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Is your Achilles tendon an uphill battle?

The Achilles tendon is stronger than you think, even when running hills.

The Achilles tendon (on the back of your ankle) is a common site for injury, especially for runners. And many people think running hills increases the likelihood of injuring their Achilles. Hill running provides many health benefits (cardiovascular endurance, strength, performance, etc.), but do the benefits outweigh the risk to your ankles? For the most part, the answer is, yes! The effects on your Achilles tendon while running on a flat surface, uphill, and downhill are all similar, meaning the risk of injury is no greater when running uphill or downhill than on the flat. Achilles injuries usually happen because of a combination of internal (ankle misalignment, muscle weakness, decreased flexibility) and external factors (footwear, over training, humidity, altitude). With movement, however, the Achilles tendon becomes more flexible, so a proper warm-up before exercise will help prevent injury.

What this suggests is that running hills isn’t necessarily a cause of injury to the Achilles tendon. More likely causes include progressing too quickly as a new athlete or not properly recovering from an injury. If you’re recovering from a previous injury to your Achilles tendon, talk to your doctor or therapist about when it’s safe to run again and how much hill running you are able to do. Be gradual in your return to running, especially hills. Don’t try to sprint up or down anything too steep too soon. But as long as you’re healthy, at your next hill encounter, be confident and take it on; your body is more likely to benefit than not.

National Veterans Summer Sports Clinic

Calling injured veterans to sign up for the National Summer Sports Clinic in San Diego, CA, September 13–18, 2015.

Spring is just around the corner, so it’s time to start thinking about sports and outdoor recreation. In keeping with the Mission ReDefined campaign (a joint effort of the U.S. Department of Veterans Affairs and the U.S. Paralympics), VA encourages eligible veterans (those injured within the last six years) to apply for the 2015 National Veterans Summer Sports Clinic.

The purpose of the Clinic program is “early intervention for Veterans battling back from injury, not only strengthening their bodies but improving overall well-being and self-worth.”

Spend a week in San Diego learning about adaptive sport and recreational activities such as sailing, surfing, track and field events, kayaking, and cycling (hand and tandem). This is a national event open to Veterans from all across the country with combat injuries ranging from TBI and polytrauma to spinal cord injuries and loss of limbs.

The clinic will be held in San Diego, CA, from Sept 13–18. 2015. The deadline to sign up is May 1, 2015; visit the Registration tab at the Clinic link above for details and forms.

Think like a survivor, not like a victim

Some individuals who have devastating injuries or illnesses are able to enjoy a good quality of life. Learn some factors that can help you think like a survivor, not a victim.

Why do some people with devastating injuries do well in their recoveries and others do not? People often focus on the negative fallout, but there can be positive consequences called post-traumatic growth. Scientists use the term “disability paradox” to refer to how some people with devastating illness or injuries are still able to enjoy a good quality of life. The characteristics of these folks describe someone with a “survivor mentality.” Characteristics include:

  • Subscribing meaning to one’s disability or lot in life and sharing this meaning with others.
  • Not choosing to live as a victim but instead to feel empowered and motivated to deal with struggles and come out as a victor.
  • Being flexible, adaptable, resilient, and rolling with the punches.

Many factors play into developing a survivor mentality. Here are some tips to help:

  • Create a strong support system: family, church, community, fellow Warfighters, healthcare providers, etc. A support system should be just that—supportive, encouraging, and a promoter of independence, not an enabler for being or feeling like a victim.
  • Maintain a “can do” attitude. See challenges or setbacks as an opportunity to learn and grow. Focus on strengths and abilities, not on limitations. Survivors exhibit the 4 Cs of mental toughness.
  • Maintain hope and optimism; focus on the future and move from thinking about the negative aspects of injury/illness to focusing on the positives or possibilities.  

DOMS: The morning after (a tough workout)

Learn more about soreness after a workout, including ways to help prevent and reduce it yourself.

Have you ever felt great after a hard workout, only to find yourself incredibly sore a day or two later? Muscle pain a day or so after exercise is common among recreational athletes. Known as delayed onset muscle soreness (DOMS), this condition can be treated at home—and possibly even prevented—with simple techniques. Strategies to prevent or reduce DOMS include stretching, protein/carbohydrate recovery drinks, and cold-water immersion. Over-the-counter medications can also help with pain but should be used infrequently and at the lowest effective dose. For more detailed information about DOMS and how to prevent and recover from it, read HPRC’s Answer, “Delayed Onset Muscle Soreness.

The latest on antigravity treadmills

Check out our updated information on antigravity treadmills and their use in injury prevention and rehabilitation.

Antigravity treadmills are becoming increasingly popular in injury prevention and rehabilitation settings. These special treadmills reduce the stress placed on the lower body during rehabilitative exercises, like running and walking, while still conditioning muscles. However, there are still questions as to whether the scientific evidence supports their considerable cost. For more about the use, evidence, and cost of these devices, read HPRC’s “Effectiveness of Antigravity Treadmills for Injury Rehabilitation.”

Intimacy after an injury

Combat injuries such as PTSD and TBI can impact your ability and interest to be sexual with your partner. Two fact sheets provide more information and suggestions.

Being able to be close and sexual are key aspects of intimate relationships. Warfighters struggling with PTSD, TBI, or other combat injuries may be surprised to find that injuries can impact their ability to have sex, derive pleasure from sex, or be intimate by connecting emotionally with their partner. Or conversely there might be too much emphasis on sex (engaging in or talking about it inappropriately).

