Achilles Problems? Stuck and in need of help please!

11 messages
27/08/2013 at 15:43

Hi,

I am 28 years old and have suffered for probably 5 years with achilles problems on and off. It started once day after a 45 minute session on a cross training and I felt a pull in my tendon on my left leg.

After a few months I got back to training and since then was able to do 5 mile runs, 7 mile runs and 8 mile runs at different stages in my training.

Recently however (last 2 years) it has got worse.

I wake up with a limp because of a tight achilles Tendon (or what I believe is my tendon but could obviously be muscles in the surrounding area?)

I also get it after I have been seated for a long time at my desk at work and should I kneel on the floor to do anything it is even worse and I find myself hobbling around like an 80 year old.

I have been to the doctors, a physio and sports massage specialist. I have also been to the hospital for a scan (like the one they do for pregnant woman) which found no tears just my left tendon is slightly larger than the other but thats it and I have just been to a podiatrist for insoles because of my flat feet.

None of which has seemed to help and whenever I run or play football I am in pain but not for all the exercise. Just parts during it and maybe at the end of the next morning.

It is making me very depressed as no one seems to know what to do. Is this something as simple as stretching or what? I dont think its a tear or anything as the docotrs couldnt find one... but then again I am maybe thinking is it because i am over weight? 

 

I am 17 stone 3 but I got to the gym a lot and some say I have a rugby type body but I prob carry around 2 stone of excess fat...

Hope someone can give me some good advice!

29/08/2013 at 21:13

Hi Steven.  I am sorry to hear about your frustration.  Your subject header caught my eye as I have battled with chronic Achilles tendinosis for over a year now.  Are you saying that your left Achilles tendon causes you pain?  It is not uncommon to wake with tendon stiffness as the foot is positioned with the toes pointing down when sleeping which causes the calf muscle and Achilles to shorten.  When we are sitting at a desk, we often rest on the balls of our feet which creates the same dynamic.

If you are not showing any signs of tears to the tendon itself (hurray!), it is possible you may simply be experiencing tendinitis due to the extra load on the area due to your weight. You don't say how tall you are but 17 stone is a lot of runner! This article is really useful and does highlight what was my downfall, that it is more common to suffer these sorts of problems if you do fast training, uphill running and are a forefoot runner.  Carrying extra weight can exacerbate any issues but it is more likely to be a myriad of things you could address to resolve the problem.  There is never usually one magic cure in the case of Achilles issues and it may take some serious detective work looking into your biomechanics and environment and daily habits to work it out.  It took me the best part of a year to solve my problem (after a failed attempt to "fix" it with plasma injections, 5 weeks in a fracture boot and new orthotics) and I am only now slowly returning to running but this isn't without discomfort and I am having to see various people to manage the irritation while the connective tissues becomes accustomed to the impact of running after a year off.  I am still not sure I am out of the woods yet which might give you an idea as to how tricky these issues can be to resolve.

http://runnersconnect.net/running-injury-prevention/achilles-tendonitis-and-insertional-achilles-tendinopathy-in-runners/  

M...eldy    pirate
29/08/2013 at 21:16

In a nut shell you need to find yourself a better physio ...

29/08/2013 at 23:43

This blog looks jolly useful too, Steven.  PF being closely related to Achilles tendinopathy in terms of triggers .

http://www.plantarfasciitisgone.com/plantar-fasciitis-heel-pain-treatment/

30/08/2013 at 14:17
MsE wrote (see)

This blog looks jolly useful too, Steven.  PF being closely related to Achilles tendinopathy in terms of triggers .

http://www.plantarfasciitisgone.com/plantar-fasciitis-heel-pain-treatment/

Good blog. And I'd recommend getting a night splint. But certainly not the one in the Shop in that blog. The strapping around the foot is much too tight. And it doesn't support as well as the ones that run down the calf and under the foot.

I got one from ebay for about £20 (or less).

