Marathon runners: Don’t let Achilles pain spoil your race day!

With the Dublin City marathon fast approaching, runners across the country are scrambling to get the last of the hard miles in. Many first-time marathon runners are continually running the longest run of their lives every weekend with the goal of successfully finishing the 42.195 km on October 28th. Runners, you have my respect! A marathon is by no means an easy thing to complete. Unfortunately for a lot of runners, run related aches and pains are all too common, especially in the latter stages of your marathon training programme. Don’t let your niggles become something more than just a one or two day affair, try and catch the pain before it can potentially ruin your race plans.

Pain in the Achilles region is one of the most common blights on a runners path to marathon glory and it’s a condition we see all to frequently in our clinic. So what causes the pain?
Tendon pain, or tendinopathy as we call it, occurs when a tendon is overloaded and has not recovered fully before the next bout of exercise. The role of a tendon is to connect muscle to bone and to transmit forces between the two, allowing us to move. Tendons do not contract, in fact they act more like a tow rope, or even a car suspension system.
There are three stages to a tendon injury, the first of which we call reactive tendon pain. This happened when a tendon is overloaded during an intense, unaccustomed workout, such as those longer weekend runs. This will cause swelling, pain and usually gets better with simple rest. Stage two is known as tendon disrepair and occurs when there are structural changes in the tendon because of recurrent overloading workouts. You may not see or feel these changes to the tendon but this can lead to more recurring problems if you continue to place high demands on the tendon and ignore the issue. If problems are continually ignored the tendon can become what we call degenerative. This is more common in older runners or athletes with a lot of mileage behind them. The tendon is generally sore to touch and you can feel thickening. This places the tendon at risk of further damage, so appropriate training is a must to prevent serious injury.

So what do I do if my tendon hurts after a run? The main thing is not to panic. The first thing to do is to try and manage the pain for the initial few days. This can be done using ice, massage and over the counter pain medication which you should consult your pharmacist on. You shouldn’t run while the tendon is sore, so a light recovery session, preferably off your feet is in order. Go for a light bike ride or swim as this will promote blood flow but wont load the tendon, which can help reduce the early inflammation. Stretching may or may not help and the general advice is to go lightly and for short 5-10 second holds if you feel that it helps you.
If the pain lasts for more than 48 hours you may need to seek help in managing your pain and help see you across the finish line. Don’t try to push yourself through the pain and continue to pile on the miles. Remember the golden rule is to only increase the mileage by 10% per week. If your pain is continuing to affect your running or is worsening, we are happy to help and assist you in your goal to get your hands on that well earned finisher medal for 2018. Happy running!

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