How to Heal Achilles Tendinitis

Alternate title:

“Stubborn experiments to help you avoid the doctor and stay injured for months!”

Who’s coming with me?

If you’ve been reading my posts, you may recall that I’ve been complaining about pain in my Achilles tendon ever since my last really good race, the Bayshore Half Marathon in Traverse City.  I was starting to have some discomfort early in the race, but things loosened up, and I had a great run overall.  However, since then the problem has nagged despite some of the random tactics I’ve tried.

I have cut back on mileage dramatically (although I haven’t gone more than a week without a run altogether).  I’ve tried massage, calf raises, eccentric calf raises, stretching, foam rolling, walk breaks, and ignoring the problem.

Recently I tried to call a physical therapist.  I was immediately deterred when I found out I would need a physician’s referral, and with renewed enthusiasm, I have vowed to heal this injury on my own.  (Unless I get to January and still have problems – then maybe my New Year’s Resolution will be to call a professional.)

So here’s my plan:

  • Low mileage – I thought I could get away with maybe 12 miles a week, but I tried that last week and didn’t have much luck.  I’m thinking we’re going to start at 9.  That’s three 30 minute runs for me.
  • No consecutive days of running.
  • No increases in mileage until I’ve gone a week completely pain free – I’ll record my experience every day in my log.
  • Warm-ups – I will walk and stretch for five minutes before starting a run.
  • Cool-downs – I will save time for an appropriate cool-down that includes stretching.
  • Foam rolling – I will foam roll at least daily, especially after a run.
  • Eccentric calf raises – I will start with a daily set of 10 single leg eccentric calf raises, using my other leg to raise back to the starting position.
  • Ice – I will ice on days that I’ve run.
  • Compression socks during runs
  • Cross-training – I will include other activities (biking, weight training and yoga) to meet my exercise requirements for the week since I’m not allowing myself as many minutes of running as I’d like.  I’ll focus on strengthening the other muscles of my core and legs.

I don’t mean to minimize the value of doctors and physical therapists.  As a healthcare professional myself, I obviously believe there’s a difference between information found on the internet and information learned from someone who went through post-graduate training to become an expert in fixing your particular problem.

In this case, however, I also don’t want to diminish the value of all the information at our fingertips.  The internet does have a wealth of information available from reliable sources like the Mayo Clinic, the Cleveland Clinic, and more.  Since we’re not talking about a life or death problem here, I’m thinking that it would be worthwhile to take advantage of some of this advice and see whether I can make a difference on my own.

I think that my first attempts at healing myself were failures because I wasn’t very systematic about it.  I tried a little thing here or there, but I didn’t plan, I didn’t record my results, I didn’t hold myself accountable to a routine or schedule.  I was very arbitrary.  One of the valuable things that a doctor or physical therapist often adds to the equation is accountability.  They spell out in very clear terms precisely what they expect you to do, and you know that you’ll have a follow-up visit to tell them whether you followed their instructions.  Then, when you haven’t followed the directions, you’ll be forced to confront the reality:  your body isn’t failing you – you’re just failing to do your best for your body.

So, I think I’ll use blogging as my accountability for the rest of 2017.  I’ll be reporting back in two more weeks, and I will answer to my long list of commitments to healing this tendon.  And I’ll also commit to making that doctor’s appointment in January if I’m still struggling.  There, now I said it.

Ok, I’m off to try my first run in compression socks.  Wish me well!!



Long Runs and Junk Miles

Beginning runners like to know what the best way to get better at running is. That’s easy. Run more. Plain and simple. Don’t make it any more complicated than that. I should quit right here but I can’t help myself and now I’m going to complicate it some.

How much should I run? How often should I run? How fast should I run? All good questions. So, let’s start with the basics. What happens when we go for a run? If you don’t go too fast and your heart is not pounding out of your chest and you can actually talk some while running, then you are doing an aerobic run. That is good for the vast majority of our training. Running aerobically (in the presence of oxygen) is the most efficient way to run. Training aerobically helps your body get better at running aerobically. This means your body gets more efficient at getting oxygen to the muscles that need it and once there, that oxygen is used to help turn food into useful energy.

