How I Got an Achilles Injury (my first injury in 5 years)

by Jason Fitzgerald

For the last five years, I haven’t had a serious running injury.

Until recently - when I injured my Achilles tendon by making a slew of poor training decisions…

Achilles Injury Post Image

This was a real injury. Not just the very beginning of an injury that a day off and an aggressive treatment approach will fix. Or a sore or tight muscle.

Nope, a full-blown repetitive stress injury. And it was completely preventable (if I had followed my own coaching advice!).

When I told one of my 1-on-1 runners, he offered some sage wisdom:

“Sometimes we all fail to follow our own advice, in a demented way it’s how we build trust in ourselves.” – Jim

I had an Achilles injury: a classic case of Achilles Tendinopathy in my left leg. I first experienced something a little “off” while warming up for an easy run the day after I ran long. During the lunge portion of the warm-up, my Achilles felt different. Not necessarily painful, but a strained feeling.

Of course, aches and pains are a normal part of running. Like one of my coaches once told me:

“During hard training, you’ll always feel something.”

But what separates those who are chronically injured from those who rarely get hurt is following a program that cuts your risk of serious injuries and manages the minor consequences of hard training. For the last five years, my training had been specifically focused on injury prevention and I had reaped the rewards of running more than every and improving my marathon best to 2:39.

I was invincible! Getting hurt is something that happens to other people…

So I didn’t think anything of my wonky Achilles. I finished my warm-up and went out for an easy 10 miler.

32 minutes later (and definitely short of 10 miles!), I was back at my apartment after hobbling through a tortured attempt at a distance run. Not one step felt normal and there were occasional bursts of sharp pain.

For the next week, it hurt to walk and there was a noticeable bump along the inner edge of my Achilles tendon. Not good.

So, what caused my Achilles injury? So many training errors that if I were one of my coached runners, I’d be furious.

How to Train Like an Idiot and Get an Achilles Injury

I was on my third 80+ mile week when I set out for a 20 mile long run. My previous two long runs had been 18 miles and while I normally don’t like to jump up by two miles at a time, I thought I could handle it (strike one).

The night before, Meaghan and I hosted a few friends for dinner and enjoyed some wine. Ok, a lot of wine. The next morning, the wine surprisingly caused a hangover and I wasn’t as recovered as I could have been (strike two).

Undeterred, I hydrated, fueled, caffeinated, and set out for my long run in Rock Creek Park. Anybody familiar with the park knows that it can be very hilly as the creek is located in a sort of valley. Run away from the creek and you’re climbing up steep, long, and sometimes technical trails.

With my head still fuzzy from my love of Cabernet Sauvignon, I ran up and down as many hills as I could find. I love them… so I ran all the hills (strike three).

And if running way more hills than I was used to wasn’t enough, the overall effort of the run was hard. I hammered the entire long run because for some reason, despite being hungover, I felt great. So why not run hard? (strike four)

Finally, I was wearing a pair of Adidas Adizero Tempos that were at the end of their life. Buying a new rotation of running shoes had been on my to-do list for weeks, but with the launch of Injury Prevention for Runners I had simply forgotten (strike five).

Five strikes later, I had an Achilles injury.

Check Your Ego at the Trailhead

I coach runners for a living – helping them run fast and stay healthy is my full-time job. And I’ll pat myself on the back: I’m damn good at it (see Brian, Deb, and Sarah). But how could I make so many mistakes myself?

For starters, I hadn’t been seriously injured in about five years. I was starting to think I was invincible after being chronically injured for nearly a decade. But nobody is immune to getting hurt – it affects beginners, elites, and everyone in between.

Moreover, each one of my “strikes” isn’t necessarily the cause of my Achilles injury. I often get frustrated when I get a question asking if a change of shoes caused an injury. Who knows? Probably not. Maybe?

The more likely culprit is a combination of factors like poor training decisions, bad form, and inconsistent strength exercises. The cause of any injury can be complex – and so can injury prevention. That’s why when I design training plans there’s significant thought put into the structure of the plan.

When you follow a sound training plan and have resources like runner-specific strength exercises, cues to help your form improve, and recovery built into that program you’re going to experience far fewer injuries (these principles form the foundation of my injury prevention program).

But even though I KNOW what to do doesn’t necessarily mean that I’ll do the right thing. I take risks with my running just like everyone else.

Wore old shoes? Probably not a big deal for a few runs.

Ran harder than usual? I should be ok.

Oops, I ran all the hills? No worries.

Jumped the long run up by two miles (while hungover)? Risky, but not a huge deal.

But I did them all at once? Not smart!

So please, do as I say not as I do: don’t combine too many risks into one run (or even a week of training). Train smarter than I did and you’ll be much more likely to stay healthy.

How’s my Achilles Injury Now?

When I first experienced pain in my Achilles, I went into injury lock-down. My self-treatment protocol has been tested and refined over the years using the latest science, personal experience, and visits to several physical therapists. The same protocol that got me healthy is included in Injury Prevention for Runners.