14/09/2013 at 18:17

Hi I had extracorporeal shock wave therapy which seems to have done the trick for my stubborn  Achilles problem. Sadly just as it fixed the other one has gone ..so frustrating 

19/09/2013 at 18:44

Ive been where you are Stephen  - the solution for me was to see a podiatrist- I'm xs mobile at my ankles and probate.. I now have custom made orthotics( bit pricy but better than the frustration of not running) and the difference was astounding- pain free running and the symptoms such as you are experiencing all settled. I went to profeet in fulham

The other thing I do religiously now is stretch and do heel drops( straight and bent knee)

Improving glutes and hams I think helped- goodluck!

PSC    pirate
19/09/2013 at 19:16

there is a pretty good chance that the calf muscles are weak and that is causing your achillies problems... fixed mine by doing heel raises on a step.  Strengthens and stretches the calf.  Start easy and build up from there.  

http://www.wikihow.com/Perform-a-Heel-Raise

Good luck.

M...eldy    pirate
19/09/2013 at 19:30

Fa rbe it for me to disagree PSC but initially with achilles issues then you should do the drops only, heel raises will put too much load through the achilles although you do need to strengthen the calf muscles also
There seems to be a friendly physio input tomorrow lunchtime so could be worth a drop in

PSC    pirate
19/09/2013 at 22:49

There was a guy on here called Snowy years back who was so fed up with his sore achillies , he did heel raises with a heavy rucksack on. Kill or cure he called it. It worked (for him). He was cured. I am not recommending his approach!  

20/09/2013 at 15:59

Hi Steve,

Achilles tendinopathy is often persistent and difficult to treat, however with the right management it can improve. I agree with PSC, calf strength is very important. Recent research now suggests that muscle strength may be one of the key areas in tendinopathy.

So how do you progress? Firstly you need to seek out an experienced physio who can do a thorough assessment and determine if it is Achilles tendinopathy and whether it's insertional (where the tendon attaches to the heel bone) or mid-portion (in the middle of the tendon). This is important as these two different types of tendinopathy have different treatments.

Secondly you need to address factors that contribute to the injury. Your weight may well be an issue and so losing weight is likely to help. Also people often do exercises or use treatments that make things worse, particularly stretching. This may sound odd but I wouldn't stretch your calf muscles as this is unlikely to help in the long term. Stretching mainly effects the tendon rather than the muscle, you want a strong, fairly inflexible tendon that can handle the force involved in running, stretching won't help this.

Crucially you need to improve the muscle and tendon's ability to handle load. This can be achieved by strengthening the 2 calf muscles (gastroc and soleus). For years people have focussed just on 'heel drops' on the edge of the step but more recent research shows that calf strengthening (e.g. simple calf raises) can be very effective if a high load is used. By high load I mean doing single leg calf raises lifting your own body weight plus around 10-20kg extra (held in a backpack).

The problem is this is often painful to do initially so I recommend a graded build up. Start with 'isometrics' on 2 legs. Do a 2 leg calf raise but hold it for 30 seconds. Repeat 4 times and do this twice per day. When this gets easy progress to doing this on 1 leg. Isometrics really help settle pain and start gentle loading.

Next up progress to 10-15 calf raises, this time without a hold. When you can do 3 sets of 15 just on your weaker leg start to add extra weight and gradually build up. This extra weight stimulates the tendon to recover - it doesn't damage it.

Ideally you want to do 2 types of calf raise - straight knee (to target gastroc) and with the knee flexed to around 30 degrees (to target soleus). Do around 3 sets of 15 reps of each exercise every other day and give it time. Tendon's take around 3 months to adapt to loading you need to keep strength work up for at least this length of time. It doesn't take long to do the exercises and it is worth it.

I hope that helps and makes some sense!

Let me know if you have any questions, also if you let me know where you're based I can try and recommend a good physio near you.

good luck

Tom

Running-physio.com


We'd love you to add a comment! Please login or take half a minute to register as a free member
11 messages
Previously bookmarked threads are now visible in "Followed Threads". You can also manage notifications on these threads from the "Forum Settings" section of your profile settings page to prevent being sent an email when a reply is made.
Forum Jump  

RW Forums