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    <title>krankin.com.au</title>
    <link>http://krankin.com.au/index.php/site/index/</link>
    <description></description>
    <dc:language>en</dc:language>
    <dc:creator>kirra@krankin.com.au</dc:creator>
    <dc:rights>Copyright 2007</dc:rights>
    <dc:date>2007-11-27T19:23:00+10:00</dc:date>
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    <item>
      <title>Are you an endurance athlete?</title>
      <link>http://www.krankin.com.au/index.php/site/comments/are_you_an_endurance_athlete/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/are_you_an_endurance_athlete/#When:03:26:00Z</guid>
      <description>Welcome to our site!&amp;nbsp; We are currently building this site with reletive information to endurance athletes.&amp;nbsp; We have articles from professional athletes such as Simon Thompson and Benita Johnson, articles from medical professionals such as Brad Hiskins (Triathlon Australia Soft Tissue Therapist for ten years), Dr Judith May (Current Australian Triathlon team Sports Physician) and many other authors (check the articles icon) items to purchase in our growing shop, a forum to have your say and to ask a question or two, plus much more on it&#8217;s way.&amp;nbsp; Check out our recent articles and jump on the forum!&amp;nbsp; Enjoy!


&amp;nbsp;&amp;nbsp;&amp;nbsp;</description>
      <dc:subject>General</dc:subject>
      <dc:date>2007-10-08T03:26:00+10:00</dc:date>
    </item>

    <item>
      <title>Jemani Francis: &#8220;The future is dependent on what we do in the present&#8221;</title>
      <link>http://www.krankin.com.au/index.php/site/comments/jemani_francis_the_future_is_dependent_on_what_we_do_in_the_present/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/jemani_francis_the_future_is_dependent_on_what_we_do_in_the_present/#When:19:23:00Z</guid>
      <description>RE:&amp;nbsp; Krankin: The City News Interview Questions

Hi Jemani

I am writing to you on behalf of a new Australian company called Krankin: “The Performance Edge”; targeting the health, fitness and sporting world.&amp;nbsp; 

I’m trying to improve your profile in Canberra:

Please answer the “The CityNews: Health section” questions below regarding your rehabilitation, recovery and performance goals:

•	Where in the world are you at the moment?

Currently working full time as a Public Servant and beginning my first season in the Pro/Elite ranks of Triathlon. 

•	What’s your most memorable sporting moment? That you’ve achieved personally!

Definitely the third place I achieved at the Hamburg Triathlon World Championships for males aged 20&#45;24 on 2 September 2007. It was so rewarding, as I found it extremely difficult to train through the Canberra winter in preparation for this race.&amp;nbsp; 

•	What is your sporting goal for 2007?

To be competitive in the pro ranks of Triathlon and possibly help Simon Thompson (a fellow Canberra resident who is the nicest guy) gain Olympic Team selection. 

•	How many km’s would you do per week (types of sessions)?

I don’t do very much swimming (possibly 3&#45;4.5hrs/week) as I come from a swimming background and find I don’t have to work very hard at it to be reasonably quick.&amp;nbsp; 

I do upwards of 13 hrs/week of cycling that consists of a time trial, 2 power sessions, a long ride and an easy session. 

As running is my weakness in Triathlons, I place a great deal of emphasis on it in my general training week. My running consists of a speed session, 2 long runs, 2 short runs off the bike and 2 easy runs (approx 5&#45;6hrs/week). 

•	How do you best recover? Stretch, spa, recover jog, etc

I find working full time and trying to be competitive in Triathlon at the same time doesn’t lend itself that well to recovery time. Therefore, to make the most of what little time I have, I receive fortnightly massages and try to get as much sleep possible throughout the week. 

•	Who motivates you?

The “older guys” at Tridents Triathlon Club are really inspirational. These guys are between 50&#45;65 years of age and have never learnt the word quit. They train 10&#45;20 hrs/week and just keep on going like the energiser bunny. Seeing these guys every week at training provides me with extra motivation to tough out difficult sessions. 

•	What motivational advice would you give “the everyday norm” to get them out of bed in winter?!!

It’s not that cold outside when you have additional layers on. 

•	Your favourite saying:…..?

