Fast tracking an injury recovery for a hike

[David Wills]

I haven't went to the doctor, but I am pretty sure I have tendonitis in my right achilles tendon. I got it when a buddy spraigned his ankle on new years eve and I got to trade my 20lb pack for his 60lb pack when I had tennis shoes on. Web MD says it could take a few months to heal, but I need to be able to train for this summers hike. Is there any way to fast track the recovery or possibly a way to train my cardio without using my feet? thanks

[Kirk Beiser]

I think your best bet is to get to a doctor and then start physical therapy. I'm no expert, but I think a light workout (enough to break a sweat on a exercise bike or treadmill) combined with good stretching would be a big benefit. But I think that if you want the quickest recovery, going to a physical therapist would be recommended.

Swimming is one of the best workouts for cardio and it shouldn't stress your achilles at all.

Kirk

[Neil Bender]

I injured my achilles tendon 3 years ago on a mountain bike tour. When I flexed my foot it felt like what one site described as 'rubbing wet leather'. Anyway, it took 3 months to heel and that was with heel wedges in shoes to keep the heel counter of my shoes from aggravating it during the day, and at night I slept with a night splint to keep the foot at right angles and keep the tendon stretched so that weighting the foot in the morning doesn't re-injure what healing occurs overnight. That area gets very little circulation and is notorious for taking a long time to heal.

[Zack Karas]

Welcome to my world! I have sprained my right ankle 6 (!) times and now pretty much have chronic tendinitis. By staying patient and not pushing it the moment you think you are getting better (this is my problem and it will set you back several weeks of getting it under control), you can slowly etch away at the tendinitis. I have been to physical therapy for it a few times before and here is the program they have always put me on:

–warm up at medium intensity on a bike for 10 minutes
–stretch you calves and achilles (facing a wall, put the good ankle forward and step back with the injured side, lean forward until you feel a stretch–do this 30 seconds with your injured leg straight (then 30 with it bent)
–work on propioception exercises
a) balance on one leg on an inflated disc if you have one, or just use a few pillows on the ground, work up to doing 3-1 minute reps with your eyes closed).
b) do a wall squat, then raise one heel as high as possible while still keeping the ball of your foot on the floor, then alternate feet. This works the soleus muscle that is most commonly associated with achilles tendinitis. If this muscle is weak, the tendon is overworked.
c) place some pillows on the ground and work on stepping forward onto them in a lunge (forcing your ankle to stabilize itself). Basically, any exercise dealing with calf strength and ankle stability is going to help you out.
d) the best exercise of all is concentric calf raises: http://www.pponline.co.uk/encyc/0031.htm
–Ultrasound (if you have one?) or simply deep massage of the ankle
–15 minutes of icing
–at night, wear a night splint (I like the dorsal night splint–I also take it backpacking as it only weighs like 6 oz and it keeps me hiking).

I have mixed feeling about using a heel lift. It does have the advantage of relieving strain on the tendon, however it does this by further shortening the tendon which increases your recovery time overall. I've talked to physical therapists who love them or hate them, so it really is a personal preference.

They had me doing this every day. I can get it to the point where if I keep a moderate pace while hiking then I'm fine, but the moment I push it the tendinitis comes back. For the first week or two of thru-hiking this seems to work, after which the ankle is strong enough from hiking 10 hour days that I don't have to monitor my pace. I've hiked the Colorado Trail, the Camino de Santiago and the CDT using the above mentioned training/maintenance program. Now, the only time I get tendinitis is when I increase my mileage too quickly.
Unfortunately, I'm now a bit of an expert on this subject, so if you have any questions at all shoot away.

[Stephen Eggleston]

Consulting a knowledgeable healthcare provider in person is always a very good thing to do. They can help you understand the details of your injury, give you treatment and rule out any more severe injury(in this case could you have a sprain, soft tissue tear or fracture?)

I am partial to acupuncture as a positive therapy for injury. Of course I am an acupuncturist(full disclosure!) If you can find someone who specializes in sports medicine that is a plus.

