Achilles tendonitis

Living with it for 15 months and finally overcoming it

81 to 100 of 153 messages
18/02/2013 at 02:12

You're welcome, John.  I've received no end of inspiration and advice from this forum myself.

 

OK, cut your Thursday session out, move the Tuesday run to Wednesday, and concentrate on your long run, which I presume is up to about 10-11 miles?  Over this length you should find any achilles tightness loosening at some point - either in the middle or towards the end of the run - when you might be able to up the pace a bit.

 

See how you go.  On race day you may surprise yourself.  I managed to complete enormous ultra events with my AT which by rights I shouldn't have been able to.

04/03/2013 at 20:04
T-Rex, I cut the running right back as each time I attempted a run, the tendon was very painful. I saw an excellent sports therapist who worked the offending calf and tendon with some ultrasound. I managed a 10 minute run on Friday then headed off to Bath on Saturday, Achilles was feeling much better after the massage. The half marathon started a little sore but any aches soon went and I finished at 2 hrs 4 mins which was great as I was aiming for a time around there prior to the injury and I found it really hard to slow down the pace once the race was up and running. Absolutely no discomfort what so ever in the Achilles now, feels good as new! Thanks for all of the advice.
05/03/2013 at 20:01

That's good news.  Personally, ultrasound did nothing for me.  I endured multiple sessions of very painful massage instead.

Keep up the calf stretches, and I would consider extending the notch in the heel tab of your shoes. I've cut all my shoes now.

16/03/2013 at 10:34
T Rex, thank you for an excellent thread. I too have been battling AT since I deployed to Afghanistan in the Summer of 2010. Definitely a mild case compared to what I've just read. I've found that the hardest part of trying to recover has been maintaining the heel raises. I've recently discovered an excellent solution to the heel raise. I bought a latex resistance band and have fashioned it into a loop that I can place over my foot and knee. This allows me to sit at a desk or in front of the TV and carry out my exercises. This has given me the best result to date. I would thoroughly recommend it to anyone suffering with AT.
17/03/2013 at 08:14

I ran my first half marathon back in 2011 and got through it injury free. However, shortly afterwards I developed a searing pain in the ball of my foot (possibly sesamoiditis) after doing a set of hill sprints. I had to stop running and switched to barefoot shoes (Merrell Pace Gloves) to keep the weight off the ball of my foot when I taught PE at the primary school where I work three days a week. Even though I use Vibrams in the gym and like them, going to zero heel all the time resulted in an angry achilles tendon. After a year of achilles pain (during which time the sesamoiditis had calmed down) I got frustrated with not being able to run and talked to a friend of mine who is a top physio in the north of England. Whilst he lived too far to treat me personally, he recommend laser treatment and eccentric training. I had a few laser and acupuncture sessions with a local physio and did my eccentric (heel drop) training religiously. I am now back running and did a 10K two weeks ago and ran 9 miles last weekend. I have gone back to wearing Nike Frees at school and also run in Frees (although I still wear my Vibrams at the gym). I absolutely recommend laser treatment if you can find someone who does it.

21/03/2013 at 20:56

Just thought I'd pop in and say hello. Been reading this thread with interest, thanks T-Rex!

I've been suffering with achilles tendonitis for a few months now. Being the stubborn sod I am I just ran through it to start with, which I'm sure made it a whole lot worse. Now paying the price. After realising it wasn't going to go away I stopped running completely and shelled out the cash to see a proper (excellent) physio. Since then I've been doing semi-regular stretching, eccentric calf raises, lunges, leg squats etc plus seeing physio and sport masseur regularly. Basically it appears to be due to a stiff lower back and right hand side, and poor calf strength, so it's all about sorting that out really.

It's definitely improving. Currenly running 20mins every other day, which is better than nothing but still very frustrating. Just going to take time I guess! 

Good to see others getting through this. Good luck to fellow sufferers, I hope it doesn't persist too long!