“The future is dependent on what we do in the present.” – Ghandi 

Yours in Sport!

 

Kirra Rankin

Rehabilitation Exercise Physiologist (AAESS)</description>
      <dc:subject>General</dc:subject>
      <dc:date>2007-11-27T19:23:00+10:00</dc:date>
    </item>

    <item>
      <title>Jeremy Ross: the MULTI&#45;Sport GURU</title>
      <link>http://www.krankin.com.au/index.php/site/comments/jeremy_ross_the_multi_sport_guru/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/jeremy_ross_the_multi_sport_guru/#When:19:18:01Z</guid>
      <description>City News interview with Jeremy Ross.

One of Canberra’s Top Male Multi&#45;Sport Racing Competitors


Hi Jeremy

I’m trying to improve your profile:

Please answer the “City News” magazine questions below regarding your experiences as a Multi&#45;Sport Racer; recovery routine and your next mission.........


•	Where in the world are you at the moment?

Canberra – Australia’s great bush capital 


•	What’s your most memorable sporting moment? That you’ve achieved personally!

I would have to say winning the Noosa Triathlon All Age group category in 1996. I had not raced an Olympic distance Triathlon before so I had no expectations, but I had done a full pre&#45;season of training in Ballarat’s infamous winter – sort of like Canberra just wetter!! Everything went to plan on race day and I had such a lead after the bike leg that I had a chance to back&#45;off of the pace over the last three kilometres and enjoy the crowds and the moment. I still hold the All Age group race record 11 years later. 


Even though, Noosa was my most memorable sporting moment, the most satisfying was a simple triathlon outside Albury after recovering from a bad LisFranc Fracture of my right foot. I was told by the surgeon that running after this type of injury would be difficult. Subsequently, it took over ten months surgery and rehab to learn to jog again. At my first triathlon after rehab I remember arriving at the end of the bike leg feeling so nervous but excited. Soon I was running – not fast – but running. It felt awesome to be competing and running again. 


•	What is your next goal for 2007/08 season?

To have a solid race at the Australian multi&#45;sport Championships in Freycinet, Tasmania, and finish in the top three at the Lorne Multi&#45;sport race. 


•	How many km’s would you do per week (types of sessions)?

I don’t go by kilometres, only time. Run – 5hrs, Swim – 2hrs, Ride (MTB &amp;amp; Road) 12hrs, Paddle – 4&#45;5hrs. 


•	How do you best recover? Stretch, spa, recovery jog, thoracic rack, etc

I eat, eat, eat and eat. I’m a big believer that your body cannot recover without plenty of food and fluid. Your body needs the fuel to repair itself, and also for energy for the next day of training. I believe sleep is important as well. When I can, I’ll try and get a deep muscle massage once a fortnight, and I stretch a lot in front of the TV. 


•	Who motivates you?

My wife Meg is a great motivator, but a lot of other people inspire me as well &#45; all for different reasons. Some of my best mates are remarkable athletes and I get a lot of inspiration from them. I respect anyone who puts in an honest 100%, and that’s enough to inspire me to do the same. 


•	What motivational advice would you give “the everyday pleb”?

Well I’m an ‘everyday pleb’ who just puts in 100%. I like to think that consistency is one of the key factors to success. It is amazing what you can achieve &#45; in anything &#45; if you work at it in a systematic, and consistent way. 


•	Your favourite saying:…..?

“Never give up, and never give in”


Yours in Sport!

 

Kirra Rankin

Krankin Co&#45;Director

Rehabilitation Exercise Physiologist (AAESS)

Level II Middle Distance Coach

Pilates Instructor

Soft Tissue Therapist</description>
      <dc:subject>Contributors, Exercise Rehabilitation Specialist</dc:subject>
      <dc:date>2007-11-27T19:18:01+10:00</dc:date>
    </item>

    <item>
      <title>Toyota US Open in Dallas (Lifetime Fitness Series Race 5)</title>
      <link>http://www.krankin.com.au/index.php/site/comments/toyota_us_open_in_dallas_lifetime_fitness_series_race_5/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/toyota_us_open_in_dallas_lifetime_fitness_series_race_5/#When:16:02:00Z</guid>
      <description>The last race of the Lifetime Fitness Series was run and won in Dallas on the weekend. This was my only event this year, having missed the races in Minneapolis, New York, Chicago and LA over the US Summer.



