Tag Archives: Injury

Battling with Insertional Achilles Tendonitis

InsertionalAchilles I’ve been struggling with Insertional Achilles Tendonitis since around February. I really need to get it sorted now, so am going to start blogging about it to maintain some sort of focus.

The history is fairly typical for this sort of injury: Overuse. I’ve been running regularly for years as a football referee. In a typical game, I will travel 10 km in a variety of ways: Walking, jogging, running, sprinting, running backwards, changes of direction… It’s all going on! When fully fit I would also be engaging in training runs of between 5 and 10 km, and last year I did the Great South Run (10 miles) with no problems at all.

I used to be a classic heel-strike runner, but switched to a minimalist style last year. I managed to transition pretty quickly and was using that style for about eight months before the achilles issues struck. Transitioning also solved the knee ligament issues I was suffering from in my left leg! Due to the long time period before the achilles issues came on, I’m not blaming the minimalist style here, but I do accept that it does load the achilles more than heel-striking — That’s how it saves the knee joints from being shot to pieces!

So what happened?

Well, over the last winter we had atrocious weather in the UK. Lots of games were postponed. I was lazy and did not keep up my supplementary training runs. Then it was the Christmas break and I didn’t do anything then either, but did put on a bit of weight! When the season started again the weather continued to be bad, so it wasn’t really until February that I was back to full-intensity games. And that was the problem. I went from a sustained period of doing nothing to resuming my usual refereeing intensity, and at that point the tendonitis started. As is typical, there was no sudden ‘BANG’ moment: it was more of a dull that came on the following morning. It never really went away and has persisted since then.

I would class the pain as annoying. It doesn’t impact my performance per se: I can still run, sprint and so on, but I just end up paying for it afterwards or the next day. Doing two activities in two days is really asking for trouble. Basically, it makes me not want to or enjoy training, and that has gotten worse over time. Not because the soreness has gotten worse, more that I am just getting completely fed up with it.

At the end of last season I took a bit of a break, but short-lived. About three weeks. That isn’t very much for an achilles tendon injury from the reading I have been doing. I then needed to train for my fitness test (Cooper Test and sprints), which I passed with no problem. Then another four weeks of rest before I got a bit over confident and did two 5k runs in two days, and the soreness came right back. Not as bad as it has been though, I will say, but again the fact I am not healed is getting tiresome.

I’ve had some physio during this time but I am left feeling that in my case, it isn’t helpful without giving the tendon time to rest first. Calf stretches cause pain due to the tugging on the tendon. It isn’t the ‘nice’ sort of pain you get when you know a stretch is doing you good. It’s the ‘Please don’t do this!’ sort of pain. There seem to be various references that the best thing to do is ACTUALLY REST IT, and certainly don’t try stretching and strengthening until that painful acute stage is over. Common sense, I guess?

The latest is that I have seen a consultant who has taken X-Rays and an Ultrasound. I’m awaiting my follow-up. The X-Ray has not shown anything out of the ordinary: Perhaps a very slight Haglund’s Deformity but it seemed very, very small compared to some of the example ones on the Internet. Besides, this did come on in an ‘overuse’ scenario. The Ultrasound confirmed a very small (1mm or less) tear. I don’t know exactly where yet until the follow-up. The optimist in me sees this as a good thing in a way: A tear can heal, even if it will take a while, and I’d rather it be that rather than some structural failure.

The immediate plan is more rest until the follow-up in a week or so. I won’t know then whether I should commence refereeing in the new season when August swings around. If I have to declare myself injured for a month or two (maybe more?!) then so be it. The important thing is to beat this. Much as I will be chomping at the bit as a result!

Watch this space…

Minimalist Running: I’m Flying!

Things are going really well in my continued adventures with minimalist / natural running. To begin with, the Inov8 F-Lite 230 shoes are amazing. Absurdly comfortable and light. Well worth the money and I keep eyeing up other shoes in their range!

The transition has gone excellently. I am now comfortably performing my usual outdoor 5k training runs. To begin with, my goal was “Get round the route with no injury; it isn’t about speed”. I realised at the end that I physically had a lot left in the tank, and had set an average time! Not bad for an effective ‘sighting lap’. It was also very obvious that any knee pain was absent. Knee soreness had become a feature of my running in ‘traditional’ running shoes, and was part of my decision to transition.

As my confidence has grown, I’ve started to increase the speed. This has taken a bit of adjustment, as before I would increase my speed by drastically increasing my stride length. Now, I am increasing my cadence instead, keeping my feet below my hips. It has felt a little strange, particularly when my GPS reports that I am hitting quick speeds but it feels like I am just gliding along!

