Achilles tendopathy - been told to stop running. What other exercise can I do? - Health + Injury

Louey

27/09/2012 at 15:24

Any advice welcome. GP and now physio have diagnosed me with achilles tendopathy and I've been given exercises etc to do. Physio told me yesterday that I need to basically stop running to give it time to recover and that it can take a long time .

I'm doing a 10k on Sunday (which I'm still intending to do after all the training I've put in) but after that I will stop for a while. But I really don't want to lose my fitness or put the weight back on that I've lost. I know I can swim but are there any other non-impact exercises I can do? I have access to a gym at work with bikes/rowing machines etc but I don't know if using those will count as resting my achilles.

Physio said that I can run a bit every so often to test the injury but I was running 3x week 5-7 miles each time and that is too much. I'm so gutted!

I'm also waiting for a scan on my ankle as I have a lump on my achilles and physio says its quite large.

WiB

27/09/2012 at 16:33

Could the physio who has checked the injury not advise you on what you are able to do?

Seeing as you are diagnosed with the tendon injury, and also awaiting a scan on the ankle and you are about to go and race anyway this weekend maybe you should just rest and recover properly afterwards?

If you want to do something, swimming may be a good option to try and avoid any pressure on the injured area.

Tom Goom

28/09/2012 at 20:51

Hi Louey,
You should be able to cycle and use the gym providing it's pain free. I'd keep the resistance/ weights low at least initially. With Achilles tendinopathy it's often about keeping the stress at a level the tendon can manage, not about resting all together. That said, there is a risk of tearing the Achilles if the tendinopathy is advanced so you should be careful with anything involving high loads or sudden movements (such as racquet sports).

Paul J-R

28/09/2012 at 21:57

Hi Louey, I was just in the same situation with sore achilles, I can now do two 20 minute runs a week and increase it by 5 minutes a week. To keep my fitness up I'm swimming (lessons at my gym), doing spinning, cycling outdoors, weights, rowing machine and core workouts. For specific running fitness I've been water running.

In fact the last month of very little running I've lost 2kg, now down to 66kg. I was actually expecting to put weight on!

neil jones 26

28/09/2012 at 23:06

Hi Louie, I seem to have something similar so really feel your frustration.

My problem started mid August just after coming back from a minor injury.
Went to the physio and had two weeks off and the lump on the bottom of the achilles more or less went. Nevertheless, got referred to the traumatologist and getting it x-rayed early November! Anyway, had been back running for a couple of weeks at gentle pace and distance when it flared up again after running a more hillier route. No pain, just the lump getting bigger. This happened a fortnight ago just before going on holiday. Decided not to run on holiday but we've hired bikes and have been cycling everyday, nothing too heavy, with no after effects.

As well as the cycling been doing calf raises, eccentric heel drops and resistance band exercises. The lump seems to be gradually going down again and I'm going to do a slow 30 minute run on Sunday to test it.

Tom Goom: do you think this exercises could be beneficial for the type of injuries described by Louie and myself? Thanks

Tom Goom

28/09/2012 at 23:47

Hi Neil,
The exercises you mention should all help, especially the heel drops. Just make sure you build up slowly.
I've written an article on achilles tendinopathy you might find it helpful;
http://www.running-physio.com/achillestendinopathy/

neil jones 26

29/09/2012 at 00:05

Thanks very much Tom. Can't seem to open the link but having problems with the mobile / coverage this evening. Will try again tomorrow. Much appreciated.

neil jones 26

29/09/2012 at 11:36

That's a really interesting and informative read Tom, many thanks again. The photos showing how to do the eccentric heel drops are really helpful and show me that I need to tweak what I've already been doing. Cheers!

Michael Clark 3

24/10/2012 at 19:08

Being doing the heel drops for 10 weeks now and my achillies still has the sore point plus is painful to run on. Feels like it never going to get better.

Paul J-R

25/10/2012 at 00:00

Michael - how much running you been doing? I did heal drops for about 8 weeks, crossed trained and ran twice a week, slowly, now I'm beginning to add some speed with my running and I'm recovering.

Are you doing the heel drops with both straight and bent knee, 3 sets of 15 twice a day? That's what worked for me....it's a boring as hell, and embarrasing when you're out and get caught...but it's working.

neil jones 26

25/10/2012 at 10:31

I was wondering the same thing Michael. Maybe you're doing too much running?

I've been running slower and shorter distances 3 times a week since the beginning of the month plus one cross-train. Like Paul, I'm also doing heel drops, albeit only once a day some days. I feel it's slowly getting better (some days it seems better than others) but it never hurts when I run or probe it. I've just got this bump on the outside of the heel that never quite disappears. Got an x-ray due a week on Monday.

