My decision point for things that I've tried and continued versus those that I've tried and thrown out has become simple: does it make me feel better or worse after doing it? While you might have just breathed a heavy sigh and rolled your eyes over that revelation, think about who you're dealing with here. I am a runner that is used to pushing myself hard through pain and discomfort all with the goal of improving my fitness and becoming faster. So, pain in a twisted way, is my friend and helps me improve as an athlete. Now consider that my best friend just shat all over me, and you might get a sense of why this simple question is novel to me.
One very important point about the recovery cycle post-injury that I just realized over the weekend is that your body goes through phases in the healing process. Maybe the rest of the world knows this, but I had never really picked up on it. This is the primary reason that I had such trouble understanding the various recommendations regarding the use of ice. It appears that ice is super important (as a component of P.R.I.C.E.) during the initial (acute) phase of an injury (first 3-7 days). There seems to be general agreement on that. However, the use of ice beyond that point is not agreed upon. Some say that it can impede healing by decreasing blood flow to the affected area while others say it does no harm and at least keeps pain in check. My point here is that treatment recommendations require context relative to the phase of recovery you're in, and, often times, they are not written in that context.
Another interesting recommendation that I found and actually really liked was to perform eccentric heel exercises. I was super skeptical at first about this one because it appeared to be based on one of those one-hit wonder scientific studies and treated as gospel forevermore. However, this was a case where the study spurred doctor's and physical therapists to try it out on patients en masse. There now exists an impressive body of evidence from people, like myself, trying this technique out with some success. Other studies have also been done to refine the technique. To read all about it, go here. What I can say about it is that my achilles and calf feel a lot better after I do these exercises even though it might hurt a little while I perform them.
So, the things that seem to be working for me are (including their recovery context):
- not running (during the acute recovery phase)
- icing after runs (during rehabilitation phase)
- eccentric heel raises 3 x per day (once I could do these with only a moderate level of pain)
- working out the adhesions in my calf muscle (for the first 2 weeks)
- massaging my achilles using these techniques (after the acute phase, but continued during rehab.)
- stretching my entire leg using trigger point massage, especially my hips and IT band (throughout)
- stretching and massaging my foot (throughout)
- heel lifts in my running shoes (led to a change in gait and stressed my peroneal tendon)
- stretching the calf while running (I felt relief at first, but then seemed to irritate the achilles later)
- heating the calf prior to running (had a neutral effect at best)
The bike is currently my cross training activity of choice. I am becoming super strong in the saddle and have found it very enjoyable to go out and hammer a hard workout on the bike trail. I am now one of those bike jockeys that I complain about as a runner, exceeding the 15 mph speed limit and passing with reckless abandon. I am actually quite courteous and do know how to cross over that magic yellow line in the center of the bike lane to avoid runners and other cyclists. I have learned to use my heart rate monitor to gauge my effort level, but have to use a lower HR max on the bike to make the percent effort comparable to running.
I still haven't pulled the plug on Eugene, though each day that goes by makes the probability of making it to the starting line seem more and more bleak. But, Eugene was a random proposition anyway and one that I am not at all married to. So, I'm making like Bonnie Franklin, Mackenzie Phillips and Valerie Bertinelli, and taking it One Day at a Time.