There are a lot of things in the chain that brings oxygen to the muscles. You need lungs to take in the oxygen. You need blood to take the oxygen from the lungs. You need pipes (arteries and veins and capillaries) to transport the blood. You need a heart to send the blood where it is needed. You need mitochondria in the muscle cells to use that oxygen. You need various enzymes to speed along the chemical reactions that take place in the mitochondria where the oxygen is used to help make ATP (our useful energy supply) from the food we eat.

All of these are things that can be improved. Your heart can get stronger. Your blood vessels can stay clean and you can make more of them. You can have more hemoglobin in your blood to carry the oxygen. You get the picture. How do we do that?

We run more. The best run for that is the long run. What is a long run? How far is it? That is totally dependent on what kind of shape you are in. For an Olympic distance runner, don’t even think about calling it a long run before 10 or more miles is up and that is probably just the beginning. For the experienced age group racer, it might be 6 or more miles depending on their current fitness. For the beginner just getting their feet wet, it might be a mile. It’s really just a run that is longer than what you are used to doing on the other days of the week.

During that long run, the goal is to go fast enough to get your heart rate up a bit but not going crazy. Then just keep on going. This forces your body to use oxygen as well as it can. Once your body sees that it is going to be needing oxygen more than normal, it will start preparing for that. Your body is smart. It will build more mitochondria. It will make more of the enzymes that are used during the aerobic process. It will make your heart stronger and more efficient. It will even help you create more blood vessels. That is one of my favorite perks. More blood vessels is what we call collateral circulation. The more of them we have, the harder it is to have a problem if one of them gets blocked.

Blood vessels, the more the better!

How often for this magic long run? No more than once a week. Doing it too often will end up breaking down something and you won’t be running for a while as you recover from your overuse injury. So, let’s say you are usually running for 3 miles at a time or 30 minutes if you go by time instead of distance. Try once a week to step this up to 4 miles, then 5, then 6. Weekends are the best time to do it just because you usually have more time and it gives a great name for a running blog.


The fastest way to get faster is to run more. Try building up to the long run. It will surprise you what you can do. Keep running my friends.

It’s a great feeling to look into the distance and know you can run to whatever you see.

The Best Laid Plans

I have run a decent number of races in my running years, and I’ve experienced many of the myriad race-day and training variables that either throw you off or boost you up.  This month, however, I had a brand new experience.  The half marathon I had signed up for in September was canceled only days before the race!  And it wasn’t some fly by night impromptu race.  This was a reasonably sized race with an experienced race director, but, so they told us, despite their best laid plans, the city revoked their permits at the last minute, requiring them to call it off.

My would-be race medal!

It made me think about all the people whose plans were changed by the decision and made me wonder how everyone handled the change of plans differently.

For starters, I’ll admit, it was easy for me to have a neutral, almost bystander’s reaction to this news because of all the races I’ve entered in my life, it was for this one that I was the most poorly prepared.  After a wonderful spring racing season, I had to reduce my mileage dramatically over the summer to accommodate my ailing Achilles tendon – no speedwork, no long-runs.  I had already contacted the race director in the week before the race to request a switch from the half marathon to the 10k.  The race was in my own town, so I didn’t have to change travel plans.  I just gained a free weekend and a t-shirt that represented a missed opportunity.  Learning that the race had been canceled was almost almost good news because it granted me a free pass on what would have inevitably resulted in my posting a poor race time for all the world to see, embarrassing and disappointing myself at the same time.  On race day, in lieu of going for a long run or trying to simulate the race, I went for a slow easy 30 minute jog and called it a day.

The beer glass that I didn’t earn but will drink from anyways!

But with that said, I know that my reaction was a far cry from that of most of the participants.  How many people, I wondered, had to cancel hotel reservations at the last minute?  How many had flights planned that they couldn’t get out of?  How many decided to head into the city anyways and make the most of it?  How many people were running their first half marathon, had trained diligently all summer, and had been nervously anticipating how they would perform?  Surely lots of people had put in more miles than ever, done their speedwork, cross-trained, and fueled just right and had high expectations for the best performance of their lives?  And of those, how many will be lucky enough to duplicate the same sequence of events, with months of successful training uninterrupted by illness or injury?  Maybe it would have been their only chance.