The day belonged to Australia’s Greg Bennet without a doubt. He had won every event so far and another victory brought with it a US$300 000 bonus! The pressure was squarely on his shoulders and I’m pleased to say that he was able to deliver.



It was a small but very high quality field that huddled together at Joe Pool Lake as dawn began to break. A strong wind was whipping up the surface of the lake and promising to make the first few miles of the bike leg even tougher than expected.



Swim specialists Craig Walton and Frenchman Benji Sanson led the tightly packed group to the first buoy and across to the second turn before it started to get really interesting. By this stage a front group was established, but with the last 600m directly into the rising sun, navigation became a major challenge. For me all I could see was orange and splashing bubbles. I just did everything I could to keep seeing splashing bubbles and for all I knew we could have snaked our way all the way in. I can’t imagine how the leaders could have seen where to go, but with about 25m to go I saw the swim finish arch and hit the shore soon after.



All the major contenders were all together in this front pack and no one had managed to break away in the water. Onto the bike course into a head&#45;wind and some rolling hills I was working hard to maintain contact as a ferocious pace was set. It was a non&#45;drafting bike leg and with just a narrow lane to ride in everyone was cautious to maintain a stagger from the cyclist ahead and avoid a fateful penalty which would basically end your race.



About 8km into the ride I lost touch with the small group that had dwindled down to about 6 or 7 riders over a rolling rise. It was an error in concentration that would cost me dearly because I was unable to bridge the gap in the strong winds and started to lose touch.



I rode the next 20km in no man’s land on the one straight long road heading toward the CBD. Eventually I was caught by 3 others and completed the bike leg at Reunion in the city centre and few minutes down on the leaders.



My lack of running over the last few weeks (recovering from a broken toe) was exposed immediately onto the 2 lap run. I struggled to find a good rhythm and was not able to make up any time on the athletes in front. I was determined to finish the race despite developing some nasty blisters and hope that it helps me build into the next few races.



The day however belonged to Greg Bennet. He powered away from the front group with the motivation of 3 cheques totalling US$420 000 to push him through the pain barrier! He crossed the line ahead of Filip Ospaly of the Czech Republic and Bevan Docherty from NZ.



I’m off to Bermuda on Tuesday for a point to point race around the historic island. It will be a new and exciting experience and hopefully I’ll send through a report next week.



Simon Thomo


Simon Thompson

Australian Professional Triathlete

http://www.simonthompson.com.au</description>
      <dc:subject>General</dc:subject>
      <dc:date>2007-10-30T16:02:00+10:00</dc:date>
    </item>

    <item>
      <title>PREVENTION OF STRESS FRACTURES</title>
      <link>http://www.krankin.com.au/index.php/site/comments/prevention_of_stress_fractures/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/prevention_of_stress_fractures/#When:17:54:00Z</guid>
      <description>PREVENTION OF STRESS FRACTURES


Stress fractures are a common overuse injury which can occur in any sport but are more common in impact sports such as running. They can occur in any bone in the body but the most common sites are the tibia, metatarsal and fibula.&amp;nbsp; They occur due to microdamage in the bone that occurs every time we exercise. Bone resorption occurs to repair the damage and replace with new bone. If there is unaccustomed activity the deposition of new bone lags behind the faster resorptive process and eventually a stress fracture will occur. Here is a brief checklist of the risk factors and preventive strategies to avoid stress fractures. 


THE RISK FACTORS FOR STRESS FRACTURE


Training factors&#45; Too much volume and intensity. Sudden change in training. Inadequate recovery between sessions

Muscle fatigue/Flexibility&#45; Leads to loss of attenuation of ground forces

Terrain&#45; Too hard a surface or uneven surface

Alignment&#45; e.g high arched cavus foot, hyperpronation, knee alignment, difference in leg lengths

Shoes – Not suitable for foot or worn

Female&#45; Are more at risk

Bone geometry/size&#45; smaller circumference of bone in cross section has a greater risk