To help with pacing, I performed the Cooper Test on a treadmill. This particular test forms part of my referee promotion in the coming season. I set it for a steady 13.5 km/h, which would equate to a 2700m distance. That’s typically what I was hitting in my old running shoes. I comfortably hit that in the new shoes, including upping the speed at the end to bring it home! Most notable to me was that afterwards, again, I had loads of energy left and no soreness. Wow!

Today I decided to run a 5k but for a good time. I had a strong pace throughout, and the end result was that I beat my PB (set last year) by 25 seconds! And, you guessed it, I had energy left at the end to up the speed for a continued duration. In the old shoes, and with my old style, my legs would have been too sore to do that.

I am really, really happy with how this is working out so far. I have increased my performance and reduced my injury level. Lots more fun to be had here! I am sure that the CrossFit and weight loss have aided this whole process, and long may it continue.

My End of Season Review

My football refereeing season of 2011/2012 is at an end. Now is the time for self-analysis in order to see how well I did, especially in comparison with my goals, and decide where I would like to go in terms of moving forwards.

THE GOOD

  1. I GOT MY PROMOTION: I succeeded in going from level 7 to level 5 (a ‘double jump’ promotion) in one season. This required a great deal of commitment and I’m pleased that there was no drama along the way.
  2. CUP FINALS: I was very pleased to be selected for a total of five cup finals. This was nearly six but unfortunately I was away on holiday for the last one. It is always a honour to be considered for a cup final and they were a great way of rounding off the season.
  3. I DIDN’T GET INJURED: Well, kinda. I will touch on this more in the next section. Essentially, I got through the season without any major problems, which was important considering how many games I needed to get in for the promotion.
  4. I ENJOYED IT! Isn’t this the most important thing? I enjoyed my games, the challenges that they presented, and the various people that I met during the season: Players, officials and fellow referees. Some early advice I received was “Enjoy your refereeing” and how true that is!

THE NOT SO GOOD

  1. MY WEIGHT: Despite being so active, I managed to to put on about 10 kilograms during the season. This was down to eating very badly. It started to have an impact on my joints plus how generally nimble I felt when refereeing (twisting and turning, changes of direction and so on). Not only that, I’m not happy with how I was looking towards the end of the season!
  2. INJURY: Linked to my weight. My knees started to play up a bit towards the end of the season due to the repeated impact of the stop/start running. Essentially, a case of Runner’s Knee. Nothing serious as rest abates it but those extra 10 kilograms were hardly helping! Oh, and having an ‘out of balance’ body, but I will come to that later.
  3. LEVEL 4: I’m now going for promotion again, to level 4. I’ve had my first assessment and while it is a commendable result for my first assessment at my new level, it is not as high a mark as I would like.

GOING FORWARD…

  1. WEIGHT LOSS: This is already going very well, and I’ve lost over 5 kilograms so far. I’m sticking to a 2000 kcal diet, with exercise allowing extra calories! MyFitnessPal is an excellent site for tracking this.
  2. FITNESS: The off-season allows me to be more stuctured in my routine. I’ve been working on a combination of normal running, interval and speed training. This has included working towards my fitness test which needs to be done in August/September (I am well on track for this). I’ve also started CrossFit in order to keep my body in good balance, to aid in flexibility and injury prevention. I’m really enjoying this.
  3. I’M LOOKING FORWARD TO 2012/2013: I’m really looking forward to the new season. I feel like I’m going to be great physical shape when it comes around, and I have a level 4 to earn!

Bring it on 🙂

The long weekend: Strong start, weak knee…

This weekend I have been appointed to three games. Two down, one to go, and things are going really well. I’m determined to keep up the momentum!

The first game was as Assistant Referee on the Combined Counties Football League. This was my first competitive game on this league this season (the others I have posted about recently have been pre-season friendlies). This was one of those occasions where the referee team has just totally gelled: Good bonding, all the decisions correct and great communication. I enjoyed every second. Not bad at all considering it was a local derby! There was the perhaps inevitable mass confrontation to take care of, of course…

It really helps when everyone on the team has the right, positive attitude: To do a professional job and have fun at the same time. Sometimes I have worked on teams where one member has been, well, a little bitter and twisted and it does bring the team down a little.

Today I had a pre-season friendly on another league as the man in the middle. This was also a fantastic game, helped by the fact that both teams genuinely treated it like a friendly! It was a joy to referee and helped by the fact that I really felt on form: Right on top of fouls etc and getting the tight calls right each time. Was very pleased to hear a spectator comment, “That’s the best referee I have seen round here”. That will keep my ego swollen for a few hours at least…

It’s not the only thing which is swollen: My right knee is feeling tender and I had to ice it after the game. It feels sore on the inside so not quite sure what it is. I hurt my Achilles last season from sprint ‘take-off’ and now I’ve hurt my knee from the sudden deceleration from sprinting when running the line! I need to be careful.

