Why didn’t she double dip Achilles?

Posted: June 10, 2011 in CrossFit, Exercise, Fitness, Health, Uncategorized
Tags: , , , , ,

Just to make sure we’re all on the same page, Achilles was the mythological half nymph/half human Greek hero who was dipped by his mother, Thetis,  into the River Styx in order to make him immortal. Unfortunately, girlfriend held onto his heel to do so, and thus created a weak spot, known thereafter as the Achilles heel. The myth also resulted in the name of the tendon that connects the back of your heel with your calf muscle. I don’t know that had Thetis had double-dipped Achilles that my tendon would feel any better; most likely, it would just have been called something else.

At any rate, my Achilles tendon is giving me grief (today it’s the right; day before yesterday it was the left). I have always had overly flexible ankles; when I was younger, I routinely would end up walking on my ankle for a step when my foot folded under. The first time my ankle swelled to the size of a softball was when I was eleven. I injured it in a 3-legged race at a Girl Scout event when my partner and I tripped over our tied ankles.

Now it’s unhappy because I have not perfected one of the many aspects of squatting: I don’t consistently push out toward the outside of my feet when squatting. I wobble inside and back out, as well as occasionally moving to the balls of my feet (wrong) instead of my heels (right). This became very evident when I tried, for a second time, to move to a lower box (18″) to use as a squatting aid rather than the 19.75″ plyo box. I thought I was knocking out my squats well enough to move forward, but the almost-tw0-inch difference was enough to show, once again, that I had form issues. (The first problem was with my knees; I wasn’t tracking them over my feet like I should. Instead, I was making the common error of letting my knees drift inward rather than keeping them pressed out. I still don’t  do it right all the time, but I’ve gotten much better about doing it more correctly more often.)

Right now, the unhappiness is confined to a little inflammation and soreness, so I’m sure Gary’s diagnosis of the problem with my squat is correct. The first pains were more like the twinge I’ve had in the past when I’ve wrenched or sprained my ankle, although there wasn’t any bruising or swelling. Ice is making it better, and it’s not screaming only when it finds a bad position like it was before.

So after figuring out the specific problem, Gary and I began discussing the larger issue of “how do we get my ankle to stabilize.” Let me back up and give you some more personal history (yes, I know it’s riveting). I’ve had two physical therapists who’ve seen me multiple times. The first, Gail Dankis, moved to Austin; the second, Stephanie Thurmond, is here in San Antonio. I’ve had physical therapy for my neck (twice), back (can’t remember exactly how many; more than twice, less than eight), hip (SI joint, specifically), feet and knees. There’s talk of sending me again for my shoulders. (Aside for those worried that CrossFit will injure you: When I asked Stephanie about what would be the best type of workout, she said that she’s worked with people injured in everything from yoga and pilates to competitive team sports. It’s not the type of workout that will hurt you so much as overdoing it and/or doing it in violation of biomechanical principles. So it’s more about how good your coach is and whether you’ll listen to that good coach.)

Anyway, when I was younger the problem was that I was overly flexible relative to the amount of supportive muscle I had for whatever body part. Now I’m not as flexible, but I have the weight as a complicating factor. Since I haven’t had therapy for my ankles yet, I was a little clueless about how to improve the strength/flexibility ration aside from the squats (which may be sufficient).  I’m going to repeat myself: It’s more important to be consistent in working out than to push too hard and injure myself and end up benched. On the other hand, I need to push myself to improve. Finding the balance is the trick.

So, as is my usual response to any problem, I resorted to research. The CrossFit Journal is a great resource; when they don’t address the problem, the public library is always a good place to look for information. I’ve looked at both, and here’s what I found out. Before I share it with you, though, I’m going to use the same disclaimer everyone else on the Internet does: I am not a healthcare professional, and this is no substitute for consulting your doctor. If you are unsure, get a professional opinion.

Here’s San Francisco CrossFit’s  Kelly Starrett, a physical therapist, CrossFit coach and frequent contributor to CrossFit Journal, in a video on Achilles well-being (I found the video though a forum at the Barefoot Runners Society, and the person who posted the link said to “Never mind the ADHD”):

Starrett has some comforting and helpful comments about the Achilles tendon (I’m paraphrasing, so if I’m wrong, it’s my fault, not his):

  • It’s the strongest tendon in your body; you could suspend a car from it.
  • It’s really hard to rupture; if you do, it’s been in bad shape for a long time.
  • If you straighten your knee and pull your foot toward your shin, and you can’t pull it past a 90 degree angle, you need to work on your Achilles tendon’s flexibility. It can be done, but if you try to compensate for a tight ankle by bending your knee instead, you can cause problems anywhere (and everywhere, I’m guessing) in the chain from your ankle to your knee.
  • If you have your foot at a 90 degree angle and you can’t move the skin around over the Achilles tendon, you’ve “nailed” the tendon into place, which can make you vulnerable to injury.
  • Take it seriously if your tendon isn’t working correctly.
  • Make sure that when you squat, your feet are not angling to the outside edges from your legs. Keep them straight out, or the torque can irritate the end of your Achilles tendon where it attaches at your ankle.

So, go me, I have both problems: inflexibility in my Achilles and tight skin over it. Unfortunately, the first way he suggests to fix the flexibility issues is to get into a deep squat and waddle around. Nope, that’s too advanced for me; my butt will drag me down to a sitting position. The second, a calf stretch, is demonstrated beginning around 6:51 seconds into the video, and is doable. (You can probably do the same stretch using a downward facing dog.)  The solution to having fixed skin around the tendon appears to be a little more attainable; he uses a lacrosse ball to try to loosen it. The instructions begin at around 4:20 minutes into the video. (Where do you get a lacrosse ball, anyway?)

Starrett has another video on tendon health that is also interesting, focusing more on the “junky tendon” and implicitly letting those of us with bone spurs on our ankles that the spurs are not the end of the road:

In this one, he uses a “double ball” rather than a lacrosse ball and demonstrates that getting the skin looser improves the range of motion in the ankle. He also uses an exercise band to work on the rest of the chain (which he connects to the back of a white van, inexplicably making me laugh) (see about 2:40  minutes into the video) to pull against your ankle and squat down the best you can. Two minutes minimum is necessary for the exercise to have any therapeutic effect.

That’s probably plenty for this post; I’ll continue with more on the Achilles tendon later. For now, see what kind of moves you can put on Achilles to get that ankle immune to injury.

 

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