I believe that most of the participants were understanding.  We had the option to choose a refund of our race entry fee, or to allow our fee to go to the intended charity anyways and accept our t-shirt, medal, and beer glass as souvenirs.  When I went to pick mine up, my fellow would-be participants seemed disappointed but not angry.  I know this wasn’t the universal reaction, however, because social media posts proved otherwise.  I noticed several people react to their disappointment with anger directed at the race, the director, the city, anyone who could possibly be implicated in the blame.  And I understand.  While it worked out well for me this time, I would have felt very differently if I’d been one of those people prepared to run the best race of my life, peaking on just the right day, then being thrown off course.  Hopefully I would have managed to react with a little bit of understanding, despite the disappointment.

This t-shirt now represents the shared memory of a race that almost happened!

Even in the face of disappointment like this, however, there are a few things to consider that help take away the sting a little bit.  Luckily, this wasn’t the Olympics, and while someone’s lifetime personal best may have been on the line, no one’s career was.  No one sacrificed their job to train for this race (I think), and it wasn’t like that anyone was going to use this race to launch their professional racing career.  (If they were fortunate enough to be that talented, then hopefully they’ll shine in their next race.)  Luckily, we all retained the right to go out on Saturday morning and run 13.1 miles with or without a race bib.  And luckily, there are more, many more, races to run.  It may have messed with your training peak and taper, but there would be plenty of opportunities this fall to register for another half marathon without seeing all that training go to waste.

So what’s the point of rehashing it?  Well, happily, this was one of those cases where I was able to take a relatively objective point of view regarding an unexpected change of plans.  I’m often less objective in such circumstances, and I’m hopeful that I can use this lesson and the observations I’ve made about the other runners the next time my plans are changed and I’m the one who’s most disappointed.  Hopefully I’ll accept the disruption and make the most of it!  Here’s hoping that I’ll be better prepared for my next race regardless of the outcome!

Lactate Threshold Training

Just to recap the last two posts on training, we have seen that muscles derive their energy from ATP. Also, more ATP can be generated from the food we eat if we can break down that food aerobically as opposed to anaerobically. So how do we do that? There are 3 ways to maximize our aerobic ability. We can increase the level of intensity at which we are still able to be aerobic. We can improve our ability to get oxygen to our muscles. And we can learn to be more efficient with the oxygen we are already using. Without getting too technical, these are done with base training, lactate threshold training, max VO2 training and running economy training. So, let’s go. One at a time. Today it’s my favorite workout. Lactate threshold (LT) training.

What is your lactate threshold? It is the highest intensity at which you can work out without increasing the amount of lactate (lactic acid) in your blood. Yes, you are producing lactate right now. I don’t care if you are laying on the couch with the remote in your hands and doing nothing more than salivating over Giada’s latest creation on the Food Network. Anyway, you aren’t feeling the effects of the lactate you are producing because your body is able to clear it out as rapidly as you are producing it with an abundant supply of oxygen. But as your workout intensity goes up you produce more and more lactate and at some point, you produce more than you can clear out and the level of lactate in the blood starts to rise and you feel the effects. This point is your lactate threshold and we want to make that point higher. That way you can run faster without feeling the effects of that buildup of lactate. How do we do that?

It’s really simple. We train at or near our lactate threshold. By pushing that limit, your body responds by increasing its ability to clear out lactate and voila! You begin to raise your lactate threshold.

Exercise physiology lab testing

So first, you have to figure out what is your pace at your lactate threshold. Most of us don’t have access to an exercise physiologist’s lab for extremely accurate measurements and most of us don’t need to. If you are close, that’s probably good enough. If you are training for the Olympics, maybe you should seek out a coach with access to that lab. But for us weekend local 5K runners, rules of thumb work pretty well. The simplest rule of thumb is to figure the pace at which you can run a 10K is about your lactate threshold pace.

For a better way to figure it, buy a book. Not just any book. Buy my absolute favorite training book. Daniels’ Running Formula by Jack Daniels. No relation to the bourbon as far as I know but there is nothing that says you can’t enjoy both the book and the bourbon.

In his book, Dr. Daniels has some tables that give you a number based on your current fitness. Your current fitness is determined by your race times. So, let’s say you just ran a 24:39 5K. You look it up on the table and that corresponds to the number 39. You then take the number 39 to the next table which gives you your proper pace depending on what type of workout you are doing. For lactate threshold training, 39 gives you a pace of 8:22 per mile or 2:05 per 400 meters for a lactate threshold run.