Bone density&#45; Low bone density

Hormonal factors&#45; Menstrual abnormalities

Nutritional factors&#45; inadequate calorie or calcium intake


PREVENTION OF STRESS FACTORS


Muscle strength and endurance&#45; Strengthening of weak areas e.g calf raises

Suitable footwear and orthotics if necessary

Correct other biomechanical abnormalities e.g leg length difference, pelvic tilt/weakness

Training surfaces should be varied

Training factors&#45; avoid rapid increase in training, too much intensity or volume

Ensure adequate calcium intake

Maintain a normal hormone status</description>
      <dc:subject>General</dc:subject>
      <dc:date>2007-10-11T17:54:00+10:00</dc:date>
    </item>

    <item>
      <title>Dr Judith May&#8217;s MEDICAL TIPS coming soon&#8230;.</title>
      <link>http://www.krankin.com.au/index.php/site/comments/dr_judith_mays_medical_tips_coming_soon/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/dr_judith_mays_medical_tips_coming_soon/#When:21:02:00Z</guid>
      <description>Dr Judith May&#8217;s medical tips for healthy living will be coming soon!

&#8220;Be patient&#8221; Krankin network &#45; she&#8217;s a busy lady</description>
      <dc:subject>General</dc:subject>
      <dc:date>2007-10-08T21:02:00+10:00</dc:date>
    </item>

    <item>
      <title>Painful Achilles?</title>
      <link>http://www.krankin.com.au/index.php/site/comments/painful_achilles/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/painful_achilles/#When:02:57:00Z</guid>
      <description>The Achilles tendon is well known to runners.&amp;nbsp; Most of the time it is a handy piece of anatomy that allows us to absorb load when our foot hits the ground, and transmit force developed by our calf muscles to propel us forward.&amp;nbsp; Unfortunately this tendon can occasionally become painful.&amp;nbsp; Those who have experienced Achilles pain will know that it can be severe enough to completely stop training.&amp;nbsp; Moreover, it can linger on for months, even years if not managed well in the early stages.


The Achilles is the tendon that attaches the soleus (deep calf muscle) and the gastrocnemius (superficial calf muscle) to the Calcaneous (heal bone).&amp;nbsp; It is a thick, cylindrical, easily palpated tendon just above your heal bone.&amp;nbsp; If you palpate the tendon inferiorly (towards the foot), you will notice the tendon blending into the Calcaneous (heal bone) to the point where it is difficult to tell what is tendon and what is bone.&amp;nbsp; If you palpate superiorly (upward) you will notice the tendon grows thick and flat as it becomes musculotendonis (the transition from tendon to muscle).&amp;nbsp; Eventually the tendon disappears and the only tissue you will be palpating is the superficial calf – gastrocnemius.


The purpose of any tendon is two fold, each having a nuance of course.&amp;nbsp; The first is to transmit force developed by the attached muscle contraction to enable movement (the two ends of the muscle coming closer together).&amp;nbsp; For the Achilles, this is when the soleus and gastrocnemius concentrically contract (when a muscle shortens via contraction).&amp;nbsp; This contraction causes the heal to become closer the back of the knee (or toe pointing) as in the exercise heal raises. There is also a mild action to bend the knee via the gastrocnemius (as the gastroc attached above the knee).&amp;nbsp; The other mechanism is to bare load when a muscle is forced to lengthen.&amp;nbsp; For the Achilles this is when the foot hits the ground when running (or walking) and the calf muscles eccentrically contract (lengthen as they contract) to soften the heal strike and control movement of the lower leg just after the heal hits the ground.


So what goes wrong with the Achilles?&amp;nbsp; Most runners will have experienced some sort of pain associated with their Achilles.&amp;nbsp; More often than not it will be an acute episode of inflammation (swelling with inflammatory cells) that occurs due to tissue damage about the Achilles.&amp;nbsp; It is usually associated with (but not limited to) a palpable nodule on the Achilles that is very sensitive, stiffness initially in the morning but warms up as you become active and pain to hop.&amp;nbsp; Hill running will be very difficult.&amp;nbsp; If treated with (but not limited to) rest, anti&#45;inflammatories, ice and treatment (assessment of possible causes and treatment of these), you will recover.&amp;nbsp; If you ignore the pain, the problem can become chronic.&amp;nbsp; The inflammation will disappear but the Achilles will become degenerative (the Achilles tissue will break down).&amp;nbsp; This can lead to the Achilles becoming very thickened and the calf muscles will become very weak.


