Achilles / Ankle Injury & Barefoot Running

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26/02/2012 at 16:08

Hi - this thread is about transferring to barefoot running (well, actually minimalist shoes) to help an achilles / ankle problem longer term - and whether that's sensible or not!

There's a lot of info to take in here so please bear with me. Hopefully some of the info i'm giving (from my physios) might help some people out there with the same problem too.

I started running c.2yrs ago and did my 2nd half marathon last September. I noticed soreness in my achilles in the mornings & at the start of runs after running the half (maybe came on during the build-up training, I can't remember). I went to a physio and they told me to stop running, which I did. She felt the problem was an ankle sprain the previous year contributed to a lack of dorsiflexion (stiff ankle joint) as I couldnt get my knee to the wall easily even with my toes against it; but also stiff calf muscles.

I stopped running & it improved but I have built up slowly to 15-20miles per week and i'm back where I started with the stiff achilles in the mornings & at the start of runs.

Back to a new physio who says the same as the first. I have decided to cut down to <10miles per week (3x3mile runs) but feel very frustrated by that. I have to do lots of calf lowers, calf raises (raise on strong side, lower on weak side), and ankle joint stretches for improving dorsiflexion.

Having reads lots about achilles & ankle joint movement on the Net and in this forum.. I decided some of the issues might be coming from the way I run & the shoes I run in. I wear Nike Structure for mild/moderation over-pronation. So I just had gait analysis at a running shop & it seems I don't heel strike at all, i'm a forefoot runner. I am also way over-striding. I haven't had a chance to update my physio since as she's away - so anyone know if this could cause the problems?

So i'm thinking of switching to minimalist trainers (sort of barefoot running but not quite) - in fact I already bought some Merrels. This will suit the way I run anyway, and allow my ankle to move more naturally where as my current trainers allow it to be lazy.

This is great for my running gait and my ankle (hopefully) but what about my achilles?

I am worried it will make it worse! I don't want to risk making my achilles worse as I know that's the only reason the physio is telling me to limit my running.

I know I have to build up slowly with these shoes - I did 3mins (literally) on the treadmill in them today.

Any advice would be much appreciated. Otherwise, I hope some of my info helps someone out there.

Thanks

26/02/2012 at 17:02
My money is on the Merrels making your achilles far worse.
I have a pair of trail goves myself which I use when running trails as I like the feed back they give me. Sounds like you need some strength around the ancle and achilles to me.
Other than stretching, what strengthing work do you do for this area?
Running on the spot on a bose ball helped me improve my ankle stability and achilles greatly.
26/02/2012 at 19:45

...here's the thing.

If you've got an injury due to poor form or poor control or poor stability in a part of your body well away from where you feel you symptoms, simply swapping shoes and/or altering technique is not goign to be a whole lotta help.

As you've seen a few physios and haven't got better with them treating your achilles/foot, then I very much doubt you've got a problem down there.....

Get proper stability, not a different running stylee....

26/02/2012 at 20:23

Don't just change to barefoot running without any proper coaching - the style and cadence is quite different from running in ordinary trainers.

vivobarefoot are a good company and have qualified coaches - i had a clinic with one and felt it was money well spent.  I could never have guessed all that he told me about technique etc

Edited: 26/02/2012 at 20:23
26/02/2012 at 23:07
Hi guys, thanks for the advice.

Six Physio - can you just explain what you mean by "if you've got an injury due to poor control or poor stability well away from where you feel your symptoms". As far as I'm aware I haven't? Unless you see the ankle as being well away from the Achilles? Just checking in case you mean something else.

I guess I realise it won't help the injury I have right now. I thought it might improve my ankle movement longer term.

The injury will only be fixed by the exercises the physio is giving me, the treatment I get & laying off running as much.

What I want to know is, will switching to barefoot shoes (given that I'm a forefoot runner anyway) cause my Achilles more issues? I think the consensus here might be Yes.

Flipperjane - thanks for the tip. Much appreciated.

Squeakz - I have been given a few strength exercises mostly with body weight at the moment & lots to do with balance including Bose ball.

I should probably mention I only started the second bout of physio 2wks ago & my dorsiflexion is already improving.