Now you know your pace. What do you do with that? You run at that pace for some of the workout. It’s not rocket science. It is exercise physiology which I think is more fascinating than rocket science but when Dr. Daniels does all the work for you, it’s easy to make a workout. Now, you can only do so much at that pace in a workout. Also, you can’t do an LT workout every day. You have to have appropriate recovery to get the benefits from any type of workout. On my team we don’t do LT work more than once per week. So, let’s be more specific.

One way to do the workout is with a steady run at LT pace of a distance you can handle. At first you won’t be able to do all that much. But after a while it’s not out of the question to do a couple continuous miles or even more at that pace. This workout would start with an easy warm-up run, then your LT run at whatever length you can handle, then a bit of a cool down run. I’m not a big fan of this workout because you just can’t do as much LT pace running as I would like.

My preference is what Dr. Daniels calls cruise intervals. These are shorter runs of 3 to 5 minutes at LT pace broken up by very brief rest periods. Our better runners I have coached can do 5 LT pace runs (intervals) of 5 minutes each with a 1 minute rest between each one. The LT intervals get the runner’s heart rate up to the LT level while the brief rest allows them to do more overall at LT pace. The heart rate does drop during the rest period but not that much and it gets right back up to where we want it quickly during the next interval. This lets them do more overall work at LT pace without seeming too hard.

How much is enough for you? The bonus of LT workouts is that you should actually feel pretty decent when it’s over. So, you should stop when you feel like you could still go one more. I would rather see my athletes do one too few than one too many. Also, I would rather have them err on the side of running too slowly as opposed to too fast. Remember you want to push the LT limit but don’t go over if you can help it. Otherwise, you are now doing an anaerobic workout and you won’t be able to do as much as you could if you stay at the proper pace.

To sum it all up and put it into practice, try this. Once per week do an LT workout in place of one of your usual easy runs. Then do your other workouts during the rest of the week. It takes a while for the benefits to kick in. Don’t expect any great changes for at least 3 weeks. It takes a good 3 weeks to adapt to any workout. Just keep repeating that one for the first 3 weeks before you consider adding to it. When can you increase the pace? That is dictated by your race times. When you race times begin to come down, then you can increase your LT training pace. If the workout is getting too easy after a few weeks but your race times haven’t dropped yet, you can increase the number of intervals or the length of each interval but not the pace. Good luck and keep running my friends!

The guy in green obviously does his share of LT training, the rest of the pack, not so much.

ATP: Your Muscles’ Source of Energy

Alright, we all agree we want to lower that 5k time. We are going to train with some proven science. What is the next step? To me, the next step is understanding just what we are trying to do with each workout. Workouts go better when we know why we are doing them. So, let’s get started.

Just to get this out of the way first, I am assuming that the vast majority of readers are more interested in distance running as opposed to sprinting. This is for you. ATP (or adenosine triphosphate)  is what powers your muscles. But what about carbs or fats? The carbs and fats and to a lesser extent, protein, are broken down to let your body form ATP. How do we best form this indispensable molecule? Without it you are at a standstill. Without it, your legs don’t move, your heart stops beating, etc. Bummer! Fortunately, there are several ways to make ATP.

ATP being used to run

The simplest way, and also your muscles favorite way to make ATP, is by breaking down carbohydrates, glucose in particular. Glucose is readily available in most cases. Glucose is stored as glycogen in the body. The body has different ways to break it down. It can be done aerobically or anaerobically. Aerobic means in the presence of oxygen. Anaerobic means without oxygen. Which is better? If you break down glucose aerobically, you generate 38 molecules of ATP for each molecule of glucose. Anaerobic breakdown of glucose gives you only 2 molecules of ATP. For you science nerds the term for the breakdown of glucose is glycolysis. Glycolysis is latin for “I like to toss around big scientific sounding words for the breakdown of glucose”. A third way to get ATP is with a molecule called creatine phosphate. We won’t worry about creatine phosphate because it only gives you enough ATP to last about 5 to 7 seconds.