I’m ecstatic to report that after nine days of time off, I’m back to running with zero pain. I’m also running faster workouts, long runs, and my overall mileage was at 75 last week.

Now I’m back to my pre-Achilles injury level and feeling good. My training was definitely modified after I got healthy to ensure I didn’t come back too quickly. If you’re interested in a personal case study on how I did this, let me know in the comments and I’ll write it up.

Soon I’ll be running the Rock ‘n Roll Half Marathon in DC on March 15 as my tune-up for the Boston Marathon. If you’re going to be in the city that weekend, stay tuned for a meetup announcement coming soon. I’d love to have a brew with you and talk running!

Until then, don’t make as many “training strikes” as I did. Run smart and stay healthy!

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{ 29 comments }

Erin Templeton

Thanks for sharing this, Jason. It’s helpful to know that none of us are immune, and it’s an important reminder to me to be vigilant with my foam roller, exercise bands, and core work.

Jason Fitzgerald

Appreciate it Erin!

chris

Very candid. Maybe switch to bourbon instead of wine?

Jason Fitzgerald

Right, I don’t think bourbon causes hangovers ;)

Jeff Horton

I’m interested in how you ramped back up following your recovery. I’ve been off for exactly four months, the last four weeks consisting of recovery & rehab following arthroscopic surgery on my left knee on Jan 8th. I’ve lost all my hard-earned condtioning and gained a bunch of holiday weight. I’ve been cleared to start running this week. I intend to take it very slowly for the next three months with a goal of getting back to my normal 35-40 miles a week by Memorial Day.

melody

I’m also interested in how you returned to your normal mileage so quickly. while my mileage isn’t much, I’m missing my 4 mile runs. I’ve taken some time off for a strained quad..I do miss running! how long is appropriate to take off for a muscle strain?

Barbara

I just learned how to properly run last year, and did almost the same thing. I was in full swing, enjoying running so much, that I ran day in and day out, up and down any hill. I started to feel sore, but shook it off thinking that I could keep running, I’d be fine. By the time I got to my destination I couldn’t walk. I still get shin splints now even a year later. I took a lot of time off, and I still remember the pain and get anxious when I run, afraid I will feel that again. I will get back to full swing eventually but I am way more careful now not the make the same mistakes.

Chuck Swanson

Jason-

Glad 2 hear your health is back. Thanks for sharing your misfortune. It’s reassuring to know WE all make mistakes… I’d like to hear about your return from injury and what you did. It would be helpful for when I have an issue again for sure. Take care and healthy well wishes! Good luck in DC & Boston..jealous

C Brown

Thanks for sharing your story. I’ve been dealing with some knee paing for the last two weeks, and I just started my “injury lock-down”. I definitely need to do be better at my strength training routines, and I am very interested in reading about what you did in order to come back from your injury. Thanks for all the great information!

Jason Fitzgerald

My pleasure! The exact protocol I followed is in Injury Prevention for Runners.

Trent

Jason, thanks for your honesty. I want you to know that I did follow your advice at the beginning of last month when I was experiencing some hip pain. I thought for sure I’d be out for at least a month, but I shut it down, followed your aggressive approach to rehabilitation by doing core work and hip strengthening and two days later I felt as good as new. It was a freaking New Year’s miracle. I still took an additional two days off, just in case, and was back at it.

Thanks!

Jason Fitzgerald

Awesome, glad to hear you’re back!

Joy Hargraves

I’m volunteering at RnR DC, but if I can swing by for a meet up, I will be there!!

Phil

Hi Jason.

Thanks for sharing this. I had a similar situation occur back in late July of 2012. I was running a long run on a very hilly trail with lot’s of runner traffic. I was forced off the trail by two oncoming runners who were completely oblivious, and this caused me to pull a hamstring and put me out of my training for two months. Then I had another two months of very slow recovery training before things were back to normal.

Not that getting forced off the trail really “caused” the injury. It was really just the final straw. Basically I was putting in high mileage (high for me – 50+per week at that time), doing too many hard workouts (sometimes 4 per week) without a sufficient “base” of mileage, and no cutback weeks of any significance. Since that incident, I’ve made sure to structure everything. I draw up my own plans, and incorporate a cutback week every three or four weeks. I limit fast workouts to no more than three per week, sometimes less depending on where I am in my training, and gradually build mileage over the course of the plan.

Since then I’ve successfully PR’d two marathons, the last putting me in the sub-4 hour category (3:59:23) with no injury! My peek weeks have been in the mid-70s (@ age 52 – not bad). I am currently reaching peek mileage for my next marathon this March.

At any rate, I agree that it’s mainly about how you structure mileage and integrate hard workouts, then maintaining the discipline to stick with the plan. Since my injury, I have avoided treacherous, hilly courses like the plague on long runs. For me, it’s just too much stress and too risky.

Thank you for sharing your experience. Obviously, you have the know-how to implement a recovery plan, so you’re back in business!

