Active baby boomers, those in the 40-60 age group are a large segment of the patients I see in my office as a sports physical therapist. Active has taken on a whole new definition for a lot of these folks. They not out there just taking a walk after dinner, or playing with the kids. They are trying to compete against themselves (the clock), and those around them through running, cycling, swimming and sometimes all of these at one time. This means they are doing one or more of these activities 5-6x a week and usually trying to fit it in between work and family time. Sometimes this leads to taking short cuts around proper stretching, strength training and improper training techniques. This leads to, in many cases, chronic Achilles problems. As with all musculoskeletal problems, more than one factor was contributing to this baby boomer's problem. First, he had a previous injury and an Achilles tear, which had been surgically repaired but perhaps not fully rehabilitated. But the doctor pronounced him healed and he attempted to gradually return to his previous activity level.  Despite trying to follow a reasonable plan of return to activity, pain set in, with a feeling of "my running just doesn't feel right".

This leads us to our second problem. Because of the surgery and/or injury to the tendon, it had lost its normal flexibility and elasticity. So the tendon could not deal with the forces in a normal way. Also, as is common after major and even minor injury, the muscles that support and control the foot and ankle had become functionally weak. He could isometrically resist all the various motions if you put him on the table and ask him not to let you move his foot and he could even do a fairly good heel raise standing. But muscles and tendons function much differently in "real life". They have to absorb forces as we contact the ground, then quickly transition that into generating forces to move our bodies. They have to do this in a rapid and smooth, coordinated fashion with utmost efficiency.

The third problem was improper mechanics that had set in his walking and running pattern. Past injuries and/or bouts of overtraining can frequently cause imperceptible changes in your gait (walking) mechanics. Your body functions much like a machine: take any machine and use it improperly and see how fast it breaks down.

So, what was the solution for our frustrated never-say quit, aging baby boomers to get back to competition? It was a multi-faceted plan consisting of stretching and soft tissue work for the Achilles tendon including multiplane stretches to get to all areas of the tendon. Two, functional lower leg strengthening, beginning with single leg balance mini-squat and reach exercises progressing through double and single leg hopping activities. And thirdly, adjustment to his orthotics with appropriate gait mechanics training. Working on the restoration of proper heel strike, weight transfer through the arch and push-off primarily the big toe joint and big toe, were all addressed.