Let’s think this through. Thirty-eight or two ATP’s? After much deliberation, I have decided that I would prefer to make 38. How do we do make sure we are breaking down our glucose aerobically? The easy answer is that you can do that as long as your effort isn’t too great. So, if I want to average 19 minutes per mile for my next 5k, that will be all aerobic. I’m not overly interested in completing a one-hour 5k. If I want a faster time, I have to increase the intensity of my run. Once it  goes past a certain point my effort starts to become anaerobic. Where is the cutoff in intensity between aerobic and anaerobic? There is no cutoff. No matter how fast you run, you are still taking in and using oxygen. Therefore, you are making some ATP aerobically. But you have a limit as to how much oxygen you can take in and use at any particular time. So, now we add in some anaerobic glycolysis (yes, I said glycolysis, I admit I’m a science nerd). We get that extra boost with more ATP but there is a downside. The dreaded lactate or lactic acid!

The two molecules only differ by one hydrogen atom and are both part of the same chain of events.

For our purposes, we can use the terms interchangeably. If you talk to a real honest to goodness exercise physiologist, they can explain that it’s really a lot more complicated than this and that lactic acid has an undeserved bad reputation. But for our purposes, think of it as evil.

Note how evil these actual pictures of lactate molecules are. They don’t even smile.

Too much lactic acid eventually brings you to a screeching halt. You are making lactic acid right now. Just being alive makes you generate ATP and without going deep into the chemical reactions, that ultimately results in lactic acid production as a by-product of the process. The good news is that until you are doing something that requires a more intense effort, you can turn that lactic acid back into something useful again and you don’t even realize it was there. As your effort increases, let’s say from a walk to a slow jog, you start increasing your lactic acid production. Now you step up to a faster pace and your lactic acid production steps up with it. Luckily, your body is removing that lactic acid to the best of its ability as you go. The pace increases again and again and again. At some point, the effort is making enough lactic acid that your body can’t keep up with it and it starts to build up. The point where your production of lactic acid surpasses your ability to remove it is called your LACTATE THRESHOLD. Note the bold lettering for that term. It is to remind you this is something important and will be critical to your training.

Back to where we were, trying to figure out how to use our glucose aerobically instead of anaerobically and therefore generate more ATP per glucose molecule and run a faster 5k. A slower pace is one option but not if you are trying to run fast times. Better options are to increase your available oxygen, raise your lactate threshold or learn to run more efficiently on a given amount of oxygen. These are known as VO2 max, lactate threshold and running economy. Each will be the subject of one of the next three entries on this site from me. Enough science for now. Now, get out there and keep running my friends!

My Favorite Blueberry Muffins

One of my favorite things besides running is food, and luckily they often seem to compliment one another.  I’d be lying if I said that I hadn’t noticed that running allows me to indulge in a few more snacks without accumulating extra weight.  I’d hate to say that I run so I can eat, but, well… it doesn’t hurt.

There’s a lot to be said for fueling properly, and today, rather than talk about running, I’m going to talk about one of my favorite ways to fuel – with my favorite blueberry muffins.  Blueberry muffins and other deliciously carby carbs are perfect for a pre-run snack because all that sugar can be put to good use right away.

I’ve been on a quest lately to find my “ultimate” version of every classic recipe.  There aren’t many things more classic than a warm, fresh, blueberry muffin, and I’m always looking for one that satisfies my craving for something sweet while meeting my expectations for delivering some worthwhile nutrients.

In other words, if I were going to just waste a bunch of calories with no nutritional value, I would choose a cupcake.  I have higher expectations for muffins.  Muffins need to deliver.

The Foodie Physician's Rise and Shine Blueberry Muffins |

I finally found a recipe for muffins that do exactly that – they delivered on their promise of being nutritionally better than cupcakes.  They’ve got blueberries!  (Obviously, but still… )  They’ve got oatmeal!  (Fiber! Complex carbohydrates!)  They’ve got wheat germ!  (Omega 3 fatty acids!)  Score.  Most importantly, they pass the taste test.  I would actually like to eat the whole dozen in one sitting, and I feel confident that I could get that done if I were brave enough to try.

The Foodie Physician's Rise and Shine Blueberry Muffins |

In the process, perhaps the best outcome of all was that my search led me to a new food blog which I adore. The Foodie Physician ( is full of great recipes with a focus on health.