So what causes this?&amp;nbsp; There are numerous causes for Achilles pain.&amp;nbsp; Start looking at the very obvious.&amp;nbsp; Has your training load increased?&amp;nbsp; Do you have very old shoes that have worn?&amp;nbsp; Brand new shoes?&amp;nbsp; Camber running or excessive hill running?&amp;nbsp; Has your dorsiflexion range of motion decreased?&amp;nbsp; Have you changed your type of training (track running, flats instead of joggers, spikes, plyometrics are all examples of what often cause acute onset Achilles pain).&amp;nbsp; You can often self assess and figure out what is causing your pain.&amp;nbsp; Change these immediately.&amp;nbsp; If you can’t see anything obvious then make a visit to your health practitioner.


What can you do?&amp;nbsp; For acute onset of Achilles pain, try to assess what has caused your pain and change that immediately.&amp;nbsp; For the Achilles itself, ice the affected area, put a heal raise in your shoe for a few days to take the load off the Achilles, cross train and gently mobilise the Achilles.&amp;nbsp; How to mobilise?&amp;nbsp; 




Pincer grip (grip with forefinger and thumb) just below and just above the nodule on the Achilles, or at least the most painful portion, and bend the Achilles back and forward.&amp;nbsp; Do this for a couple of minutes at a time, three to four times a day.&amp;nbsp; This will often decrease the amount of pain felt when hopping and walking and promote recovery.&amp;nbsp;  


For chronic Achilles pain, eccentric calf exercises are the most important part of treatment.&amp;nbsp; The concept is to put load through the Achilles (which is now devoid of inflammation and becoming degenerative), to create a healing inflammatory response, and more healthy connective tissue will be laid down to heal the tendon.&amp;nbsp; How to do this?&amp;nbsp; Stand on a step, heal raise on both legs, now with your body weight on the painful side, slowly allow your heel to drop below the step height, and repeat.&amp;nbsp; For a hypothetical set, try three sets of six to begin with.&amp;nbsp; Be prepared for the Achilles to initially become more painful.&amp;nbsp; This will subside and slowly the Achilles will become less painful and your typical signs and symptoms will decrease.&amp;nbsp; By all means, please consult your health practitioner if you need direction.


To prevent Achilles pain, be careful with major changes to your training method and load.&amp;nbsp; Also, do preventative exercises as suggested above, including Achilles mobilisation.


Happy running.</description>
      <dc:subject>Contributors, Soft Tissue Therapist</dc:subject>
      <dc:date>2007-10-08T02:57:00+10:00</dc:date>
    </item>

    <item>
      <title>Medial Knee Pain &#45; Pes Anserenus</title>
      <link>http://www.krankin.com.au/index.php/site/comments/medial_knee_pain_pes_anserenus/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/medial_knee_pain_pes_anserenus/#When:03:12:00Z</guid>
      <description>Anatomy

Pes Anserenus is the term given to the common attachment of three muscles that insert into the tibia, just below and medial to the knee.&amp;nbsp; These three muscles are from anterior to posterior the Sartorius, Gracilis and Semitendinosus.&amp;nbsp; All three have separate origins and separate nerve supplies but converge about the medial knee before inserting into the Pes Anserenus.


Further anatomical considerations

The origins of these three muscles are quite diverse.&amp;nbsp; Anterior (in front of) to the hip, originating from the anterior superior iliac spine (boney prominence at the front of the hip) is the sartorius.&amp;nbsp; Deep in the adductor (groin) region, originating from the inferior ramus of the pubis, is the Gracilis.&amp;nbsp; And the Semitendinosus is one of the hamstring muscles and originates from the Ischial Tuberosity (the ‘sit bone’ or the boney prominence at the base of your buttocks).&amp;nbsp;  All three muscles are superficial and can be palpated easily although the Gracilis is quite difficult to identify as it is quite thin.&amp;nbsp; 

Importantly, there is a bursa lying underneath the three tendons as they attach into the tibia.&amp;nbsp; Bursa are fluid filled sacks that can be found all over the body and are there to protect against two unyielding tissues frictioning on each other and causing tissue damage.&amp;nbsp; In this case the two surfaces are the three tendons (as they traverse over the medial tibia) and the boney surface of the tibia itself.


