In the final chapter of our tendonitis special, we look at how patients can reduce the risk of tendonitis flaring up again.
Sarah says she will lay off the running for a few weeks, taking walks instead to maintain her fitness levels, and says she will try a yoga or pilates DVD she has at home to try as a way of gently stretching her Achilles tendon. Is there anything she needs to bear in mind when she feels she has recovered from her injury and is ready to return to running that will reduce the risk of tendonitis flaring up in the future, she wonders?
There is little that can be done to specifically reduce the risk of tendonitis occurring in the future, but adopting some common sense measures may help on a more general level:
- Avoid overuse of the affected area. In Sarah’s case, after several weeks of not running, it might be sensible for her to repeat the past few weeks of the Couch to 5K programme that involves interspersing periods of walking with running intervals rather than attempting to run 5k straightaway.
- Strengthen muscles around the affected area. Sarah’s plan to do some gentle walking plus an activity such as yoga or pilates is a good one, but she might want also to seek advice from a physiotherapist about other muscle strengthening exercises. A decent physiotherapist will be registered with the Health and Care Professions Council (their status can be checked at hcpc-uk.org) and a member of the Chartered Society of Physiotherapists. The CSP has a ‘find a physio’ facility on its website at http://www.csp.org.uk/your-health/find-physio/find-physiotherapist
- Warm up before exercising and cool down afterwards. Dynamic stretching, including some cardio work, before embarking on a run ensures joints are warm and moving smoothly and lessens the chance of injury. A basic warm up routine can be viewed at http://www.nhs.uk/Livewell/fitness/Pages/how-to-warm-up.aspx. Similarly, a cool down routine, such as that at http://www.nhs.uk/Livewell/fitness/Pages/how-to-stretch.aspx stretches out muscles that may be taut after exercising to improve flexibility, and also helps slows the heart rate and relax both body and mind.
- Wear appropriate clothing for the activity being undertaken, with a particular focus on footwear. Running shoes are not like other trainers, as they are designed to allow the feet to bend with each step, and this flexibility can cause problems if they are used for different sports. Gait analysis – which involves being videoed while running on a treadmill to see whether the feet roll inwards, outwards or stay in alignment – can be helpful, and is offered by many sports shops, as is having trainers properly fitted to avoid the risk of blisters, black toenails and other sources of discomfort.
- Run on a soft surface, such as grass or a running track, rather than pavements or roads to reduce the amount of impact passing through the joints.
- Consider joining a club or getting a personal trainer if Sarah wants to push her running further, for example, by attempting longer distances or cutting her 5k time, so she can take advantage of the expertise of others rather than relying on a generic programme or something she has put together herself.