You can find her original post including the recipe here. While you’re at it, browse the site – I was super impressed.  I now have a longer list of things I must try.

So, You Want to Be Fast

You want to be fast? Yeah, me too. Having coached several state champion high school runners, I get asked a lot for advice. My first question is, are you willing to do what it takes? I mean we all want to be fast, but are you really willing to do what it takes? Most of us middle aged and beyond runners aren’t really up for the grind of hard core training. But understanding a few concepts can help you make the most of the training you are already doing. Is this your picture after running half way around the block?

Would you rather this be your picture after mile 9 of your next half marathon?

Well, let’s get a few things out there right now. First, just because I have coached some state champs doesn’t make me an awesome coach with all the answers. It actually means I have coached some very talented girls and haven’t made enough mistakes in training them to derail their chances. Nobody can make an untalented person into a champion. But we can all improve, just not indefinitely.

Second is the secret workout. What is it? You tell me because as far as I know there isn’t a secret workout that only the best runners know. The real secret is that consistency is the key. Training on a regular basis is the only way to truly improve. No matter what your workouts are, consistency is the key.

Third, and maybe most important is that the rules of exercise physiology apply to everyone. Yes, even you. We may not like it, but you can’t get around the science of training. So, for my next few entries on this site I will be talking about the various workouts we do and how they work and a little of the science behind them.

First lesson: Do you get in better shape when you do a workout? Surprisingly, the answer is no. At the end of the workout you are in worse shape than when you started (assuming you did enough for it to be a worthwhile workout). Now that doesn’t seem to make sense. But here is the explanation.

If you do a good workout, you will put some stress on your body. It should be more than what your body is used to doing during the other 23 hours of the day. During the workout, the stress you are applying to your body tears down your muscles and other parts of your body. The benefit comes later. Once you are done working out, your body shows just how smart it is. Your body prepares itself for the future. It thinks “if this fool is going to do that again, I had better be ready for it”. So, if you recover long enough, your body will repair the damage you have done and then make itself even better than it was before. A little stronger, a little faster, a little more capable of dealing with the stress of the workout you did.

Now if you wait long enough before doing your next workout, your body will relax and go back to its original level of fitness. It takes work to stay at the higher level of fitness and your body won’t waste its time maintaining that higher level unless it needs to. So, the key is to do your next workout at that window in time where your body has improved its fitness over the original fitness level but before it has time to revert back to the original sloth-like level of fitness the average couch potato enjoys.

Then the magic happens when you repeat this cycle. Workout – recover – workout – recover, etc. It sounds too easy. But that’s the rule. Stress yourself, then rebuild yourself to be better prepared for future stress. Why can’t we all do that? Because, we like to watch TV, we like to lay on the couch, we like to eat junk food and veg out. Workouts are hard. They don’t have to be killers but they should be at least slightly uncomfortable. Otherwise they aren’t providing any stress to your body.

Frequently asked questions:

  • How much workout do we need? Just enough to push your body beyond what it normally does. More is not better. If you get greedy and try to do too much, you will go beyond stress and enter into injury territory. One of the most common problems encountered by new runners is the too much too soon thing. If a little running is good, a lot must be better. Shinsplints, plantar fasciitis, patellar tendonitis and many other overuse injuries have a field day with over eager rookies. A good rule of thumb is to not increase your mileage by more than 10% a week. That can be hard when you are starting with zero miles. Obviously, you have to take a leap of faith and work your way up but just be careful. When in doubt, opt for a more gradual increase in your workouts.


  • How much recovery do we need? That depends on a lot of things. At my age, I need more recovery than my high school runners do. I try to avoid running on back to back days. But I’m 62 years old. A younger runner can run on back to back days. Olympic runners train every day, some days twice. But they worked really hard and for many years get to the point where they can handle it. If you are younger and want to try to run more than every other day, just don’t do back to back intense days. Alternate hard workouts with easy days or cross training days.


So, for my next few entries on our site, I want to cover the following topics. No heavy science, just a simple explanation and how they can help you shave time off that next 5K or just be able to take a brisk walk without having to stop and take a break on the nearby park bench to catch your breath.

Energy systems (this sounds really boring but is important for distance runners)

Max VO2

Lactate Threshold

Running Economy

How do champions think?

Keep running, my friends!