Function

As a group the sartorius, gracilis, and semitendinosus muscles are primary flexors of the knee. These 3 muscles also influence internal rotation of the tibia and protect the knee against rotary and valgus stress. 

The individual function of the these three muscles is quite diverse.&amp;nbsp; In brief, the sartorius which has a nick name of the ‘tailors muscle’ acts to hip flex (bring knee towards thorax) and laterally rotate (rotate the thigh outwards) the hip, as well as flex the knee (bend the knee) and laterally rotate the tibia (outwardly rotate the lower leg).&amp;nbsp; It was called the ‘tailors muscle’ as this was the position tailors would sit in to sew.

The Gracilis is one of the long adductor group and is thought to adduct (bring towards the midline) the thigh as well as flex the thigh.

The Semitendinosus being one of the hamstring group helps extends the thigh as well as being a stabiliser of the medial thigh.


Pathologies/Injury

The Pes Anserenus is not a commonly discussed area unless there is pathology to the area.&amp;nbsp; The most common injury is to the bursa that lies under the tendons and over the tibia.&amp;nbsp; What is assumed to occur is that the friction between the tendons and the tibia becomes too much for the bursal tissue to handle and it fails and becomes inflamed.&amp;nbsp; The result is a painful, aching sensation that is sometimes red, hot and swollen (inflamed) but not always.&amp;nbsp; Running becomes painful and pain only subsides when you stop.&amp;nbsp; Rubbing the area will further inflame the area as you will be further irritating the bursal tissue.


Treatment

Depending on the severity of the bursitis, you may have to decrease or stop running for a brief to extended time to allow the bursa to settle.&amp;nbsp; Because the bursa in this area is quite superficial, topical anti&#45;inflammatories may help.&amp;nbsp; Simply place a large dobble of gel over the painful site (don’t rub it in or you risk further irritating the bursa) and put glad wrap over the area to keep it on the focal area and off your bed sheets.&amp;nbsp; Sleep in this over night for a couple of nights.

Before diving into stretching it would be best to consult your Health Practioner.&amp;nbsp; Stretching may further compress the tendons over the angry bursa and exacerbate the problem.&amp;nbsp; Figuring out why these three tendons are creating excessive friction is necessary to objectively treat this condition.&amp;nbsp; It quite simply might be one or all three of these muscles become tight and shortened or it could be a more complex pelvis issue that your Practioner can assess and treat.


Self Treatment

Instead of stretching these muscles and risking further irritating the bursa, try self massage to these three muscles.&amp;nbsp; Use some form of cream, sorbelene for example and slowly glide your thumbs or fingers along these muscles.&amp;nbsp; Identifying them may be a bit tricky so either consult someone to help you out or go for the global approach and work the surrounding area, as close to these muscles as possible, spending time on what you palpate as tight.&amp;nbsp; Alleviating this muscular tightness may help reduce the load on the bursa that is inflamed but keep in mind that once a bursa is angry, they tend to take a while to settle down.&amp;nbsp; And note, if self massage to these muscles makes things worse, stop and consult your Health Practioner.

Cortisone may be an option for persistent Pes Anserenus bursitis.&amp;nbsp; Clinically this type of cortisone injection shows excellent results but of course; try your conservative treatment first.


Summary

Your Pes Anserenus is the attachment of three thigh muscles that traverse from the pelvis to the medial lower knee.&amp;nbsp; The bursa that stops over frictioning of the tendons over the tibia may become inflamed if the friction is excessive.&amp;nbsp; Sort advice before stretching but certainly self massage the muscles involved.


