#373 How stress can help your Achilles tendon recover faster and get stronger - DOC

#373 How stress can help your Achilles tendon recover faster and get stronger

Today on the Doc On The Run Podcast, we’re talking about how stress can actually help your Achilles tendon recover faster. 

In this episode, we’re talking about how it is that stress, when actually applied in the right way, can help your Achilles tendon recover faster so you can get back to running with less risk of reinjury. But the biggest concern with runners when they have an Achilles tendon injury is that it’s going to continue to degenerate, turn into Achilles tendinosis, and then potentially even rupture. 

So obviously the worst kind of Achilles tendon injury is a full rupture of the Achilles tendon. But you have a whole continuum of trouble that can actually damage the Achilles tendon. You could have Achilles tenosynovitis. Tenosynovitis means there’s inflammation around the tendon, but not within the Achilles tendon itself. You can have Achilles tendonitis where there’s inflammation within the tendon itself. And then you can have Achilles tendinosis, which is where you have chronic stress, chronic inflammation, you actually have damage to the Achilles tendon fibers. Tendinosis makes those collagen bundles within the Achilles tendon mushy, weak, and they’re not able to support the load like they’re supposed to. And then you’re actually prone to partial tears and full rupture of the Achilles tendon. 

When you get any stage of Achilles injury and you’re a runner, you’re trying to figure out what you can do to get it to heal as quickly as possible. The sad reality is that healing of any injury goes on for much more than that first few days where you have pain, or for the first few weeks where the doctor is telling you that it’s really injured. 

You have a remodeling process that goes on for a long period of time. There are really three phases of all wound healing. First is the inflammatory phase where it’s red, hot, painful, all that. You have increased swelling. That’s where the initial tissue cleanup phase kind of happens. Second you have the proliferative phase where you’re actually getting proliferation of collagen. You’re getting to repair the tissue, you’re getting rebuilding happening. And then after that, you have the remodeling phase. The proliferative phase just actually lays down lots of repair very quickly, it’s disorganized. It’s all helpful, but it’s like wrapping a bunch of chicken wire and duct tape around an injured piece of tissue. 

And then the remodeling phase is where it actually gets broken down so that those disorganized, not so useful pieces are removed, and perfectly aligned collagen that’s laid down in the direction that will absorb stress is actually most helpful. If you think about the cable on the Golden Gate Bridge, you have a lot of bundles of individual strands of wire, all going in exactly the same direction. So each little bitty strand of wire is actually supporting part of that load.

But when you get tendinosis, and some of them are mushy, and they’re not helping, they’re not bearing the load anymore. Similarly, when you’ve had an injury to the Achilles tendon, you have some disorganized collagen in there, it’s helping to hold it together as a repair, but it’s not going in the right direction.

This is where stress comes in. When you stress the Achilles tendon very deliberately, and very carefully, as it’s healing, the cells in the tendon itself, the tenocytes which are the cells that actually lay down collagen will respond to stress applied to it. Why is that important? Well, if you put yourself in a cast, or you’re in a fracture walking boot, and you’re not moving the tendon at all, you’re going to get healing, but your body doesn’t know where to put the collagen. So you get indiscriminate collagen. And that’s what we call scar tissue. 

But when you actually apply stress to a piece of tissue like a tendon or a ligament, and you stretch it the way that it’s normally stressed when you’re using it, the tenocytes actually know what to do, and they start laying down more collagen in the right direction, instead of just any direction at all. And that actually makes it stronger a lot faster. So the way to go about this is to very deliberately, and systematically load the Achilles tendon in a way that’s not going to put it at risk of reinjury, but will actually direct those cells to lay down collagen in the right direction. 

That’s part of what I show you how to do in the Achilles Tendon Course for Runners. But you’ve got to be deliberate about it. You have to make sure that you’re doing exercises that will stress it correctly, you have to make sure that you’re loading it safely, and you have to make sure that the timing is appropriate. I will tell you right now that there’s a limited amount of time that your body will actually do this where it’s remodeling, where you have this pliability of the tendon, and the tenocytes will respond. If you do it every hour of the day, you’re just going to get damage. You have to do it at intervals that make sense, and you have to be very careful to not over-stress the tendon.

If you’re thoughtful about it, and you understand what to do, you can apply stress, very deliberately, to the Achilles tendon, that will actually get those cells to help in the repair process, to lay down more collagen that goes in the right direction, so it will be stronger when you run. That’s really the key. 

If you want to understand all of the single, non-surgical things you can do, right now, all that stuff’s in the Achilles Tendon Course for Runners.

So go check it out. You can get it, you can download it, you can view all the lessons and it’ll help you understand all of these things that are ways that you can tell yourself whether or not you can get it to start to improve with some really simple things you can do at home. Check it out!

Achilles Course for Runners

Step-by-step guide to curing Achilles tendon
so it doesn’t come back!