21/03/2013 at 23:31

Hi Boingy.  it is frustrating but you will emerge at the other side with patience and care.  Looks like you're doing all the right things.  AT is often due to inflexible calves, so stretch them out continuously!  Come down stairs heel first, raise your toes when sitting at desk, etc.  Eccentric and straight heel lowers off a step are very good.  I'd go steady on heel raises.

PSC    pirate
22/03/2013 at 05:50
Does running in mud (sticky mud) cause additional stress do you think? I do support the "don't sit for long periods" comment. It equally applies to hip abductor problems which are exasperated by sitting.
16/04/2013 at 17:43
Hi T Rex. Hope you still look at this thread.thanks for sharing your experience with us. I would welcome your input .Having started suffering AT problems in my left foot to the extent that I'm going to miss VLM on Sunday I found your story whilst looking for a quick solution. This should have been my ninth marathon . I guess my AT was caused by weekly interval sessions I've been doing on top of higher mileage than I've been used to-av 65 miles pw. I didn't really get any warning apart from a little niggle...it's not as though it progressively worsened it just hit me last week after a MLR.
I had AT in both Achilles about 6 years ago and it seemed to take forever to go. Like you I discovered that returning to running seemed to do the trick and unfortunately it took me sometime to start doing this. I massaged my Achilles myself ...very painful and I did stretches heel drops etc. I thought it had gone for ever
Whilst I appreciate you can only speak from your own experience I am wondering how long I should leave it before gradually reintroducing running. The same applies to heel drop stretches. Do you think it wise to leave the Achilles a week or so to let the inflamation subside and just rest and ice or do you think it best to get on with active recovery straight away ? When I tried running last night every step hurt - in my left heel. It got unbearable when I ran at marathon pace. I jogged home slowly though which is consistent with your advice to slow down. When running slowly did it hurt all the time but eventually start to improve? I'm worried about making it worse by running and making it harder to recover by not running.
Hope you can help. Thanks
16/04/2013 at 23:24

Hi 2oldnever - yes I keep a paternal eye on this thread. I'm not an expert medically but I have had immense experience of this injury.  The worst case of it my sports injury therapist had ever seen.  Sounds like you've overdone your training, sadly, but don't despair!

If you are in an acute phase of pain with the achilles continuously inflamed and spongy, stop running. You'll need to ice that, and the best way is to submerge you foot in a bucket of icy water for 15 minutes every few hours. If the pain is continuously very sharp, say about 8/10, you're looking at the possibility of a partial rupture of the tendon which is serious.

Apart from when icing keep the tendon warm.  As soon as you can do light stretching.  When you come up from heel drops favour the good leg. Do eccentric ones as well with the affected foot at an angle. When sitting lift your toes up on something 2-3 inches high.

Try walking properly to start with, forcing yourself to do a proper gait cycle putting the heel down first and not limping.  Come downstairs heel first. Avoid standing on tip toes (if you can in fact do that on the bad leg - I couldn't).

As to running start as soon as you can but very slowly.  Make sure the surface is level and no downhills. You'll find it will be very uncomfortable when you first set out to start with, but if the pain isn't too acute - say up to about 4-5/10 - persevere carefully.  I found the pain eased after about 4 miles and I was able to do a few more miles after that at only about 2/10 pain level before it started increasing again which was the time to stop.

16/04/2013 at 23:39

As you will have read I interspersed my runs with sessions of deep tissue massage from my sports injury therapist, with a run and a massage 3-4 days apart at the beginning, over time gradually lengthening the period between massages and fitting more runs in.  The purpose of the massage was to break down all the scar tissue and free up the tendon fibres.  She referred to 'crystals' within the tissue which needed dispersing - in fact you could hear them crackling as she worked.

It is extremely unlikely you will have the courage to self-massage to the level required - the pain approaches 10/10 - and is best left to the expert.  My therapist spent 10-15 minutes each time on the calf first before moving to the achilles area.

Ice after each run and massage.

Above all, though, keep active in one way or another.  I'm afraid you are going to have to accept poor performances until the injury has completed disappeared, which it will eventually.

