Common Achilles pain training errors – Boom-and-bust cycles

The Training Error Series:

• Common Achilles pain training errors – Boom-and-bust cycles (this article)

• Achilles pain training errors – Not enough R&R

• Achilles pain training errors – Large increases in weekly mileage

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In this article, we explore the "boom-and-bust cycle" training error. About 80% of overuse running injuries, like ongoing Achilles tendon pain, can be attributed to training error. If you have an ongoing problem like this and have tried exercises but not addressed the training component, it could be one reason why your problems are persisting. Remember, if you need more help with an Achilles injury, you're welcome to consult one of our team via video call.

The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.

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In this article:

1. What is a boom-and-bust cycle?

2. Does rest help for Achilles tendon pain?

3. Boom-and-bust cycle

4. How do I know if I’m doing this?

5. How we can help

Ali also discusses it in this video:

What is a boom-and-bust cycle?

Boom is when you’re running and continuing to hit running targets and/or upping your training programme. There may or may not be some mild symptoms.

Bust is the exact opposite. Pain and injury has reared its ugly head and you have had to stop completely to rest the injury.

Does rest help for Achilles tendon pain?

In a nutshell: not really.

Tendon pain that lingers about for weeks, months, or even years indicates a change in the tendon. The collagen fibres and cells which make up the tendon can change shape which can look like a swollen bump, instead of being organised in nice straight bunches of fibres.

The amount of pain and symptoms doesn't tell you anything about the severity of the injury. Pain is part of an alarm system in your body and what you feel depends on how sensitive your alarm system is.

When you stop training and rest it just calms the alarm system down – it doesn’t rehabilitate or change the structure of the tendon. To change the structure of your tendon, you need to do specific exercises that stimulate the tendon to produce normal strong cells and collagen fibres.

Boom-and-bust cycle

This is like an analogy of “pressing on a bruise”.

Stop training for long enough, and the alarm system calms down and the pain decreases – you have stopped the aggravating running activity therefore you are no longer “pressing on the bruise”.

Then it feels better and you start to boom and run again. It might be alright for a while as the alarm system wakes back up, but you are now really “pressing on that bruise” in our analogy.

Your nervous system, which is in charge of the alarm, starts shouting at you, and because you’re continuing to train and not listening to it, it shouts louder and louder (by increasing your pain) until in the end you have to stop training and “stop pressing on that bruise” again.

How do I know if I’m doing this?

If you have the ability to track your runs with technology, you will have access to your weekly mileage, or you can simply just add it up by looking back over the last few weeks/months. If you then plot this onto a graph, it can show you periods of higher mileage and lower mileage. Did the lower mileage period fit with Achilles pain?

A GPS enabled runnnig watch, such as those made by Garmin, can help you to keep on top of your mileage.

For more options, you can visit the Garmin Store on Amazon.

To plot your general trend over time can be really useful and something to get in the habit of doing. If this is your pattern, I would advise that you look for advice on how to change your weekly training schedule to allow your Achilles to recover and not reach the bust phase every time. Like I’ve mentioned above, you have to also combine this with specific exercises that target the Achilles tendon and change it back into a strong healthy tendon.

A good tip is to step your training programme up slowly. For example 10% mileage gains for three weeks and then for the fourth week drop back 10% to allow your body/Achilles to adapt and repair itself.

Data can also be useful for plotting other characteristics such as speed or elevation. You may find similar boom and bust general trends with spikes or troughs of these.

How we can help

Need more help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.

We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Treat My Achilles we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.

About the Author:

Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram, and Twitter.

References:

1. Barton, C.J., Managing RISK when treating the injured runner with running retraining, load management and exercise therapy. Phys Ther Sport Volume 29, 2018, pp. 79-83.