Happy running.</description>
      <dc:subject>Contributors, Soft Tissue Therapist</dc:subject>
      <dc:date>2007-10-07T03:12:00+10:00</dc:date>
    </item>

    <item>
      <title>Achilles Pain &#45; What to do?</title>
      <link>http://www.krankin.com.au/index.php/site/comments/achilles_pain_what_to_do/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/achilles_pain_what_to_do/#When:02:39:00Z</guid>
      <description>The Achilles tendon is well known to runners.&amp;nbsp; Most of the time it is a handy piece of anatomy that allows us to absorb load when our foot hits the ground, and transmit force developed by our calf muscles to propel us forward.&amp;nbsp; Unfortunately this tendon can occasionally become painful.&amp;nbsp; Those who have experienced Achilles pain will know that it can be severe enough to completely stop training.&amp;nbsp; Moreover, it can linger on for months, even years if not managed well in the early stages.


The Achilles is the tendon that attaches the soleus (deep calf muscle) and the gastrocnemius (superficial calf muscle) to the Calcaneous (heal bone).&amp;nbsp; It is a thick, cylindrical, easily palpated tendon just above your heal bone.&amp;nbsp; If you palpate the tendon inferiorly (towards the foot), you will notice the tendon blending into the Calcaneous (heal bone) to the point where it is difficult to tell what is tendon and what is bone.&amp;nbsp; If you palpate superiorly (upward) you will notice the tendon grows thick and flat as it becomes musculotendonis (the transition from tendon to muscle).&amp;nbsp; Eventually the tendon disappears and the only tissue you will be palpating is the superficial calf – gastrocnemius.


The purpose of any tendon is two fold, each having a nuance of course.&amp;nbsp; The first is to transmit force developed by the attached muscle contraction to enable movement (the two ends of the muscle coming closer together).&amp;nbsp; For the Achilles, this is when the soleus and gastrocnemius concentrically contract (when a muscle shortens via contraction).&amp;nbsp; This contraction causes the heal to become closer the back of the knee (or toe pointing) as in the exercise heal raises. There is also a mild action to bend the knee via the gastrocnemius (as the gastroc attached above the knee).&amp;nbsp; The other mechanism is to bare load when a muscle is forced to lengthen.&amp;nbsp; For the Achilles this is when the foot hits the ground when running (or walking) and the calf muscles eccentrically contract (lengthen as they contract) to soften the heal strike and control movement of the lower leg just after the heal hits the ground.


So what goes wrong with the Achilles?&amp;nbsp; Most runners will have experienced some sort of pain associated with their Achilles.&amp;nbsp; More often than not it will be an acute episode of inflammation (swelling with inflammatory cells) that occurs due to tissue damage about the Achilles.&amp;nbsp; It is usually associated with (but not limited to) a palpable nodule on the Achilles that is very sensitive, stiffness initially in the morning but warms up as you become active and pain to hop.&amp;nbsp; Hill running will be very difficult.&amp;nbsp; If treated with (but not limited to) rest, anti&#45;inflammatories, ice and treatment (assessment of possible causes and treatment of these), you will recover.&amp;nbsp; If you ignore the pain, the problem can become chronic.&amp;nbsp; The inflammation will disappear but the Achilles will become degenerative (the Achilles tissue will break down).&amp;nbsp; This can lead to the Achilles becoming very thickened and the calf muscles will become very weak.


So what causes this?&amp;nbsp; There are numerous causes for Achilles pain.&amp;nbsp; Start looking at the very obvious.&amp;nbsp; Has your training load increased?&amp;nbsp; Do you have very old shoes that have worn?&amp;nbsp; Brand new shoes?&amp;nbsp; Camber running or excessive hill running?&amp;nbsp; Has your dorsiflexion range of motion decreased?&amp;nbsp; Have you changed your type of training (track running, flats instead of joggers, spikes, plyometrics are all examples of what often cause acute onset Achilles pain).&amp;nbsp; You can often self assess and figure out what is causing your pain.&amp;nbsp; Change these immediately.&amp;nbsp; If you can’t see anything obvious then make a visit to your health practitioner.


