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Old 02-07-2012, 03:52 PM   #1
Jan Vandelden
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Achilles tendon

Are there more cases of injuries due to boxjumps of the Achilles tendon??
One of my cliŽnts tore his tendon last night, and I know of one more case.
I think the rebound is pretty dangerous with the boxjump.
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Old 02-07-2012, 07:14 PM   #2
Sara Lynn Miller
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Re: Achilles tendon

Kate Rawlings.
http://katerawlings.com/2011/12/03/no-more-tears/


The rebound is not great for the back either.

Last edited by Sara Lynn Miller : 02-07-2012 at 07:17 PM. Reason: add
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Old 02-07-2012, 07:46 PM   #3
Steven Low
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Re: Achilles tendon

Yes, there was a rash of injuries last year in the qualifiers for the games.....

High rep box jumps generally not really a good idea.

No high level athletes in other sports take that many high impacts for good reason.
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Old 02-08-2012, 03:21 PM   #4
David Meverden
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Re: Achilles tendon

Is there anything a CrossFit athlete can do to avoid this injury if he/she might be required to do them in a competition? Aside from stepping down off the box, of course, which wouldn't be close to competitive with others.

Is there any physical preparation that could help prepare the body for high rep box jumps?
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Old 02-08-2012, 04:54 PM   #5
Steven Low
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Re: Achilles tendon

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Originally Posted by David Meverden View Post
Is there anything a CrossFit athlete can do to avoid this injury if he/she might be required to do them in a competition? Aside from stepping down off the box, of course, which wouldn't be close to competitive with others.

Is there any physical preparation that could help prepare the body for high rep box jumps?
As much as I hate to say it....

High rep weighted calf raises (like 30-50+ reps are good for tendon healing) are probably good prehab work for this type of stuff if you HAVE to do them.

Calf raises
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Old 02-08-2012, 08:05 PM   #6
David Meverden
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Re: Achilles tendon

Ugg. Yeah, I don't like that answer either.

While I've got your ear Steven I'm just going to pepper you with questions because a lot of this achilles stuff just isn't adding up for me.

1) What about Calf Raise Negatives (umm, calf lowers?)? I've seen them cited as a treatment for achilles tendinitis before but don't know why they recommend negatives instead of just calf raises. Is the intention to have people do weight above their maximum? If so, could something similar be useful in this case?

2) Would sprinting or running stairs help prepare one's achilles? It seems like most ruptures happen while people run, at least sampled from the 10 videos on this webpage that show ruptures: http://achillesblog.com/crutchman/to...-on-tapevideo/ (not necessarily WFS) so it seems like the stresses are in the same ballpark.

For that matter, if that CF open WoD had had a 40 yard dash instead of box jumps would you have gotten less achilles ruptures? Apparently there are 66,000 achilles sports injuries (WFS) that require hospital time, rehab, or surgery (WFS) every year. If 1/4 of americans are athletes that these injuries happen to then that would be 0.88 ruptures per 1,000 people. This blog entry (WFS, except for language) says there were 20-25 ruptures from last years open, but weren't there 24,000 participants? That's about 1 rupture per 1000 people, which isn't much above the very rough estimate above. Is sprinting just as dangerous as high rep box jumps or are the numbers off some where?

3) People generally approve of low rep plymetrics, including depth drops, but not high rep box jumps, but why does high reps matter on a tendon? Why isn't height of the drop the central/only risk factor? As an engineer I know that if you repeatedly stress a piece of steel at stress of 35,000 psi it will fail after about 11,000 repetitions. If you increase the stress to 45,000 psi (a 28% increase) it can take only ONE TENTH that many cycles (1100) before breaking. Stess is the much bigger factor than number of cycles. So why doesn't the relatively inert tissue of the tendon act the same way? Why are 15 depth jumps from 40" supposedly safe and 50 box jumps from 24" aren't? Or are all plyometrics inherently dangerous but no body hears about it since there aren't 24,000 people in garage gyms doing depth jumps?

So many questions!
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Old 02-08-2012, 08:51 PM   #7
Steven Low
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Re: Achilles tendon

1. Eccentrics are used for tendinosis -- chronic degeneration -- because they create inflammation for the healing process.

For more details, wfs
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

(3 stages of "tendonitis" ... treatment differs depending on what stage you are at)


2. The problem with the stats is that you can't tell whether people were highly conditioned athletes or random joe blow.

You also don't know whether people are working through pain/tendonitis or not.

Runners are notorious for working through injuries to keep running... I wouldn't be surprised if those make up the majority of the running related achilles ruptures.

Properly structured S&C should theoretically prepare an athlete better for the rigors of the sport -- so yes, sprinting and running stairs can theoretically help. BUt too much can be too much regardless.


3. 40" is like the super upper limit of height depth drops are taken from and usually only by extremely well conditioned athletes (think people that have been training in their sport for 15-20+ years).

It's not just the 50 box jumps of 24" inches in workouts though. The former higher ones aren't done when fatigued. And they aren't coupled with other impact work in the same day/workout like you would get in a workout.

Don't get me wrong -- most of these injuries aren't sudden if the tissue is healthy. I would likely suspect if you look at the histology of the tendon even if there is no overt symptoms of indicator tendonopathy there would probably be some level of degeneration in the tendon from high rep overuse.

Remember, tendons and other connective tissues heal much slower than muscles. In CF you're constantly attacking the cardiovascular system and muscles with high intensity exercise. The things that will break first are going to be connective tissues like tendons (achilles, medial epicondylitis, patellar tendonopathy, biceps tendon, etc.), labrums (see SLAP lesion), possibly menisci with poor function,etc
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Last edited by Steven Low : 02-08-2012 at 08:54 PM.
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Old 02-09-2012, 02:41 PM   #8
David Meverden
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Re: Achilles tendon

Thanks for the info Steven.

So, do you think it's just the fatigue that is the problem, not the high repetitions, per se? The tendon doesn't fatigue, but I could see that if your calves and associated muscles are fatigued then they won't absorb the impact as smoothly, thus higher force for a shorter time, which could be an important factor. Stills seems weird, though.
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Old 02-09-2012, 06:22 PM   #9
Steven Low
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Re: Achilles tendon

Yes, fatigue is a factor as you noted.

If a muscle doesn't have the ability to absorb force as well, it will "jerk" down.

It's the same thing you see with tendonitis -- the muscle has poor input because of the pain -- so the motion is usually jerky on the eccentric which accentuates the forces placed on the tendon.

Hence, why tendonitis can often get worse very quickly.

It's a combination of factors coming together. High reps is definitely a factor too.
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Old 02-14-2012, 12:30 PM   #10
Ryan Hoegner
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Re: Achilles tendon

Quote:
Originally Posted by David Meverden View Post
Is there anything a CrossFit athlete can do to avoid this injury if he/she might be required to do them in a competition? Aside from stepping down off the box, of course, which wouldn't be close to competitive with others.
David, unless you have a chance at 250K in July, I would step down. Or you can jump down, set your feet and jump back up. I ruptured my achilles about 14 months ago playing basketball. It's a really ****ty injury. I still do local competitions. If they program box jumps its just not worth the risk to rebound at the bottom. I also do not let anybody at our box do this.

Ryan
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