Thanks again - I love running, it's the best thing I've ever done
27/02/2012 at 07:56
Hi C

Wrong word(ish) using injury. For example you may have have poor control around your pelvis due to poor postural patterns. This may not give you any symptoms at all in or around your back, pelvis or hips.

The poor movement here (pelvis, back etc) will increase the load elsewhere, such as an Achilles over load.....

What's your single knee squat like? If it's different, then there's a potential issue that'll need addressing.

Hope this makes sense.
27/02/2012 at 10:42

OK this makes total sense now.

I have a slight leg length discrepency (only 5mm) on the same side as the injury. This slightly tilts my hips/shoulder on the left side & I get neck & lower back pain. I menioned this to my physio last time as I wondered whether it may be the source of injury but now I am wondering even more.

I will check this out. Thank you for your help.

28/02/2012 at 17:59

Chandl3r -- Body weight excercises are all you need, it may be worth attempt to locate a local body balance class (yoga, pilates, Tai chi) - I really find that this type of class helps my flexability, core strength and stability which works well for me.

 Personally I think Six Physio is giving you solid advise, I had knee issues which nobody could resolve untill I had a full and propper biometric assement which Identified a week hip, solving this resolved my issues. You need to take a sensible approach towards addressing issues, ramdom acts such as changing shoes rarely improves things long term.

Edited: 28/02/2012 at 19:39
04/03/2012 at 10:38
Hi again,

I have decided not to attempt changing trainers / running technique at least until it's better - don't know what I was thinking!

I have been doing eccentric calf raises on a step (3x10 - once a day to begin with). I am stretching my calf muscles as much as I can. I'm also doing lots of stretches that should improve the flexibility in my ankle (toes towards my shin) & some balance nd core stability work.

I have also cut down running to 3x3 miles per week (this week & last).

However... the Achilles soreness right now feels at its worst. I used to say it was stiff in the morning & at the start of runs. Now it's sore in the morning, causing me to limp & sore for about the first mile of my run. Last night I tried to run for a train & couldn't because I'd been sat down for 30mins & it felt painful to run when I stood up.

So... I'm seeing my physio Thursday & I'm guessing they're going to say No More Running.

My question is.. are the eccentric calf raises supposed to make it feel worse to begin with? Also, should I do them off the step or on the floor? I understood you needed to drop the heel lower than ground level but maybe that's too much?

Thanks for any advice.
04/03/2012 at 10:39
Oh by the way - my running has been in my normal trainers (stability) - I haven't changed footwear or anything like that.
30/08/2012 at 22:08

Chandl3r,

I hope your condition cleared up. Would be good to find out.

My opinion on your predicament is as follows:

  • The over stride is your main problem
  • You need to ensure you have good ankle movement in the saggital plane (forwards and backwards with foot flat to ground)
  • Your caf/achilles problem is caused by the over stride and you (either consciously or subconsciously) landing on forefoot with calf/achilles stressed
  • "Gait Analysis" in running shops is used to sell shoes

It is very simple to fix this to be honest with you but no amount of chatting on a forum can better a one to one session with a good coach.

The VIVOBAREFOOT shoes and coaching philosophy work very well indeed. I am a certified VIVO coach and I have to say what I learned was truly a revelation.

If you continue to have problems I would advise you to go to the VIVOBAREFOOT coaching clinic site and seek out a coach near you. It will change the way you run and with a bit of determination and persistence from yourself you will make permanent and quite dramatic improvement to your running technique and look forward to running without fear of recurrent injury.

 

02/09/2012 at 11:04
Hi Ian

Thanks for your post & your advice.

Here's an update..

I stopped running altogether for 12 weeks & started doing interval training on the stationery bike and various weights/core stability exercises in the gym.

I got referred to another physio for a 3rd opinion and she confirmed/diagnosed the problem coming directly from lack of dorsiflexion in the ankle. I did minimal calf raises as they seemed to make it worse and changed to exercises to increase dorsiflexion (leaning the knee over the ankle with foot flat on floor).

I am now injury free and much fitter than before thanks to all the gym work. I now train 5 days a week with a mix of cross training, strength and running and almost glad I got the injury in the first place.

Loving life and loving running.

I will check out a clinic for better running technique. I still run on forefoot but in normal / minimum stability trainers. However I make sure I don't run on my toes or over stride.

