Achilles Tendonitis Recovery

I had a severe case of Achilles Tendonitis recently, took two weeks off and have now been pain free for the past week. Any thoughts as to when I can start running again and how much is sensible to start with. I am very wary as this was quite the worst injury I have experienced and do not want a repeat.

http://www.runnersworld.co.uk/forum/forummessages.asp?dt=4&UTN=8022&V=8&SP=

945 posts on the subject of achilles tendonitis. Hope the link works.

On 5 May, I got achilles tendonitis. I have been running for 3 years and in January did a 28 mile coastal marathon. I regularly ran 20 miles on a saturday and then 10 on a sunday with 2 or 3 more runs during the week. I was going really well but in April, I did too many miles and my achilles decided to let me know. I got it after doing a 5 mile run and the following day it was painful to walk, climb stairs etc...

For 3 weeks I did eccentric leg exercises and didn't run. Then I started back. Couple of 2 and 3 mile runs and then 6 milers. After only 7 runs it flared up again. I haven't been running for nearly 6 weeks since the flare up and I am going for my first run tomorrow. I aim to run 2 miles, 3 times per week and then build up by 10% per week provided it doesn't flare up again.

It appears starting back too quickly with too many miles is a common occurrence and leads to it flaring up again. I still do exercises daily and self massage. Currently I have minimal stiffness in the morning, it goes after 7 or 8 steps. I have no pain in my achilles doing day to day activities. The only pain I have is if I sit on a chair, point my toes (achilles compressed) and rub the tendon firmly with the edge of my finger.

All sufferers have their own ideas about the best course of action but the only thing we all seem to agree upon is that time is the greatest healer.

Good luck.

Thanks Smalleyboy.

I think I will go for a very cautious approach. I am terrified of a flare up as a result of overdoing it, you definitely back up my thoughts on that subject. What was the nature of the pain - was it niggling from when you started back, or was that a sudden worsening towards the end?

I got injured on 5 May and rested until end of May. Over the first 3 weeks of June I ran baout 8 times with the longest run being 8 miles (keen to get back into training!). On my last run on 21 June, I had to turn and come back after only 3 miles because my achilles was constantly sore. On the 7 runs prior it would be stiff for half a mile and then the stiffness would disappear. It would be tender to touch after a run but i thought it would get better. it didn't and I decided to rest it further. Yesterday was my first run back. I did a slow steady 2 miles.

Just before my run yesterday I would have rated my achilles as being 90% fine. After the run it was 85% and today it is back up to 88%. I currently have no pain at all in my achilles when i manipulate it or massage it unless I dip my toes (compressing the tendon) and then it is tender to firm touch. It has been like this for the last 6 weeks. I plan to run 2 miles x 3 times per week, increasing each week by 10%. Any additional pain and I will ease off and rest a while. Currently my achilles is stiff in the morning for approximately the first 30 seconds of getting out of bed, then fine after that.

I wouldn't say I had severe tendonittis as i did stop as soon as it felt sore on 5 May. I typically ran 100 miles per week but in April I did 140 miles and believe my injury was linked to a 40% increase. I was running well and thought I could handle it! I think it is important while you are resting you try to establish the source of the problem. The wrong shoes is often cited. However in my case, I have my gait analysed every year on a treadmill at an Up and Running shop. I change my shoes after 300 miles and have 2 pairs of shoes on the go at any time. I had run 1500 miles in the same make and model of shoes in the 18 months prior to injury. I am 99.9% certain that in my case, it simply was over use.

I have been told the achilles tendon has a poor blood supply and this is why it takes a long time to heal. It also gets worse with age. I am 40. I am hoping that gentle running will increase the blood flow and strengthen it over time. Time seems to be the key to recovery.

I have chronic achilles tendonitis and have been instructed not to run for at least 6 MONTHS by my physio, who I see weekly, after being referred by my GP as i was in so much pain.I am slowly getting better but this is because i actually taking her advice and not even attempting to run. 

I can swim, cycle, do weights but that is it - i can't even use a cross trainer without pain. 

I would rather do as she tells me than start back running to be struck down with this again - the pain was unbelievable and i was told it would have been better if i had ruptured my achilles as it would have healed so much quicker.