Herbal poultices and liniments can be very helpful. There are some readily available ones out there, try a good health food store. Some options: Tiger Balm, Zheng Gu Shui, any Chinese injury/analgesic liniment, Traumeel or Arnica Oil/Cream.

A nice home remedy is to mash fresh comfrey root(or dried comfrey root powder) with apple cider vinegar, apply the paste to the affected area and then cover with a cloth. Leave this on overnight or for several hours, repeat for 5-7 days. This is a bit messy so be careful.

As always(as others have mentioned) give your body time to heal. Avoid excessive strain to the injured area. Gradually include non-weight or light-weight bearing exercise(biking, swimming, etc) and stretching. Work your way back into more vigorous exercise.

[Matthew L.]

I definitely advise seeking physical therapy. The main problem is rushing back before you are ready. While it is amazingly frustrating being injured (I know), you must take the appropriate steps and time off or run the risk of really missing a lot of time. The comments above are great. One that I can add is make sure you stretch it some before you get out of bed in the morning. One of the best times to reinjure a strained muscle is the first few steps in the morning. The muscle is tight from the long sleep and is very vulnerable. Even just a minute or two of light stretching in bed can prevent this from be aggravated. I hope it works out for you!

P.S. I am a huge fan of hydrotraining. My cross country/track coach in college was one of the nation's first advocates of "running under water" as a great way for us to train if we were injured. I ruptured my calf (wickedly painful) and this helped me maintain my distance base for the six weeks that I could not run. I cannot say more for it!

[W I S N E R !]

I've had achilles tendonitis off and on while doing ultra-distance cycling. Five days before a scheduled 200 mile ride I had a bad case…Ice every day, combined with stretching, had me back in shape. Don't simply apply an ice bag, though…Freeze some water in a small Dixie cup- peel it, leaving half of the ice exposed and the other half covered as a grip. Massage it in good in long strokes. This has also helped me tremendously with IT Band syndrome in my right knee during marathon training.
Good luck.

[Matthew L.]

That Dixie ice cup works great. It is a fantastic help for those kinds of injuries, and I have used it often. It may be a great aid.

[Don Wilson]

My advice – don't be impatient as you might regret it. Take it slow, stay in shape using other activities (swimming, etc). Better to be psyched for your hike, but not in optimum shape than to risk more injury.

[David Wills]

I appreciate all that advice. I've never really been injured before so it's a whole new thing to deal with. I will definatley be patient and slowly work back into the swing of things.

[Andrew :-)]

I also suggest seeking a healthcare practitioner. I find that injuries heal so much faster with a bit of professional help. The sooner the better.
I regularly see a couple of different Chiropractors (depending on my requirement at the time) and am amazed at how fast I can now recover from injuries.
I'm studying Chiro, hence I prefer this type of healthcare but there are many types which can speed your recovery and also ensure that you recover completely and avoid recurrances.

It would be wise to see a practitioner to ensure you don't have problems with scar tissue effecting the joint function and strength which may lead to future problems.

A practitioner can also advise on tapping methods or safety measures to use whilst hiking if required. you may be given stretches, exercises, do's-and-don'ts etc.

Good luck with it

[Gene .]

Craig I've been icing my A'T since last week's hike was a bit longer than I planned; ended up torturing myself. Got home and realized I had injured my Achilles with too much aggressive hiking in the cold, after not having gotten out much in the preceding weeks. Dang! this hurts….

[George Matthews]

What's worked for me…

1) Ice
2) Anti-inflamatory like Naprosyn, Ibuprofen, Motrin, etc.
3) Rest (if you don't, then it could really get bad)

[David Wills]

I've been doing the SAS and excercycle almost everday, and took an overnight trip this weekend. It was my first trip since the injury. We only did about 6 miles for each of the two days, but everything worked well. I think I can start doing the treadmill a little bit as long as I continue the excercises mentioned in the linked webpage.

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