#338 4 Steps to Achilles Tendon Rupture When Running - DOC

#338 4 Steps to Achilles Tendon Rupture When Running

Today on the Doc On The Run podcast, we’re talking about the 4 steps you need to take to rupture your Achilles tendon when you’re out on a run. 

I was just talking to a runner, and this is one of the people that I talk to on a frequent basis, so every month I added just a couple of people who are in this inner circle coaching group, where I talk to them regularly, I follow up with them every couple of days, sometimes every day, depending upon where they are with their injury, and this guy was having some trouble.

He had some pain in his Achilles tendon, and we had to talk about what it really takes to rupture the Achilles tendon, because he had a little bit of a tendon issue that actually could put him at risk of a complete rupture of the Achilles tendon, because of where he was actually having pain and tenderness in the tendon.

Now, of course, that’s one of the things we talk about in the Achilles Tendon Course for runners that I put together, but it really struck home because he had a plan of actually going and running on a really windy hilly trail. That can really put your Achilles tendon at risk. 

Today I was actually out on a run on a similar trail. I was thinking about this topic, because as I was running uphill, and as the trail changed direction, I realized it’s one of the things that can cause an Achilles tendon  rupture.

We know that most of the time for you to get a rupture of your Achilles tendon it’s not that you just have to use it, or you have to run, or you have to do something like that. 

Achilles Tendinosis Puts Runners at Risk of Rupture

You have to first get some damage in the tendon from repeated overloading or from chronic inflammation, and if you develop tendinosis where you actually have this degeneration on the inside of the tendon then it can become prone to rupture. But you’re not going to rupture your Achilles tendon running in a straight line. You’re not going to rupture your Achilles tendon doing a marathon. You’re probably not going to rupture it running on a track. But there are some things you can do that will actually cause it to rupture.

I think sometimes it’s really helpful if you can understand how you would actually rupture the Achilles tendon if you were deliberately trying to go out and do that to yourself. Then it helps you understand what you shouldn’t do and what you should avoid when you’re actually running and you have pain in the Achilles tendon, and you’re concerned that you could actually do some damage. 

4 Steps to Achilles Tendon Rupture

In order to actually rupture the Achilles tendon there are four things you really have to do in sequence in order to cause it to rupture. If you really want to know all the detail about this make sure you sign up for the Runner’s Rapid Recovery Summit, because Dr. Stephen Schroeder is going to show some videos that actually have real incidents, where there were athletes that ruptured their Achilles tendons while they were doing activity. You can see exactly how it happens, which is really, really useful if you have Achilles tendon pain. Four things you have to do in succession in order to rupture your Achilles tendon are this. 

Step 1: Bend the Knee

Number one, you have to bend the knee. What you’re trying to do if you’re going to rupture the Achilles’ tendon is put the Achilles tendon itself on maximum stretch making the tendon as elongated as possible, and stretched out as possible before you fire the calf muscle and pull it tight. This is the way it works. Step number one is bend your knee. You can imagine if you’re running uphill, obviously, you pick up your foot. You put your foot on the hill in front of you. Your knee is bent because your foot is up higher, so you have to bend your knee in order to have it in that position. That’s step number one. Bend the knee.

Step 2: Dorsiflex the Foot

Step number two is to dorsiflex the foot. You’re basically bending upward at the ankle. Obviously, if you’re running up a hill that’s going to accomplish that. If you put your foot on the ground and your heel goes down to the ground, and the foot is placed on the hill in front of you then obviously your knee is going to be bent, and your foot is going to be maximally dorsiflexed, or pulled upward with your toes up toward your shin. Your knee’s leaning forward toward the slope. Your foot is on the slope. The sole of your foot is flat on the slope, and that forces your foot upward bringing your toes up toward your shin while your knee is bent.

Step 3: Pronate he Foot 

Step number three is to pronate the foot. Now, pronation is that motion where your arch actually collapses. There’s several different ways to do that, but how it usually happens when somebody ruptures their Achilles tendon is that they pronate the foot by changing direction and externally rotating the foot. But in truth, your foot doesn’t rotate at all. You rotate around your foot. Imagine for a second we’re talking about your left foot. You’re running up a slope. It’s on a curvy windy trail. You put your left foot up on the slope in front of you. Your knee is bent. Your ankle is bent upward with your foot and toes up toward the shin. Then you change direction, and turn right at the moment that you push off hard. That’s what will do it.

As soon as you twist, and you twist to the right as if you’re changing direction to the right around a switch back as you go up hill while you have your foot planted on the ground. The foot is flat, but it’s dorsiflexed. Your knee is bent. Then as you twist to the right you actually maximally pronate the foot. That pronation actually stretches the Achilles tendon just a little bit further. 

Step 4: Push with foot in that position

Then you push off. When you push off hard, and you fire calf muscle with the foot maximally pronated, your knee bent, the foot dorsiflexed. When all those things happen at the same time, it applies so much force to the Achilles tendon that it causes it to rupture.

Those are the four things that you have to do in succession if you want to rupture the Achilles tendon. Obviously, if you’re trying to not rupture your Achilles tendon the last thing you should do is go run uphill, on steep slopes, where you have to change direction. Because if you do all four of those things at the same time, and you push off hard, or frankly, if you’re pushing off, and the ground gives way underneath you and your foot slips you may rupture your Achilles tendon.

If you want to know more detail about that, if you want some more information about it, you want to go in depth about Achilles tendon ruptures, and repairs, and rehab, and all that, make sure that you sign up for the Runners Rapid Recovery Summit, where Dr. Schroeder’s going to talk about this in detail. You can really understand everything that you need to do, not just about what happens with Achilles tendon ruptures, but how it happens, what surgical repairs look like, the pros and cons of surgical repair of a ruptured Achilles tendon in athletes, and perhaps more importantly, what runners need to do differently with the Achilles tendon so it can heal fast, and support you when you run after the torn Achilles tendon has healed.

Go sign up. The conference is free. It’s called the Runner’s Rapid Recovery Summit. There’ll be a link in the show notes at docontherun.com, but you can also sign up here 

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