On Tue, 28 Sep 2004 16:45:43 +0100, Peewiglet <[email hidden]>
Quoted message said:I've got chronic achilles tendonitis
Just found the following, near the bottom of this page (if naught else
it might add to a greater understanding):
Rainmaker's Hiking Mechanics
http://www.trailquest.net/mechanics.html
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How I Care For / Prevent Achilles Tendonitis:
I had my first bout of Achilles tendonitis in 1992 when I hiked the
Appalachian Trail. It redefined my concept of pain. It struck the 3rd
day after I left Springer Mtn., put me off the trail twice, and I was
still bothered by it (this is putting it mildly) when I reached Mt.
Katahdin after 7 1/2 months of hiking. Believe me, it is nothing to
take lightly or fool around with.
The fact that I was able to complete my hike was due largely to the
efforts of an orthopedic doctor who took an interest in my hike and
gave me a crash course in tendonitis.
The Achilles tendon is the large tendon located at the back of the
ankle. Flex your ankle so that the front of your foot and toes are
pointed toward the ceiling and you'll be able to feel it.
When we hike uphill, the back part of the foot is lower than the front
part of the foot (heel is lower than the toes). Just like the motion
indicated above of pointing the toes towards the ceiling to feel the
Achilles tendon, this uphill hiking motion causes the tendon to be
stretched tight. Occasionally, the tendon will get more of this abuse
than it can handle. At that point, it may become painful and inflamed.
When I began to get severe pain in my Achilles tendons, I got off the
trail and went to a doctor. This was a fairly easy decision to make,
because I couldn't walk. My hike had temporarily lost its meaning and
purpose, anyway. If I ever have pain like that again, I'll do the same
thing. However, I will make sure I go to an orthopedic doctor who has
experience treating sports related injuries, even if I have to get on
a bus or train and travel several hundred miles from the trail to do
it.
One of the first things the doctor did in 1992 was look at my hiking
boots. He pulled out one of my arch supports and looked at it closely.
He then explained how it appeared to over-compensate for the arch.
When it forced the middle of my foot up, it was also forcing the heel
down, which was helping to stretch the Achilles tendon. He performed a
quick and painless arch support-ectomy on both hiking boots. I was on
the road to recovery with a lesson learned the hard way. The doctor
suggested that I not use any arch supports for a while, then switch to
a set that didn't provide so much lift for the arch.
He also examined my Achilles tendons and said that other than the pain
of inflammation, they were fine (no other injuries or structural
damage). I believe it is very important that a medical professional
make this determination. A ruptured Achilles tendon is a very serious
injury.
He then explained about how important it is to warm up tendons with
slow, gradual use, using the analogy about baseball pitchers warming
up extensively before trying to throw a 90 mph fastball. He suggested
that I remember that analogy after I returned to the trail, and that I
walk around slowly without my pack for several minutes each morning.
He also suggested that I start hiking each morning slowly, and
gradually increase my hiking speed as my body gets warmed up.
He also made other suggestions. He said to get rid of my hiking boots,
because my tendons would not tolerate the leather rubbing against them
with every step. He suggested that I switch to jogging shoes for a
couple of months on my hike. I had an old pair of jogging shoes, and
had them resoled with Vibram soles. Although I didn't realize it at
the time, I'd just created one of the first pair of Trail Runners. I
used those shoes for about 600 miles of hiking, then switched to
fabric-style hiking boots. I haven't hiked in leather boots since
1992, and never will again. I now use lightweight Trail Runners for
3-season backpacking.
The doctor also explained how I could use oil (any kind of oil, even
vegetable oil) to massage my Achilles tendons in the evenings and
mornings. He suggested that I ice the tendons, but explained how
important it was not to use ice on them until I was finished hiking
for the day. He used another sports analogy, asking me to think about
all the times I'd seen athletes put ice on an injured limb, but only
after they were finished for the day. When's the last time you saw
Michael Jordan ice his knee, then return to a game?
He suggested that I not do any stretching exercises for my tendons,
stating that stretching them is what got them in their present
condition to begin with. He suggested that I just walk around slowly
in the mornings, and listen to my body. He said that it would tell me
when it was ready to hike. He was right.
In the end, the doctor told me to take a few weeks off and instructed
me how to care for my tendons. He told me that I could then go back to
the trail, and that if I could stand the pain, I could hike. I could,
and I did.
I still warm up slowly in the mornings. I get twinges in my Achilles
tendons now when I'm hiking, but using the above techniques,
thankfully it has not reached the point where it has put me off the
trail again.
It would have been very easy for this doctor to merely tell me I had
tendonitis, prescribe some medications and tell me to go home and
rest. This would have been treating the symptom. However, in addition
to treating the symptom, he also treated the cause. The willingness to
treat the cause of a problem (in addition to the symptom) is one
standard that I now apply to health care professionals. Personally, I
feel that someone who treats only symptoms is in the sickness
business, and someone who treats the cause and the symptom is in the
health business.
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SteveO
NE Climbers & walkers chat forum;
http://www.thenmc.org.uk/phpBB2/index.php
NMC website: http://www.thenmc.org.uk
