If we are looking at the averages, it’s just a little thing. Usually around 5 cm in length and 5 mm in diameter, it is frankly amazing to consider that this relatively obscure little anatomical structure can regularly withstand as much as 8 to 9 times our bodyweight without so much as a whisper of complaint.
But when the Achilles tendon is unhappy, irritated, puffy, and inflamed? Well, that’s a different story altogether.
I’ve been an athletic trainer for over 20 years. I have evaluated, managed, and rehabilitated more cases of Achilles tendonitis and tendinosis in patients than I can remember. Sometimes it is the tendon that is acutely irritated (tendinitis). Other times, the tendon begins to actually degenerate and die (tendinosis). Still other times, the fibrous sheath surrounding the tendon gets irritated (paratenon irritation).
However, in each case, one thing remains the same: Every. Step. Sucks.
I recently became better acquainted with the symptoms of a paratenon irritation and a pretty fiery case of acute tendinitis in my right foot/ankle. Now, I have never really been much of a runner, mind you, but over the course of the past 6 months, I’ve added regular road runs to my weekly routine. I started simple with free “Couch to 5K” and then “5K to 10K” apps that had me completing the recommended rate of 3-4 runs per week. In both apps, each run is preceded by a 5-minute warm-up walk. However, once I completed those programs in their entirety, I still had two weeks to go before my first-ever 10K road race. Wanting to stay in shape and stay motivated up until race day, I switched to a new app that included training programs for longer distances.
That’s when it started.
The very first day in the new app, I stepped out of the house as I had done regularly for weeks, tapped the “Go” button on my phone as I had done for weeks, and followed the instructions to the letter as I had done for weeks. However, unlike every run I’d done previously since I’d started, I wasn’t prompted to warm-up walk for 5 minutes. I was instructed to run.
In retrospect, I knew better. At 46, my body needs more time than it used to in order to get up to operating temp and perform. However, I specifically remember thinking “This is pretty cool. No warm-up. I’ll get done 5 minutes faster.”
That first run went okay. No pain. No sudden injury. No problem. If anything, I felt a slight twinge of pain near the end of the run but I didn’t think anything of it at the time.
However, the next day I stepped out of bed at 6 am and was greeted by razor-sharp pain screaming from the back of my right ankle. I hobbled to the bathroom in horror, immediately concerned that all my hard work in preparation for the race might go down the drain. That’s when the thought hit me: “You didn’t warm up yesterday.”
I sure hadn’t. My right Achilles tendon was red, puffy, tender, and downright angry as I probed it with a reluctant index finger. What an idiot I had been. I had been training faithfully for months for this, my first-ever road race. I had even decided to really push myself and opt for the 10K distance rather than the easier 5K option. But here I was, less than 13 days away from my first starting line. And now I could barely even walk.
I did everything I knew to do in order to get ready as best I could. Ice. Heat. Instrument-assisted mobilization. Stretching. Strengthening. Electrical stimulation. Range of motion. In all, I managed to squeak out and limp through a total of two more runs at markedly lower distances. I drove to that first race never once having successfully run the distance I was going to attempt that day.
It was literally 5 minutes. The difference between just another run and an injury that I am just now starting to fully recover from another 2 months later was about 300 seconds. But the pain, the aggravation, and the poor performance hung around for over half a year.
I managed to compete and finish that first race with a fair amount of pain but a focused, concentrated effort to get through just so that I could finally say I’d done it (probably yet another dumb move but topic for another post). But the lesson learned remains: take care of the little things. One dumb omission on my part had cost me mightily. Little things matter. Check on those you care about. Be regular and relentless in your growth pursuits. Check off more things than not on your daily to-do list. Track your victories and learn from your shortcomings. Because when we fail to do the little things, they can quickly blow up into big things.
But it doesn’t have to just be negative, though, friends. My all-time favorite coach, John Wooden, once put it this way: “It’s the little details that are vital. Little things make big things happen.”
One chapter at a time. One mile at a time. One set at a time. One paper at a time. One job application at a time. Inch by inch. Moment by moment. We can either leverage the little things to help us move the mountains that live between who we are and who we aspire to be. Or they can master us and derail our progress on the path toward our dreams.
Be encouraged, friend. This is your day to master the little things.
And for the love of all things collagen, would you please walk a little bit and stretch before you just blast out of your front door on your run?
#bettereveryday #relentlesspursuit #mevsme