Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

from your Achilles tendon as it’s a fairly frequent problem in runners. You need to be a bit careful here, because ignoring it and just carrying on running risks long-term damage. The Achilles tendon connects your calf muscles (the gastrocnemius and soleus) to your heel bone (the calcaneus). When the calf muscles contract, the tendon helps to lift the heel off the ground. Running can put a lot of stress on the Achilles, particularly if you increase your frequency or distance of running too quickly, and if you do a lot of hill running or speed work. You might have heard of Achilles tendonitis, which was thought to be a simple inflammation of the tendon from over use, but we now know that although there may be some initial inflammatory changes, over time, microscopic injury, including tears, occur in the individual tendon fibres. The tendon may thicken and become stiffer to protect itself. This is more accurately called Achilles tendinopathy. The structure and strength of the tendon is altered, and if ignored then it can ultimately lead to weakening and, at worst, complete rupture (tearing) of the Achilles.

Don’t ignore Achilles pain, swelling, thickening or lumps. Taking early action can prevent a lengthy recovery, prolonged time off running or a potential tendon rupture. First you should rest to take the strain off the Achilles. Apply ice (15 minutes several times a day), gently massage or foam roll your calf muscles to relax them and consider taking an anti-inflammatory. This should help to ease the initial symptoms, but you then need to move onto a longer-term strategy to strengthen your calf muscles and look for underlying causes. If it was simply increasing your distance too quickly, then a period of rest and a gradual return to running with adequate rest days may suffice, but it may be more complicated than this. Poor biomechanics, muscle imbalances, tightness and weakness can all lead to Achilles problems. This is a specialist area and I highly advise seeing a physiotherapist who can tailor a recovery programme to your exact situation. With careful management you can avoid or at least reduce your chances of long-term Achilles problems.

Real-life runners

My Achilles issues were improved by getting some professional help from a specialist chiropractor. She taught me great stretching techniques and, being a runner herself, understood the mental side too – the drive to have to run! Following her advice, learning techniques to improve my stability and mobility, plus my investment in some compression socks, has really helped.

Mike Whelan, runner and Leinster Rugby fanatic

Q I’ve sprained my ankle. What’s the best way for me to get back to running as quickly as possible?

A Don’t underestimate the common sprained ankle. Even though no bones have been broken, a sprain can cause significant problems. Ligaments stabilise joints and when sprained they get overstretched and torn, for example by going over on your ankle. The pain, swelling and any instability of the joint needs careful management to get you back running as soon as possible. Good rehabilitation of ankle injuries is crucial if you want to return to full strength.

Use the PRICE protocol (see here) as first-aid for your ankle and assess how severe your injury is. If there’s no swelling, and you can still weight-bear without too much difficulty, then you’ve got a minor sprain and might be running again after two weeks. If the pain or swelling is immediately very severe, or you’re still unable to weight-bear after two days of PRICE, then you need to be medically assessed in case you have broken a bone. Assuming no fracture is seen, then it’s a case of working hard and being very patient, because severe sprains can mean four to six months off running.

Rehabilitation focuses on getting flexibility, strength and stability back in your ankle. It’s best to be up and about, gently mobilising, as soon as you can. In the first couple of days start by gently flexing and extending your ankle several times through the day. Try using a towel looped under your foot to gently pull it towards you. Build up to rotating it and writing the alphabet in the air with your foot by the end of the first week. Then you can start to do some strength work, gently pushing your foot into the ground, aiming to be able to stand on one leg. Try going up and down on your toes (calf raises), with both feet at once in the early stages. You can do this sitting in a chair if standing is too hard initially. Once you feel confident and strong with up and down movements, then add in some sideways and twisting ones, such as standing on one leg while twisting your body, side stepping and walking in a figure of eight. If at any point your ankle begins to swell more then it’s a sign that you’re doing too much. Elevate it, reduce your activities and then slowly build up again. You may want to invest in an ankle support or get a physiotherapist to advise you how to tape your ankle.

The point at which you can run will depend hugely on the individual, but once you feel confident with the stability, strength and flexibility of your ankle then you can begin to jog and then run. Start on a treadmill or find some flat grass – avoid uneven and bumpy surfaces. In reality it takes around 12 weeks for ligaments to heal up, so even if you feel OK, do take care for three or four months.

Hips and spine

Q I’ve heard other runners talk about piriformis ­syndrome. What is it?

A Piriformis syndrome is quite literally a pain in the bum! The piriformis is a muscle which runs from your lower spine (sacrum) out to the top of your thigh bone. It’s located behind the gluteus maximum muscle, but is much smaller than this giant. You have one on each side of your body and its job is to