Phil

Franzi

Wow, what a story. Reminds me to be more focused on every angle not just running form and strength training. Glad to hear you are better. It would be very interesting to hear how you are back without pain in 9 days… can a tendon really heal so quick?

Jason Fitzgerald

Depends on the severity of the injury (and every person is different). The exact protocol I used to get healthy is in the injury prevention program, though I’m happy to share my modified training post-injury.

Deb

huh,,,and after all my deviations & extra marathons, I am actually behaving with my most recent post race recovery. I guess you really are human like the rest of us :)

Greg

Yes please on the case study. As a marathon training plan user coming off arthroscopy, would absolutely be in for a meetup near the RnR weekend in DC. Take it easy on the vino!

Cassandra

I just had my first real running injury in about 6 or 7 years as well–a stress reaction (early stress fracture) in my femur. And I know that I made several really poor decisions in a row that contributed to that. The first dumb decision was going out for a couple of intense 3-hour sessions of x-country (skate style) skiing over the x-mas holiday. I had never tried it before and thought “I’m an athlete. I’m in good shape. I can go super hard for 3 hours. No problem.” Although I didn’t know it at the time I think I strained my hip flexor and then got back from my holiday and jumped back aggressively into training (after two weeks off running–also dumb) and even did a two-hour hilly trail run when my hip was really tight from the beginning of the run and didn’t quite feel right. It wasn’t “hurting” so I thought it was okay but I could barely walk the next day. I ended up then having to take 3 weeks off running (just did cross-training) because of my hip and then last week finally got an MRI and learned that not only to I have psoas tendonitis but also the beginnings of a stress fracture.

Mary

Glad to hear your recovered but would love to know exactly what you did after you limped home. I’m finding it very difficult to heal a calf/achilles injury for the past 6 months and certainly wouldn’t be attempting any speedwork.

Campbell

I’m actually interested in your comment about being “caffeinated” for your long run – do you do that regularly for long (and/or other) runs? Is caffeine something you rely on, via either coffee of caffeine pill? Did you think that heightened arousal led you to run when you otherwise might not have?

Jason Fitzgerald

Yes I love coffee. I drink it before most runs – it’s a proven performance enhancer! More at http://strengthrunning.com/2010/07/health-benefits-of-caffeine/

Lindsay

Jason,
I’d love to hear about the “personal case study” you did on how you got back to being healthy so quick. Also, I ran the rock n rock half last year, it’s a pretty fun run – lots of things to look at along the way. Enjoy it pain free :) and good luck!
Currently, I’m following your plan and it’s going well so far – my times especially my work out/long run times keep getting faster :). Look forward to hearing if there is a meet up near the DC area!
-Lindsay

Tim

I would love to hear more about how you recovered. I am coming off the same injury only I have been off since August and am just now very slowly getting back to running. It took me about 11 weeks of PT, 3 weeks in a boot and lots of $$$ so any tips I could garner from your experience would be great. Thanks

Claudia

Hey Jason, sorry about that.
Poor judgement abounds here as well. My foot goes to sleep after running for about 30 minutes? To hell with it, I’ll keep going, it’ll sort itself out. Fast forward, weeks later: my foot still goes to sleep after running for about 30 min AND it kind of feels a bit sore after running? To hell with it, I’ll go FASTER whenever I feel it going numb.
Result: Just had to take a week off because of an inflamed nerve in my forefoot AND apparently I better get used to orthotics.
Bonus crap: orthotics don’t really fit into my beloved Minimus Road so on top of it I have to switch to some other shoe. Ran in my Kinvara this morning, they’re good but heavy compared to my MRs.
Silver lining: shoe shopping on the horizon ;)

Tiffany

I’m also interested in how you returned to your normal mileage so quickly. while my mileage isn’t much, I’m missing my 6 mile runs. I’ve taken some time off for a strained quad..I do miss running! how long is appropriate to take off for a muscle strain?

Marius Bakken

Dear Jason,

I’m a Norwegian two-time Olympic runner (13.06 5k back in ’04) as well as an MD. I have been following your blog for quite a while and want you to know that I’ve added you to a list of the Top 100 Running Blogs for 2014!

You are there, and deservedly so, in spot # 3!

http://www.marathontrainingschedule.com/blog/awesome-list-top-100-best-running-blogs-2014/

My blog is quite new and certainly not as established as yours, but I try to share
quality, inspirational posts with my readers. Here’s one of my latest posts for
you to check out:

http://www.marathontrainingschedule.com/blog/45-mind-numbing-facts-figures-statistics-running-2/

If you like it, please feel free to share with your readers. ;)

Keep up the wonderful work – and if you ever want to get in touch to discuss running or blogging, you have my personal email.

Kind regards,
Marius Bakken, MD

Jason Fitzgerald

Thank you for the kind words Marius and the honor in being on your Top 100 list! That’s awesome. Excited to have you as an SR reader :)

Marius Bakken

Jason, your spot is well deserved – you keep on producing quality posts (+ I like your science/running combo) and I will continue visiting in the future also.

all the best,
Marius

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