What can you do?&amp;nbsp; For acute onset of Achilles pain, try to assess what has caused your pain and change that immediately.&amp;nbsp; For the Achilles itself, ice the affected area, put a heal raise in your shoe for a few days to take the load off the Achilles, cross train and gently mobilise the Achilles.&amp;nbsp; How to mobilise?&amp;nbsp; Pincer grip (grip with forefinger and thumb) just below and just above the nodule on the Achilles, or at least the most painful portion, and bend the Achilles back and forward.&amp;nbsp; Do this for a couple of minutes at a time, three to four times a day.&amp;nbsp; This will often decrease the amount of pain felt when hopping and walking and promote recovery.&amp;nbsp;  


For chronic Achilles pain, eccentric calf exercises are the most important part of treatment.&amp;nbsp; The concept is to put load through the Achilles (which is now devoid of inflammation and becoming degenerative), cause a healing inflammatory response, and more healthy connective tissue will be laid down to heal the tendon.&amp;nbsp; How to do this?&amp;nbsp; Stand on a step, heal raise on both legs, now with your body weight on the painful side, slowly allow your heal to drop below the step height, and repeat.&amp;nbsp; For a hypothetical set, try three sets of six to begin with.&amp;nbsp; Be prepared for the Achilles to initially become more painful.&amp;nbsp; This will subside and slowly the Achilles will become less painful and your typical signs and symptoms will decrease.&amp;nbsp; By all means, please consult your health practitioner if you need direction.


To prevent Achilles pain, be careful with major changes to your training method and load.&amp;nbsp; Also, do preventative exercises as suggested above, including Achilles mobilisation.


Happy running.</description>
      <dc:subject>Contributors, Soft Tissue Therapist</dc:subject>
      <dc:date>2007-10-07T02:39:00+10:00</dc:date>
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    <item>
      <title>Prevention of Injuries &#45; Better than treatment of Injuries</title>
      <link>http://www.krankin.com.au/index.php/site/comments/prevention_of_injuries_better_than_treatment_of_injuries/</link>
      <guid>http://www.krankin.com.au/index.php/site/comments/prevention_of_injuries_better_than_treatment_of_injuries/#When:20:40:01Z</guid>
      <description>PREVENTION OF INJURIES – BETTER THAN TREATMENT OF INJURIES:

RE:&amp;nbsp; 10 Krankin Tips (Pre&#45;habilitation, Recovery &amp;amp; Mobility on Stability)

 

1.	Consistent Sleep Pattern: scientific research reveals that between 10pm and 1am – our bodies recover the best (REM Sleep).

2.	Soft Tissue Therapy: regular STT allows the tendons, ligaments and damaged muscle tissue to rebuild and rejuvenate.

3.	Self massage: focus on main muscle groups (rubbing/stroking up towards the heart); set your watch for 8 mins, while watching TV at night – between dinner and desert! Or in the add breaks (30 mins a commercial TV shows, has nearly 13mins of adds!)

4.	Massage your feet – research reveals that the feet have many trigger points/energy channels that assist “energy&#45;blood&#45;flow”….

5.	Scheduled “Full” rest days: do something you don&#8217;t usually do (go to a different coffee shop – make an effort to not dress in tracksuit pants or bike pants!); go to the movies; have a picnic.&amp;nbsp; Scheduling RD&#8217;s avoids having a “forced RD” &#45; 

6.	Regular Pilates/Yogalates/Core Strength session: helps with breathing, mobility on stability, strength endurance &amp;amp; posture.&amp;nbsp; I recommend doing 10mins of core after a long run/walk – especially concentrating on good form &amp;amp; correct muscle activation.

7.	Running/Walking Drills: perform 10mins of running/walking drills twice a week (see City News next issues for specific running/walking drills): concentrating on posture and fast turn&#45;over.&amp;nbsp; Preferably after a run – muscle memory is important for your next run!

8.	Breathing:&amp;nbsp; I recommend massaging your intercostal muscles (tiny muscles in between your ribs)....full use of your LUNGS is very important for everyday activities.&amp;nbsp; 

9.	HOT COLD HOT COLD showers: I recommend 1min warm water (with self massage&#45; increases blood flow); then 20 sec cold water (breath!) x repeat 3 times.&amp;nbsp; Very extreme; though very rewarding and refreshing!

10.	Be good to your Mum.


Yours in Sport!


Kirra Rankin

Rehabilitation Exercise Physiologist (AAESS)

Level II Middle Distance Athletics Coach

Pilates Instructor

Soft Tissue Therapist</description>
      <dc:subject>Contributors, Exercise Rehabilitation Specialist</dc:subject>
      <dc:date>2007-09-25T20:40:01+10:00</dc:date>
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