To learn more, check out these two fact sheets from the Uniformed Services University: “Reintegration and Intimacy: The Impact of PTSD and Other Invisible Injuries“ and “Physical Injury and Intimacy: Managing Relationship Challenges and Changes.” Both include suggestions for how to improve intimacy.

To learn more about other specific mental-health conditions, check out HPRC’s Mental Health & Suicide Prevention section. Also check out HPRC’s section on Relationship Enhancement.

Tips on tendonitis

Tendonitis results from damage to connective structures in your body. Learn more about it and get your body back in action.

You’ve been training, and now you’re in pain. It could be you’re having a painful introduction to one of your tendons. Strong tendons connect your muscles to the bones in your body and help you move by pulling on the bones when your muscles contract. Damage to tendons can occur from repetitive activities (including running and firing your weapon repeatedly over an extended period of time) or from sudden movements that put too much stress on a tendon. If you can’t avoid these activities, then pay attention to the warning signs that a tendon could be reaching its breaking point: pain, especially when moving the affected area; swelling over the area of pain; and, possibly, loss of motion in the joint.

The best way to avoid having to get treatment for tendonitis is to prevent it from happening in the first place! Follow these tips:

  1. Overall health: Maintain a healthy diet and weight, and check out HPRC’s Nutrition domain.
  2. Posture and body mechanics: Pay attention to your posture and make sure that you use correct body mechanics, especially when lifting and moving heavy objects.
  3. Maintain adequate muscle strength so your body can react to stresses you place on it.
  4. Maintain adequate flexibility.
  5. Consider proper workout gear, especially footwear; check out this HPRC article for more information.

How do get yourself back into your training program if you are suffering from tendonitis? The American Orthopaedic Society for Sports Medicine and the Cleveland Clinic recommend the following:

  1. Activity modification: Rest the affected area. This could mean taking some time off from activities that cause pain and further damage. For example, if you’re a runner with Achilles tendonitis, try biking instead until the tendon has healed enough.
  2. Ice: Cold can help to decrease pain and swelling.
  3. Physical therapy: Gentle stretching and strengthening exercises, as well as massage, might help but should be done under the supervision of a healthcare provider.
  4. Anti-inflammatory medications: Ask your physician about medications that can help your condition.
  5. Bracing or casting might be needed in severe cases.

You should see your doctor right away if you experience fever, redness, and warmth in the affected area, or multiple sites of pain. For more information on injury prevention, check out HPRC’s “Preventing common injuries,” which covers six specific areas of injury: wrist and hand, knee, ankle, rotator cuff, back, and IT band.

Performance Strategies for injury prevention

An ounce of prevention is worth a pound of cure. Check out our performance strategies for preventing common military injuries.

Injury prevention is critical in maintaining optimal performance and operational readiness. Ankle sprains, knee pain, and back pain are very common injuries in the military. Take the time now to protect yourself from injury, and you’ll be glad you did later. Read our performance  strategies to help fend off common military and athletic injuries, compiled from our recent injury prevention series of posts.

A big name for a common knee problem

One very common cause of knee pain has a fancy name, but avoiding it can be quite simple if you follow some important advice.

Chondromalacia is a knee problem that can have a number of different symptoms, including pain. It can your ability to exercise, but even more problematic is that it can interfere with your ability to meet the demands of your military duties.

Here’s the basic rundown on chondromalacia: In a healthy state, the kneecap has soft cartilage beneath that allows the bone to glide smoothly against the other bones of your knee joint. When the smooth surface wears away, the back of the kneecap becomes rough and rubs the other bone surfaces, causing pain. The key to avoiding this condition is maintaining that smooth surface.

According to the American Academy of Orthopaedic Surgeons, muscle weakness, imbalance, or tightness in the thigh muscles can contribute to chondromalacia. It’s important to maintain strength in your quadriceps and hamstring muscles; follow a strength-training program to develop and maintain strong muscles. Also, make sure that you have enough flexibility in your quads; if the muscles and tendons are too tight, they can force the kneecap to move or “track” incorrectly in the natural groove of your knee joint. If you do a lot of running, make sure your footwear isn’t old and worn, because the shock-absorption of shoes decreases as they age. When it comes to knee pain, an ounce of prevention is worth a pound of cure. Strengthen and stretch your muscles, and you’ll be on your way to keeping your knees ready for action.

Minimalist running shoes: Do they really prevent injuries?

Barefoot-style running and minimalist running shoes are growing in popularity, but some new research now shows there are risks.

Barefoot-style, or minimalist, running shoes are still growing in popularity in the military, and the debate continues over whether this style of running prevents injuries or just causes different injuries. There is new research on minimalist running shoes (MRS) and their impact on lower leg and foot injury. After a 10-week study, runners who transitioned to Vibram FiveFinger minimalist running shoes showed signs of injury to their foot bones, while the runners who used traditional running shoes showed none. The types of injuries the MRS runners demonstrated were early signs of inflammation, which may or may not be associated with pain or joint dysfunction. If they are, it might be difficult for the runner to know he/she is actually injured until it is too late and the injury has progressed. More research is needed to determine if other factors (weight, running form/style, mileage, running surface) contribute to injuries associated with barefoot-style running. At least one recent study suggests running style may be a factor. For more in-depth information, read HPRC’s InfoReveal.

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