16/04/2013 at 23:43

Hello, PSC.  Sliding around in mud most likely to affect thigh muscles I would have thought, especially adductors.

17/04/2013 at 09:51

T Rex - great thread thanks. I've only just found it, but have just read it in its entirety. Some great tips in here too, which I shall definitely be trying.

So much of what you've said rings true for me - lots of sitting and driving at work, very bad pain just walking at times, going down stairs a callenge, pain very bad first thing etc. I couldn't even contemplate self-massaging it either, due to the pain! I'll definitely try the cutting the shoe thing though - not come across that one before, thanks.

Interested to get your thoughts on some of my experiences/symptoms too if ok? I first started having issues in Spring 2011. Probably caused by doing VLM in race shoes (Adizero Adios) - I ran a great time (for me) and had no problems during the race, but the next day both my achilles were in pieces. It was probably a good 10 days after that before I could even walk properly too, let alone run! Since then I've basically been trying to cope with it, but it affects my training quite considerably. It comes and goes I guess, but is a real problem for me when I do big mileage - so I guess an overuse injury.

When i run it's often very painful early doors but then eases a bit. However, at the mo once I've done circa 5 miles or so it then comes back quite badly. Anything over 40 minutes or so leaves me in a lot of pain for a couple of days afterwards.

In terms of 'treating' it. I've tried different shoes and heel inserts etc, and have even experimented with orthotics. But it always comes back. My running 'style' isn't good - poor posture, heel striker, over-pronate a bit, quite a slow cadence etc. It's the toeing off bit that seems to be an issue for me. I just wondered whether you'd consciously tweaked your style, cos you mention concentrating heel to toe - I almost feel like I can't do that, cos the toe off bit causes issues.

Edited: 17/04/2013 at 09:52
17/04/2013 at 10:01

Reason I ask is I've been doing some reading on technique, barefoot stuff, drills etc. Just generally reading up on a variety of things. One thing I feel helps me (but I'm finding it difficult to incorporate into running) is to just pick my feet up instead of toeing off (if that makes sense?) I think I read it in the Chi-Running book.

In that he has an exercise where you walk - but he gets you to imagine you have a little bar on the inside of each ankle. As you pick up your foot you have to lift it over this imaginary bar. So you're effectively picking your foot up in an exaggerated way and doing a sort of circular motion with your foot. I've found (when walking) this is completely pain-free, Now I know it's not feasible to walk like this all the time, but it got me thinking re running technique.

I'm working really hard to try and concentrate on relaxing my ankles/lower legs when I run. They're very tense usually (my body tensing to 'protect' the damaged muscles/tendons possibly, but this actually makes it worse!) When I'm tensed the shock of landing/impact makes my achilles/ankles much worse I think - possibly why I get pain after 30-40 minutes of running.

So I'm trying to relax, have limp lower legs and move my feet in a more circular motion when running now. Basically not toeing off, but picking my feet up, trying to run with higher knee lift and landing 'whole foot' (NOT on my toes) and then speeding up my cadence. When I do this I seem fairly pain-free when running, but I can't keep it up for very long (maybe 5-10 mins).

Just wondered if you'd dabbled with any of this?

My thoughts re me are I need to change something technique-wise. Otherwise I'm only ever treating the symptom, and not addressing the route cause. Think I need to be much more patient though!!

Just interested if you'd made any changes to your form such as this, or whether persisting with the treatment but sticking to your normal style had been ok for you?

Edited: 17/04/2013 at 10:04
17/04/2013 at 11:52

T Rex-thanks foryour input. My achilles doesnt feel soft and spongy more like rock hard. I cant feel a lump in it like the time before when I had problems. Its generally ok to walk on though I was limping after my 5 miler on Monday. Icing does seem to free it up too. The pain seems to be in the heel though when touching the area its ok and its the lower achilles which hurts. I dont think im as badly injured as you were but its bad enough so that everystep of a run hurts in the heel area worsening the faster i run. I think I will try different running shoes. Walking on my heel seems ok too.

