Inflammation is your body's defence mechanism (From Your Local Guardian)

Inflammation is your body's defence mechanism

11:42am Tuesday 24th February 2009

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Say you're wearing a new pair of shoes and you can feel them rubbing a bit, when you get home and take them off, you find you've got a blister.

That's inflammation - the pressure where the shoe has rubbed is harming the soft tissues in the skin and the blister is a defence response.

The same thing happens in your tendons, ligaments and joints. So if there's a tendon that's working extra hard, if it's being pulled at an awkward angle or is caught somewhere, the body responds with inflammation. You can't see it but often you can feel it!

So why do runners have problems with their Achilles tendons?

If you're a runner, Achilles tendinitis is a common problem.

Sometimes it can be the heel tab on the shoe which literally rubs against the tendon when you run, or it can be the way that your foot lands as you run, it may be slightly skewed so that the tendon is working extra hard in one zone and gradually it gets a little inflammed.

You might at the same time be aiming to increase your distance very gradually over time, and as you do so you feel a very mild ache after running and then seemingly out of the blue you have a pain and tightness in the tendon which makes running harder, more painful or stops you altogether.

Problem! You then rest it for a week or so, it starts to feel better, you try running again and the pain's right back there. You're stuck, losing condition, but you can't get back to training.

Why are they so slow to heal?

The cell turnover rate is slow in tendons, they don't have much blood supply and healing requires the right conditions and even then it can take a while.

Sometimes it's possible to alter the tension on an Achilles, so that the sore area is no longer working so hard.

This can be done by taping the tendon or changing the way the foot plants and pushes off - you've heard of pronating and over pronating - that's when the mid foot loses shape as you step through and it can be corrected with a different running shoe or inserts that support the foot from beneath (it's best to get an expert eye to help you with that kind of correction, otherwise it's possible to overdo it and if you've always been a runner, ask yourself why would your foot suddenly start to create problems for your Achilles?) Good Question.

Sometimes the answer is further up the system. It may be that the muscles around your hips and pelvis have become a little weaker on one side, so that the way your whole leg lands and pushes off during running strains one zone of the tendon more than another.

Think of it as a mechanical system: if the upper part is wonky, it will overstrain the lower part. The muscle control around your pelvis and hips is what helps to line up your leg as you run.

There's plenty of variation within the range of normal, what counts though is your normal and if you have a persistent injury then the way to correct it can often be to look at what's happening further up the chain.

How can I check for this sort of thing myself?

Well you can certainly check a couple of basic things if you know what to look for.

When it comes to stability around your hips and pelvis, it's worth looking at really basic balance.

Stand in front of a long mirror and get a sense of what happens when you transfer all your body weight to one leg, do this really slowly and check out how much you lean sideways.

For instance, if you lift up your right leg, you will see your shoulders drift ever so slightly to the left. Your balance mechanisms automatically shift your body weight for you so that you don't topple over.

Now start again, standing straight with weight evenly across both feet and gently lift the other leg. Compare what happens and see if you think there's a difference.

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