It takes time....unfortunately. I am now fully recovered. The problems I had related to not resting when I started to get the pain. Racing when I shouldn't etc. etc. I did cut off of the part of my shoes that was near to the tendon area, and this did help. I am not convinced about the eccentric stretching, as in my case it seemed to aggravate the injury. My physios advice was that when you can start to run again you should take a zero tolence approach and stop at the first niggle. If only I had done that in the first place!

However on the brighter side give yourself some time off and you will get your running life back.

All good advice

 You'll need to check your knee to wall distance to make sure you've got adequate flexibiity on the affected side.

Start slowly, and stop while it's stil pain free. Don't be tempted by short term gain (always gives long term pain!)

OP, sorry to hear aout your problems.  Have a read of this thread, too:

http://www.runnersworld.co.uk/forum/forummessages.asp?dt=4&UTN=185569&V=1&SP

As I said above, take it easy, and as long as you do not rush it, it will heal and you will get back to normal.

Hello.  AT a "popular" subject for threads at the moment.

I had it for 15 months and finally deemed myself clear of it at the beginning of this month.  I chronicled my experiences over a couple of dozen posts on a thread I started recently.  You may find it informative.  It's probably on the second page by now, but with all these threads from spambots it's hard to find anything at the moment!  I'll try to find it and boing it for you.

Might be better than trawling through 945 posts!!

if I can comment on what has been posted above:

• avoid compressing the tendon - it's the opposite action you need to concentrate on by doing stretches
• don't be afraid of light exercise and running on it, with great care about foot placement and avoiding downhills, especially steep ones
• no, you can't rush it, but you can move the healing process along
• seek professional help from a sports injury therapist who is experienced at deep tissue massage/manipulation (not a physio)
• you may not be pain free at any point (I wasn't) but stop activity if the pain is sharp and "pincer" like, Otherwise carry on.  I found getting back to running was part of the healing process. 

I'll stick around if any questions.

Cheers

T Rex

I've had this rotten injury since 14th April. After prolonged physio and doing eccentric exercises, I am going to try for a run/walk round the block. It's been horrid not being able to run but this time I have stuck to advice and although it's been a long road, think we're almost there. Still stiff in the morning but at least I can walk normally now rather than hobbling along!

Glad to hear it Gladys1146.  At the time, it seems like full rehabilitation will never happen, but give it time and a measured approach, and you will gradually get there. 

I started running again in January this year after 7 months off, but with a few new rules.  

1) First twinge, stop immediately.

2) Continue to strengthen muscles, tendons and ligaments of the calf with single-legged weighted eccentric calf raises.  One calf/ foot absorbs and elastically pings back way over body weight repeatedly during running, so eventually, these will need to be heavy.  First take advice from a sports physio or qualified gym instructor.  

3) Always complete a full warm down.  Always complete a full stretch afterwards

4 Always complete a dynamic warm-up before doing time trials or running fast

5) Take rest days when your body says it needs them, not when your training plan tells you to

April isn't that far behind us, so still be a bit careful.  It may be a few months before you can perform maximally without fear of a relapse.

Good luck!

propaganda wrote (see)

 I am not convinced about the eccentric stretching, as in my case it seemed to aggravate the injury. 

I spoke to my physio about this only yesterday (Same issue - achilles pain), she said that when it's sore, it's a bit like having an open cut on, say, the knuckle of your finger.  You wouldn't want to keep bending the finger because you would force the cut open again!

Her advise was to stretch very gently if it's sore, or just basically keep moving to prevent any scar tissue gluing against adjacent tissue.  But she said when it starts to feel better then I should start stretching fully.

I also asked her should I stretch it until it's painful....her reply was "No, not any more, that is no longer what the latest research suggests".  She told me to stretch it until I felt discomfort only.  For me, it's 3 x 15 sets of heel drops with straight leg, and another 3 x 15 with bent knee.

FInally, I said when I drop down with one heel, I need extra weight before I feel any discomfort....that's probably because I'm fairly light anyway, but she said add some weight in a rucksack, to keep myself balanced.

Hope that is useful info.

Questforspeed. I totally agree with everything you say. Hellish injury but time will heal it if you do not do anything rash. Thankfully I am now fully recovered although I still get the occasional twinge. My mistake was not paying sufficient attention when I got the original injury, in fact ignoring all your advice!

Propaganda, glad to hear you are now fully recovered. It's pure living hell, this injury, isn't it? Fortunately there is a route out of it, but it does take time, as various sufferers have attested.