Thanks all for your fantastic advice.
02/09/2012 at 11:20

Hi Chandl3r,

 

That's great news! Lack of mobility in the ankle is a common one. It's usually easy to fix too, you just need to keep doing those exercises to maintain the range of movement and to get your calf/achilles to relax/lengthen enough to work correctly.

Sounds like you have also fixed the other problems of over striding and landing on forefoot deliberately which is good.

When you get chance though, I'd still recommend you spend a bit of time with a coach because they can make absolutely sure you are running with good posture and the way VIVO works, you get instant feedback and a very simple way of maintaining that posture.

Really good to hear you have recovered and made positive changes!

Feel free to get in touch if you want/need any advice going forward.

03/09/2012 at 06:45
You mentioned over striding I would suggest trying to increase cadence to around 170-180 footfalls per minute. Check out both Chi and Pose running techniques. Also I wouldn't go minimalist yet - the best option is to wear lighter racing flats.
03/09/2012 at 06:53
Also I too have gone down the "gym" route too and look to a variety of activities for strength and fitness including swimming, stationary bike, cross trainer, concept 2 and stairmaster. The latter if you can find one is a revalation - try doing it with no hands as fast as possible it's like running without the impact! Also I am doing specific "barefoot" stuff which involves deep squatting, jumping, hopping and skipping - all barefoot. I have weak feet and feel in the long run these exercises will pay off big time.

Good luck. Nick
03/09/2012 at 07:46
Thanks Ian, I will check out the sessions.

Nick, I've counted cadence on the treadmill and it's about 150-160 with a lot of effort to not over stride. I can't imagine getting it to 180. Any tips? I know the right music is meant to help..
03/09/2012 at 09:00

As the previous have posted, I would sort out mechanics of how you run before changing shoes... fix the underlying issue.

Over-striding is asking for injury... as with every footfall the lower kinetic chain has to deal with the ground reaction force until your centre of mass catches it up. Get your feet underneath your body more.

A tip for keeping cadence up is to mentally count 3 footstrikes every second. So in your head say 1-thousand, 2-thousand etc and you should have done 6 steps.

03/09/2012 at 09:13

CHAND3£R: Shorter strides. Try concentrating on the cadence not on the stride length. Land with your foot right underneath you, not out in front at all. I average 190/minute; I find it easiest to count for every left-right so I generally hit a count of 95/minute. You might find it easist first to try this slower than you usually run. You can find metronome sites online - I set my laptop up near the treadmill initially, playing a 180 metronome beat loudly - I'm sure you can get one for an mp3 player. Or you can buy an electronic metronome - there are some fairly cheap on the web, but check they'll do 180 - some only do set speeds and 180 isn't one of them.

03/09/2012 at 09:15
Cadence: if you've moved towards POSE or Chi Running, lean forwards at a more aggressive angle from your ankles. Gravity will be pulling you forwards at a quicker rate and, as long as your feet are contacting the ground under your centre of mass, you will have to pick your feet up faster, or else fall on your face ;P

http://jogtunes.com/jtc/jtcartistssigned.php?a=queen&Submit=Search is a nifty little site that gives you the BPM of pop tunes.

However, most of the fast runners you see at races most certainly don't use this kind of gait and will often lengthen their stride rather than up their cadence. I see this kind of running as something therapeutic for my body that I do on my LSRs. During races, I throw caution to the wind and just run fast, and then try to stretch out and warm-down the damage I've done to my body afterwards.

Swimming is great for ankle flexibility, particularly if you can do a decent front crawl or 'body dolphin' stroke.
03/09/2012 at 12:04

Chandl3r, getting to the 180 (guidline) is easy if you posture is good. It is difficult to maintain if you have postural issues because one helps the other. Good posture helps you to position the body in the optimum way for good rhythm.

180spm isn't hard and fast either. mostly for endurance running expect it to fall between 175 to 185.

Metronomes help greatly for you to understand what you have to do with your legs to get them to fall into the beat at different running speeds.

With regard to overstriding: don't try not to overstride because conscious effort interrupts the subconscious act of running - it slows things down and that will cause over striding!

Posture is key but ten minutes with a good coach and you would see what I mean.

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