A setback is a setup for a comeback.
A few days ago, I had a sharp pain in my knee as I was running down the stairs. It was a few hours after a long ride on the bike trainer. Leading up to that point, my knee felt fine, so the pain totally caught me off guard. I went about my day without experiencing any more discomfort. The next morning, I stepped out of bed and could tell something was off. I felt the sensation of heat around my entire knee and as I walked down the stairs to the kitchen, my knee felt weak and achy.
My heart sank. For the last week, I’ve been babying an Achilles flare up, and now this.
Up until a couple weeks ago, I was feeling great and ramping up my training volume after coming back from my recent foot injury (read more about it here). I downloaded Sally Macrae’s fitness app during my recovery to start a running-specific strength routine. Once I was cleared to run, I began her 6-week run and strength program. My Achilles flare up happened after my long run on week five. We went to Fruita that weekend and because it was a drop of close to 2,000 feet in elevation, I ran a half-marathon distance at a faster pace than usual. Apparently, my Achilles wasn’t happy about that.
I didn’t notice any pain until a few days later. I decided to take the rest of the week off of running, but sprinkled in some aerobic work on the bike and stair master (no pain in my Achilles on either machine), a few strength sessions, and around 30 minutes of mobility work each day. Last week, I got back to running, albeit at a much lower volume. I jumped back into week six of Sally’s training program, but instead of doing all of the aerobic training as runs, I spent some of the time on the stair master or bike trainer to take it easy on my Achilles.
Though my Achilles isn’t back to 100%, it’s feeling a lot better. There’s still a bit of swelling and some tightness, but no pain during activity. Just when I thought I could get back to my regular training routine, my knee flares up. Ugh!
Such is life, I suppose. I’m learning that perfect training days are few and far between. The best thing I can do is work with the conditions I have and just keep on keeping on. My takeaway this week: my tendons are weak and need some love.
When my Achilles flare up happened, I did some research on recovering from tendon injuries and stumbled across a YouTube video from The Movement System called From Weak to Strong Tendons. The video suggested isometric exercise as the best method for rebuilding tendon strength. Here’s a quick summary of the information presented in the video:
Isometric exercise involves holding a position for a set period of time. The static hold causes muscles to contract slowly and tendons to lengthen. This lengthening causes a stress relaxation response, which is required to rebuild a damaged tendon. The recommended training protocol for building strong tendons is as follows:
- Time: hold for ~30 seconds.
- Tension: Loading threshold is~70% of maximum force output. There needs to be enough stimulus to cause the tissue to remodel.
- Volume: 4-6 sets; 2-3 different exercises; 3 days per week or every other day (48 hours between sessions). Maintain a consistent routine for several months. Pain is ok (4/10) during exercise. Pain should return to baseline within 24 hours.
This morning, as I was doing my mobility work, I watched another YouTube video from E3 Rehab that discussed rehab modalities for tendinopathy; specifically, patellar and Achilles tendinopathy. The video also highlighted the importance of isometric exercises for strengthening tendons and provided additional exercise progressions for restoring tendon function (listed below).
- Stage 0: Isometrics
- Stage 1: Heavy, slow resistance
- Stage 2: Energy storage and release
- Stage 3: Return to sport
The video gave several examples of exercises for both the knee and Achilles, of which I started implementing into my training today. Here’s one of the training protocols given for patellar tendinopathy:
[1-2 exercises; 2-4 sets of 6-12 reps; 2-3 days per week]
- Squats
- Split squats
- Step down
- Single leg seated knee extension
I highly recommend watching both videos if you’re dealing with any kind of tendinopathy!
My goal was to start a 50K or 50-mile training program after I finished Sally’s 6-week run and strength program. I guess the universe had other plans for me, so for now I’ll be sticking to a (mostly) strength-based program. Specifically, one that incorporates the isometric and heavy, slow resistance work geared towards strengthening the lower body tendons that seem to be failing me any time I attempt to increase my aerobic training volume.
We’ll see how things go over the next few weeks. Hopefully, I’ll feel strong and ready to get back to a regular aerobic training routine soon. I’m still trying to figure out if my body will tolerate a few longer duration, low resistance cycling or elliptical workouts mixed into my new strength routine. I’d love to maintain the aerobic base I built over the last six weeks, but I’m wondering if the repetitive motion (despite low resistance) will irritate the tendons and lengthen my recovery time.
Seems there’s never a simple answer when it comes to human physiology. It’s going to be a lot of trial and error as I work my way to the start line of the 100-mile race. That’s the fun of it, I guess. Here’s to another week of choosing to endure the highs, the lows, and everything in between.
As always,
One foot in front of the other, we make our way forward. Nothing brings the rewards of moving. Just keep moving.