18/04/2013 at 00:19

2oldnever.  That's a bit encouraging, actually.  If it's that low and there doesn't seem to be any inflammation you might only have damage to the muscles which connect the achilles tendon to the heel bone.  Muscles heal a lot quicker than tendons which have minimal blood flow. If the pain is in the heel itself there are other injuries in that area that I don't know about.

The answer is still going to be heel drops and other calf stretches.  If you can see a sports injury therapist, if only once, all the better.

 

Hi, LS21.  If the pain is in toe off that makes sense because at that stage the achilles is most contracted.  What you say about running form is very interesting and sounds like would certainly help.  Not tried anything similar myself.

In the long term running in shoes with lower heels - as in barefoot shoes - may help in that the achilles has to stretch further.  In the short term while you're managing AT pain you'd be better off with normal shoes and even putting heel inserts in so the achilles isn't aggravated too much.    When the injury has cleared up I would certainly experiment with different shoes. You're not going to be able to test new shoes in your current state!  It does sound like your existing shoes caused the injury.

At 52 I'm not sure my body is up to the stresses of less cushioning that minimalist shoes would cause.

At the very least all sufferers with AT should cut down the heel tab on their running shoes.  I've done it to all of mine.  Bit of a wrench on new £80 shoes!   As part of your shoe choice look at the height of the heel tab and try to find the one with the lowest.

18/04/2013 at 00:23

I have to say since Feb 2012 I have not had even a hint of AT in my previous affected foot (left).  Often get worrying twinges in the right one but hasn't led to anything yet.

18/04/2013 at 10:00

Excellent stuff cheers. I shall have a play round with things and see how I get on.

And re form/shoes - it's my form I need to look at. I agree that I went down the route of racing flats (not minimalist shoes per se) but I didn't alter my form at all - and that's what triggered this off for me. Moving forwards I'm keen to look at how I land. Currently it's with a straight leg, sticking out in front of me a bit, and landing heel first. Probably how most folk run I guess. So I come crashing down on my heel and I take all the impact through my ankle joint. If I'm only doing 40 miles a week I'm ok with it. But double that for Mara training and I break down after a few weeks. I've had tendonitis in pretty much every area from my calf down.

Hence me thinking of addressing my form. Otherwise I feel I'm only ever addressing the symptom and not the root cause. Will just see how I get on with it though, and report back on here.

Edited: 18/04/2013 at 10:01
29/04/2013 at 11:41

LS21-how are you getting on with your AT? I havent run since the18th April and still have stiffness and discomfort .I am going to try a jog at the end of the week to see if there is any progress. In the meantime Ive seen my GP who prescribed strong anti-inflammatories and suggested I see a physio in a due course if things dont progress. I am now trying to stay fit swimming and easy spinning.Im also doing the eccentric heel drop exercise.Fed up to say the least.

29/04/2013 at 14:16

So-so TBH mate. I tried messing with my gait/cadence a bit as described above - and whilst this did alleviate some of the achilles pain I started getting aches and pains elsewhere. Side of my knee in particular (well, about 2 inches below the outside of knee so don't think it's ITBS-type stuff). So I've gone back to a pair of older, much heavier but more supportive shoes (Nike Lunar Eclipse). I did a bit of running last week. Ran Wed, Thu and Sat and all seemed 'ok' - but on the Sat run I was out for about an hour. After 45ish mins achilles started to grumble a bit, so I had yesterday off and it feels ok again today - so I'll go out again later on I think.

I've found consciously lifting my foot helps - the thing of imagining you've got to lift your foot over an imaginary metal rod on the inside of your ankle or whatever.

I've also been standing with my foot about 6 inches or so from a wall and bending my knee - then trying to get my knee to touch the wall whilst keeping my heel in contact with the ground. Stretches the soleus and keeps things moving in the area where I get stiff.

I've also been doig this - http://www.yinyoga.com/ys2_2.0_asanas_ankle_stretch.php

Don't go mad with this one. but it helps me a lot. Key for me is keeping the ankle joint as flexible as poss really, so these various stretches help that.

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