Sonia O'Sullivan: How runners can best deal with the dreaded Achilles injury

Irish Times

a day ago

Every athlete has an Achilles heel, and it's inevitable they'll run into an injury there at some point in their career. There's no such thing as good or bad timing, it will always feel like the wrong time, as momentum and fitness is lost and the mental battle begins to get through the non-running phase.
It's also the one injury that all athletes dread to even think about. It might be an Achilles niggle, a strain, a small tear, or a complete rupture, only it doesn't always present itself in a typical way. On some days it hurts more than others, on some runs it can mysteriously disappear, but it often frustrates the athlete with its non-linear treatment and return to running.
It can also strike any athlete at any time. Jakob Ingebrigtsen is off-track with his training due to an Achilles injury, the Norwegian star posting some videos on social media of his patient approach to the recovery. He also knows he's already playing catch-up on some of his rivals.
Ciara Mageean
also
spoke last week about her slow recovery
from the Achilles injury which forced her out of last summer's Olympics. Having undergone surgery last September, she's still not back on the track yet, and won't be racing at all this summer.
READ MORE
[
Ciara Mageean on the slow road back to fitness
Opens in new window
]
Some injuries are clearer cut than others. The bone stress reaction that athletes also fear is actually the simplest one deal with it. The consensus is that bone takes six weeks to heal, so that means committing to six weeks of non-weight bearing activity, then the reintroduction of weight bearing activities as the athlete sets out on the road to full recovery.
There are some new theories now that bone injuries are perhaps not as straightforward as we thought, and that bone, as a living tissue, also needs some stimulation to promote healing and get back to some weight-bearing activity sooner. This is something that is still in experimental stages, requiring close monitoring by a medical provider with experience in this area.
I can clearly remember back to when I was dealing with Achilles injuries in the 1990s. I was lucky that the injuries cropped up in the springtime, the least worst time, so I only missed out on the World Cross Country or World Indoor events. The outdoor season was always the priority for me, so there was time enough not to panic.
Even though I was never happy to miss any races, I knew if I put my head down and worked hard on the rehabilitation then I'd be back even stronger. I can remember turning up at the Hartmann International Clinic in Limerick city, staying in the apartments above so that I could have twice daily sessions, and also access to the gym and cross training equipment.
The scans revealed that I was a perfect candidate for Achilles surgery, but Gerard Hartmann gave me two options; the first was conservative intensive treatment, alongside a bucket of crushed ice where I would immerse my ankle, alternating with warm water, at least four times per day.
If there was no improvement in four weeks, the second option be surgery. With option one, all I would have lost is four weeks, whereas with surgery you straight away give up at least six months.
Both Achilles, left and right, caused me trouble throughout my career, and I always took the conservative option. This didn't give much leeway to any other activities outside of treatment, rehabilitation, icing, strengthening and cross training for at least four weeks. Then a slow and gradual return to running.
The greatest benefit of all was the mental resilience this protocol gave me when I eventually got back racing. Putting the decision into my own hands and determining my outcome is something I have continued to carry with me through life, and pass on to athletes I work with. Including my daughter Sophie, who was in a similar position with an injury last year, just four months out from the Paris Olympics.
For Ingebrigtsen, it helps that he's been down the Achilles injury route before. He had a similar issue last season, before the track season got going, yet managed things and still produced a record-breaking European and Olympic gold medal-winning season.
Jakob Ingebrigtsen. Photograph: Maja Hitij/Getty
The big difference this year is the Achilles has reared its head a little bit closer to his opening races. Particularly the Oslo Diamond League meeting on June 12th, where he normally kicks off his season at home. There was talk of world records over 5,000m, but this will now happen without Ingebrigtsen's name on the start list.
Not everything is lost though, as there are still 15 weeks before the World Championships in Tokyo get started – just under four months – so ample time to heal and recover and get back into a high level of training. This is also off the back of maintaining fitness in the gym, on the bike, the cross-trainer and special gravity-defying treadmills that many athletes now use on their road back to full recovery.
These treadmills that Ingebrigtsen was seen using this week allow an athlete to maintain their running specific training, while not carrying their full body weight. This can be adjusted as they are able to tolerate more weight and force going through the body as the Achilles begins to heal and regain strength. Unfortunately not available to all runners.
Mageean has no doubt the surgery on her right Achilles will allow her to get back to compete on the World and Olympic stage in future years. She's understandably getting a little impatient, but with any injury, it's important to believe in the healing process. Mageean only needs to look at her left Achilles, and how she recovered from surgery on that back on 2013, to have trust in that process too.
When you've been to multiple World Championships like Mageean, you can afford to step back. But no athlete likes to get too far away from the racing track.