SPECIAL TO THE POST-INTELLIGENCER

During the running portion of a half-Ironman triathlon event last year in British Columbia, Cherilyn Suiter made a wise tactical move. The former national-caliber triathlete didn't step up her pace or jockey with the leader. Instead, she walked the last five miles. 

"My Achilles felt like it was going to rupture," said Suiter, a Lynnwood-based triathlon coach who operates DC Suiter Coaching. "I only had two choices in mind -- quit or walk. You don't want to mess with your Achilles tendon." 

The Achilles tendon is most definitely not a mess-around body part. It can be a trouble spot for recreational athletes, especially as we move into our 30s and beyond. One reason is that, although it's the body's largest, this tendon has a limited blood supply in its location above the heel and below the calf. And our cells hold less water as we get older, making the tendon less supple. 

Plus, there is the push-on factor. There are no doubt hundreds of runners preparing for the upcoming Seattle Marathon who are feeling tweaks in their Achilles tendons. Taking some rest days or doing cross-training on a stationary bike or in the swimming pool could be just the remedy. 

"I send people to a community or YMCA pool that has a deep end," said Suiter. "I recommend deep-water running. Lots of pools have [flotation] belts that allow you to run in the water without any impact on your feet or tendons." 

Suiter pointed to exercise research showing that deep-water running over an extended period can maintain your fitness level during times of injury. Health club pools often don't have deep ends (liability issues), so you may have to search to find the right pool.

The Achilles tendon is subject to significant forces -- up to eight times your body weight -- during any sort of running or participation in what researchers like to call "velocity sports" such as basketball or volleyball. There's also bad -- but not surprising -- news on high-heeled shoes: They shorten women's Achilles tendons, putting them at greater risk of injury. 

Flat feet can be another factor. Runners call it over-pronation, which means the arch of the foot collapses upon bearing weight, putting added stress on the already pressured Achilles.
One frustration among weekend-warrior types is that the onset of Achilles problems can be gradual or sudden. It is a good idea to stay aware of how your Achilles tendons feel during and after exercise. One might be more tender or "talkative" than the other. 

"One issue is determining if you have constant or intermittent pain," said Monika Johnson, a physical therapist at Virginia Mason Medical Center. "Constant pain means you have a lot of inflammation. Waking up with pain also is a signal of inflammation." 

Johnson has one rule if you are limping from a barking Achilles: Stop running until the pain subsides. 

Along with cross-training options, there are some strategies for Achilles pain. The standard R.I.C.E. (rest, ice, compression, elevation) is a good routine for mild to moderate Achilles symptoms. 
Stretching while warm, either after exercise or a hot shower, said Johnson, can help prevent any further microscopic tears to the tendon. She suggested a lunge type stretch (one leg bent to no more than 90 degrees in front of you while the back leg stays straight). Hold for 30 seconds and do it three times with no bouncing motions. 

Johnson said pre-exercise stretching is more about "getting things moving." She said stretching after, say, a run or tennis game, is the best time to "work on tissue length." 

Not stretching, or running through irritation, can lead to scar tissue on the Achilles. That increases the chances of rupture and months of rehabilitation, said Johnson. 

Improper footwear might be a culprit and worthy of your attention. Johnson said athletic shoes need to be replaced every six months to a year, depending on the intensity and frequency of your physical activity. She gives high marks to the local Shoes-and-Feet chain. 
Johnson took an intriguing stand on shoe replacement. She recommended against buying a second pair of athletic shoes on sale. 

"Even if your shoes aren't worn out, get new ones," she said. "The materials in the shoes break down even in a box in the closet." 

If you try some of these remedies and are still scratching your head about what else to do, Johnson recommends a biomechanical assessment to analyze your form and gait while on a treadmill. 

"No one is completely symmetrical," she said. "We're compensating for being out of physical alignment." 

For instance, Johnson said tests show her left side is weaker than her right side. So it's no surprise that her right Achilles tendon has pained her. Other possibilities might be that your hamstring muscles (back side of the thigh) are tight and your tendons have to work harder. Curvature of the spine can lead to tendon pain, along with flat feet or the wrong shoes. Some people benefit from orthotic inserts in their shoes. 

A physical therapist can help with balance exercises to improve all muscles and tendons and, in turn, relieve the stress on your Achilles. 

"It's hard to get people to pace themselves," said Johnson. "But a couple weeks of not pushing through it can make a big difference."