they are a must when you first start running again. It is crucial to be able to control the pace and gradient of your runs, something that you cannot do outside. Also, the potential for slips and trips outside is a risk not worth taking, particularly in the more dark and wet autumn and winter months. You can systematically increase your pace and distance in those crucial first few weeks and stay in control when the urge to sprint off is strong. Just make sure Mr Knight isn’t around.

4. Choose your outdoor run routes carefully.
Those first runs outside post rupture are a thing of beauty. You’ve spent months in a boot, months being able to do nothing but heel lifts and then a few more months spent trying to not to fall asleep on the dreaded running machine. Finally, you feel normal again, shivering in the cold air and inhaling the friendly fumes of London. The key to this final part of your rehab is choosing a route that is Achilles friendly. By this I mean flat. The flatter the better. The only times (touch all the wood) that I have had Achilles pain is when taking on a punchy incline or a steep set of steps. Steps are a no go. Don’t even think of running down them. Stay away. They stretch and torture your tendon. You want a tarmacked route, that is lit and you know well. Did I mention it needs to be flat?

 

Ultimately the right physio and patience are key in rehabbing your tendon the right way. As I have alluded to earlier, the process can be beyond grim, particularly if you’re a regular runner. Choosing the right physio to guide and encourage you through this makes the difference and is worth every penny. In time your Achilles will get better and you will run again. Just don’t rush it.

 

Back to running

I snapped my Achilles heel on June 30th 2015. It happened during a typically low-skilled, high energy football performance on a crumbling five-a-side pitch in east London. I am regularly asked about the noise it made – “is it true that it sounds like a gun shot?” “Did everyone stop at the sound of it?” “Did any grown men cry?” Reassuring it did make a decent noise, although as the years have passed the story has morphed into some World War II epic with me screaming, “medic, MEDIC,” as everyone stopped playing, started crying and then gave me a standing ovation as a I was carried on shoulders off the pitch with Adagio for Strings rising in the background.

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As a result I couldn’t run for the best part of two years as I tried to rehabilitate my flabby tendon back to health. I was gloriously unaware of the impact running had on my mental health until this period. Before my tendon snapped like a cheap thong, sport and particularly running were a constant in my life for the best part of 12 years, something I did almost daily without question. Often this was associated with training for events which I gleefully completed before hurriedly entering the next. This gave me a sense of self-worth and identity that, until it was taken away, I had no idea about.

When my physio first examined my tendon he used the analogy of cooked spaghetti – mine felt like the kind of pasta you have left bubbling on the hob and forgotten about for 40 minutes. A healthy tendon, I was told, should have the consistency of hard spaghetti packed tightly together. He made it clear that running again was by no means a given and so I started a programme of heel lifts and exercises that as the days, weeks, months and years passed saw my heel return to something near al-dente.

Finally in November 2016 I was able to start running (for one minute before walking for 5). For the past few months I have been running “properly” again. A great deal of this has been with my brother whose idea of a fun Friday night is running 26 miles around London on his own and then doing it again the next day. As I drag myself around the canals and parks of east London desperately trying to keep him in sight, the bile rising in the back of my throat, I often simply dream of the run ending. But every time I go there are moments, sometimes for a minute, sometimes for most of the run, when my breathing softens and a calmness spreads that I don’t experience doing anything else. In these moments I realise why I run and I understand how lucky I am to be able to do it.

I never thought that rupturing my Achilles heel would be good for my running and in many ways it is not. But I’ve never enjoyed it more.

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