Hi guys! My name is Maryke. I'm one of the physiotherapists from treatmyachilles.com,
where you can get online physiotherapy treatment for your Achilles pain. So, the question today is:
Is it okay to train with pain or run with pain? Now, the answer to this question is, ‘Yes and no.’
I'm going to discuss three headings under this topic. And the first instance we're going to look
at: What does the pain in your Achilles tendon actually mean? Secondly, we're going to have a
look at why the 24-hour response of tendon pain is important to take note of. And then lastly,
we're gonna look at how much pain is okay and why it is okay to train with that. Good! So,
if you've got any questions, remember to pop them in the comments, and I'll get back to them. And if
it's possible for you to tag me, then that will make it easier for me to see your questions. So,
what does pain in your Achilles tendon mean? Now, the body develops pain in reaction to injuries,
and it acts as an alarm system. So, it basically makes you aware that there's a problem somewhere,
and it wants you to take care of it. Now, it's important to understand that pain does not equal
injury or does not equal damage, rather. So, you can have a lot of pain, but that doesn't mean that
your injury is very bad; it may just mean that your alarm system is shouting really loudly. And
we know definitely that for people who's had pain in an area for more than three months,
the alarm system starts to shout really loudly, and it takes less and less and less to trigger
that alarm system. So, what this means in practice is that you’re now developing pain when actually
you shouldn't have pain, and it's not causing any tissue damage. Now, it'll make sense in a
minute why this is important, as I move on to the next topic of 24-hour response. So, tendons
can be sneaky. They often only tell you 24 hours after you've done exercise that you've overstepped
the mark. I don't know if you've noticed: If you've got Achilles pain from a tendinosis or
a tendonitis, then you may have found that you can initially work through the pain. So, you'll
feel it a little bit when you start running, and then it just disappears. But then it may come back
a lot worse a few hours later or sometimes the next morning. And that is because tendons often
have a slow fuse to only show its true colours later in that day or the next morning. And if
we think of symptoms that we don't want to see is, we don't want a massive increase in pain or
even stiffness or more constant ache within that 24-hour period, because that may be an indication
that your training was too hard that you did there. Now, let's put all of that together. So,
remember pain does not equal damage. So, some discomfort is okay, and we have to monitor the
24-hour response. And it comes as no surprise that the research has shown that up to a level of 3
out of 10 pain is okay to train with, and most of the research studies looking at specific Achilles
tendon exercises as well as running with Achilles tendinopathies; they've allowed the subjects to
train with the 3 out of 10 pain, and as soon as it got more than that, they asked them to
decrease the training or just pull back from it all a little bit to give it time to recover. But
as long as the pain stayed within that level, all the subjects still managed to recover while they
kept their fitness. Now in practice, I find it's difficult for my patients to gauge what is a 3 out
of 10 pain. So, I find something that's useful is to think of it as a discomfort rather than a
pain. So, if you doing your Achilles exercises or you're going for your run, and all you can feel is
a bit of a discomfort – so, you kind of know it's there but it's not really painful – and then also,
within the next 24 hours you don't get a massive increase in your pain – so, it's again,
you just know it's there but it's not really that painful, and it takes 24 hours then it's
gone – that level of discomfort is absolutely fine to train with. If it's more than that,
it means that your training session was a bit too hard, and you will have to pull it back. Now,
it's a bit difficult to get the hang of this at the beginning, and it can be really useful to work
with somebody who's got experience with helping you to do that. And this is part of what we do at
treatmyachilles.com. We'll analyse everything you do in your life, so, including your run training,
your day-to-day activities, because sometimes it's things you do during your work or your daily life,
looking after kids, that actually also load your tendon. And we put all of that together to get a
picture of why your tendon pain flares up from time to time, and then we help you plan it out
so that you just put the right amount of load through that tendon to help it recover but not
push that pain above the 3 out of 10 level. So, let me know if you've got any questions;
I've popped a link to the website in the description of this video. And yeah,
have a look and see if any of the information on there is useful for you. Take care!