One more game to go (Assistant again) to polish off the weekend: Let’s make it a great finish!

Bringing up the fitness and now… STRETCH!

I recently rejoined the gym on my work campus as running outside was just not happening any more. The current weather in the UK has put paid to that. I was soaked through just walking back from the gym to the office (30 seconds!) due to the lashing shower that suddenly appeared.

The adage which applies is “Get fit to referee, don’t referee to get fit”. Absolutely true and my ‘judo fitness’ has very much helped me hit the field of play running. I have yet to struggle to keep up with play but of course most of my games are at ‘parks’ level until I climb the ladder a bit more.

However, my body has not adjusted to the style of exercise too well. Lots of changes in speed (walk..jog…SPRINT…walk…stop…SPRINT) and direction have put quite a stress on my hamstrings and achilles. The achilles in particular forced me to rest but is now mostly under control. My hamstrings are tight as anything as it is due to my years of computing so this needs resolving. Some Asics Gel Lethal 11 boots are helping there!

Firstly, I’m working on running in the gym, working towards the Cooper test. I have no need to take this test for a long time but it is a nice benchmark. Starting point is 2500 metres in 12 minutes which I can manage fine on a treadmill but of course that is easier than doing it outside (even with a 1% incline). It’s good to start teaching my body the pace though. I’ll be mixing that up with interval training.

Secondly, lots of stretching. I’ve been neglecting this FAR too much. Obviously this is concentrating on my problem areas as mentioned above but I’m making sure I do EVERYTHING so I don’t just transfer the problem somewhere else. Early days but so important.

There we have a mix of aerobic and anaerobic exercise and stretching. I haven’t thought about core strength much yet but it will need to feature to help keep things balanced… hmm…

Hampshire Split Grade Open 2009

I attended the Hampshire Split Grade Open in the capacity as referee at the weekend. The venue will always hold a special place in my heart for various reasons: I got the final points for my Dan grade there, I have medaled there before, and I think I got my first referee qualification there as well.

There were plenty of people I knew there, including representatives from my own clubs (Which made me miss them terribly given my current Achilles sprain which stops me training AT ALL which is horrible).

It was a scrappy day for me to begin with. Our mat was delayed starting as the mats themselves had not been correctly laid out and this took time to fix. Then our team was in a state of flux anyway so no sooner was I on, then off again, and then having lunch! It worked out in the end as I stayed on to referee the Open and got some of the Finals to do as well.

Lance from the upcoming Hampshire Judo Academy was present to advertise and that is an exciting project in itself. The emphasis is on all the Good Things, and not just three days of Western-style Randori resulting in bits falling off the judoka who are present. Check it out.

Despite this being a low-level event in the big scheme of things, it was great to see judoka from Willesden and Camberley judo clubs. This meant that there was some great judo to watch, especially when they fought each other!

It was not my best day of refereeing. I didn’t get anything wrong or anything like that, but I did not feel in the zone either. I have had the opportunity to study some of my work on video. Essentially I look too ‘rushed’ so I just need to calm it down and take my time. Some IJF-level feedback I received was that I am ‘over-gesticulating’ which is a habit I’ve picked up from the football refereeing where you NEED such strong body language to sell decisions! Looks totally wrong on the judo mat though.

Essentially, I need to be serene and controlled, rather than somewhat fierce and controlled. Which sounds like good advice for judo in general, if you ask me…

Neck, Tiger Balm and the cold outside

I’m not sure whether my neck is any better or worse, compared to how it was prior to the injection. It has certainly been better the last few days, but of course it was more sore after being poked, prodded and stabbed.

Tiger Balm has been working really well for me. Sticky warming ointment. Perfect. Plus I guess it forces me to give the neck a good massage, or it is just going to ruin all my shirts! There have been a few occasions when I’ve pressed on a point and the pain has mysteriously totally vanished for a while. So sudden it was to the degree that I was scared to move my neck for a bit in case I had done something serious. Acupressure? No idea. But I remember my consultant tried something similar in my first appointment as a test to see if it relieved the pain. Something to ask about…

As yesterday it was pretty good, I decided to go for a run outside at lunchtime. It was six degrees Centigrade outside. I only had my t-shirt and shorts. But, hey, that temperature seems to fall within safe limits. I did two miles and it was just fine. Although my shoulder did twinge a bit, mostly my fault for pretty much storming out the door at a rapid pace (no proper warm-up) and pounding up the road before settling into a more sensible stride. The whole thing was really invigorating.