The physio’s couch: essential Everest training

Everything was going swimmingly. I managed to climb Manaslu, an 8000 metre peak in Nepal, in October, was back running again, and even managed to top up my mountain fitness with a spot of climbing in the Andes over Christmas. All I needed to do was ramp up my training a bit in the early part of 2012 and I would be ready to attempt Everest in the spring. But then: disaster. Instead of a pair of running shoes I found myself using all this.

Medical paraphernalia: will some of this fix my achilles tendon?
Medical paraphernalia: will some of this fix my achilles tendon?

Since the early part of January I’ve been suffering from achilles tendonitis in my right ankle. This is a regular sporting injury that I suffer from intermittently ever since completely rupturing my left achilles tendon in 1995. Tendonitis is a result of scar tissue healing across tiny tears in the tendon, causing it to become inflamed. The tendon becomes tight and needs to be stretched regularly to keep it loose and comfortable. The achilles tendon bears a lot of body weight, however, and too much pressure on it causes more small tears, more scar tissue, and then you’re back to square one again.

An exercise bike, for heaven's sake!
An exercise bike, for heaven’s sake!

I’ve had a lot of physio advice about the problem over the years, and usually my ankle gets better and I’m back running again after a couple of months. This time it’s been more persistent, partly because I’ve had to continue my training alongside the healing process, and haven’t been able to rest it as much as I ought to. I’ve used various bits of kit to try and get better, as you can see from the photo. Some have worked better than others, but I think all of them have been useful to some degree.

  1. Night splint – I wear this at night. It keeps the foot at 90 degrees to my leg while I’m sleeping, thus helping to keep the tendon stretched at a time when it otherwise wouldn’t.
  2. Ibuprofen – As well as being a painkiller, ibuprofen helps prevent inflammation in the tendon and I’ve been taking it daily.
  3. TENS machine – This contains electrodes to attach to my ankle. The device emits small electrical charges which help reduce pain and massage the tendon.
  4. Orthotic heel – These go inside my shoes, and contain a stiffened arch which prevents the foot from rolling (‘pronating’), which causes additional stress on the tendon.
  5. Heel lifts – These also fit inside my shoes and keep the heels about 1cm higher off the ground, reducing the pressure on the tendon.
  6. Ankle support – Does what it says on the tin. This wraps around my foot and keeps the ankle supported while I exercise.
  7. Latex exercise bands – As well as stretching exercises to keep the tendon flexed, I’m doing regular strengthening exercises to make the tendon strong and reduce the chances of a recurrence. It’s amazing what you can do with a small bit of rubber (said the bishop to the actress).
  8. Exercise bike – Finally, but just as importantly, my exercise bike, since I still need to keep fit in spite of my injury. Although I’ve been able to manage some light jogging, running is right out because it involves a lot more pushing up with the toes, putting great stress on the achilles tendon. Fortunately cycling is non-weight bearing, so although it means I’m developing the wrong leg muscles for climbing, it’s been a great way of maintaining fitness levels.

My injury came at just the wrong time, and I’m going to be heading to Everest with my ankle still injured, and not as fit as I’d hoped. I’m still determined to give it a go, and know I would have regretted it more if I’d cancelled my expedition and not tried. There are always uncertainties with the weather when climbing big mountains, and summits are never guaranteed. The injury is just one more uncertainty to add to the mix, but a lot of being able to cope at high altitude is psychological as much as physical. Having climbed another 8000 metre peak only six months ago, I will have retained some mountain fitness and know what to expect. I’m staying positive, and will enjoy the experience whatever the outcome.

If you want to know more about achilles tendonitis rehabilitation, there’s some excellent information on the Sports Injury Clinic website.

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