Paul, does the skin feel very tight when you do the first couple of heel drops? This something that I've begun to notice more and more recently.

Either of you guys use a heel insert?

Michael Clark 3

25/10/2012 at 18:05

I didn't run for the first seven weeks of the exercsie. Started to run once a week just 2.5 miles. Being doing the heels drops bent and straight, plus with the racksack with weight in it.

Been cycling to try and keep the fitness going.

neil jones 26

25/10/2012 at 18:54

Sorry to hear that Michael. It must be incredibly frustrating for you. Hope this isn't a daft question, but have you had it x-rayed, been to a physio, etc?

Michael Clark 3

25/10/2012 at 18:59

Saw the physio at the beginning of August, he diagnosed the problem. Haven't been back since, said there was no need to, I think I be booking an appointment soon.

Brook

26/10/2012 at 19:09

Mine took a good 6 months the first 3 months of which I didn't run at all.
I also recommend the heel drop exercise.
The other thing I had was shock wave therapy. Three sessions in March/April and another three in early October. Not cheap at around ??200 for each 5 minute session! Thankfully BUPA paid mine.
If you don't know it's a hand held device like a cress between a drill, gun and hair dryer and pounds the affected area like miniature hammer blows. It really hurts but only during the five minute session, not at all afterwards. It apparently has an 87% success rate but they don't fully understand why it works. I cannot be certain it helped me as opposed to time, but on balance I think it did and would recommend it. I've just completed 20 weeks and around 800 miles training for the NYC Marathon next Sunday so I guess that's a good commendation. I also recommend anthroscopy for meniscus injuries which I had a year ago and did a quick for me half marathon three months later. Thanks again to BUPA!

J77

28/10/2012 at 08:12

Brook, can you tell me a bit more about your shock wave therapy? I've been dealing with Insertional AT for about 6 months now and I just can't seem to get rid of it. I've tried almost everything with the exception of Graston and I'm wondering if I'd just be better off going straight to shock wave and not worrying about other conservative treatments. How did you feel after the first three sessions and may I ask why you went back in October for another three? Did the first three not work? I've read that treatment is usually 1-3 sessions and since I'll be paying privately I want to make sure I've got the funds. How much, if any, running did you do after each session and do you experience any pain or stiffness at any time now? Thanks for any advice you can provide.

Brook

28/10/2012 at 19:11

Hi J77. Yes 1-3 sessions 7-10 days apart and five minutes each is the norm. As I said it hurts while being treated but that pain stops as soon as the treatment stops. I did feel some instant relief afterwards as the specialist would normally pinch my tendon before treating it to identify the area of pain and that would really hurt, but when he did likewise after the treatment I couldn't feel anything. However the next day I would typically feel a little soreness. As I previously said the first three were I think effective. BUPA had said they'd authorise up to three sessions but when in September I felt a twinge that was quite painful, but just for a second, my fear of New York being threatened led me to ask BUPA if they'd authorise three more sessions. To my surprise they said yes so I booked the sessions as a precaution, but when I actually went I could feel virtually nothing but thought what the hell, I'll still go as BUPA are paying. I'd say then that the first three sessions helped and the second three probably weren't necessary.
As I speak my achiles is 99% better with only an occasional but negligible twinge.
I hope this helps and I do recommend shock wave therapy for this kind of injury based on my own experience.

J77

28/10/2012 at 20:12

Thanks Brook. I'm thinking I may not bother with Graston and just go straight to shockwave therapy as I would be paying for that out of pocket as well.

Paul Collins 22

04/11/2012 at 13:03

If you would like any more information about shockwave therapy please feel free to PM or email me. I use Shockwave therapy for athletes on a dailly basis and would highly recommend it for achilles tendon problems in particular.

The treatment is non invasive and involves little time off. visit www.shockwavetherapymiltonkeynes.co.uk or www.miltonkeynesphysio.co.uk for more information.

Kind regards

Paul

Louey

08/11/2012 at 20:16

My notifications seem to have stopped so I didn't realise there were loads more replies (and very useful ones too )

Tom - that article is really useful, thanks for posting the link.

I stopped running for a month, have had weekly physio and ultrasound therapy each time. Physio gave me eccentric loading exercises which I've been doing pretty religiously - started off with simpler ones and now am doing the ones described in Paul J-R's post.

Had an ultrasound on my ankle and radiologist diagnosed it (again) as achilles tendopathy. He said I needed to see a foot/ankle orthopaedic surgeon and gave me a name of a couple he recommended. Fortunately (I thought) I have private medical insurance so bypassed the NHS at this point and booked direct with the consultant he recommended.

Consultant recommended shockwave therapy, but then said that my insurance company is the only one that won't cover it as they say its experimental. Sure enough, on phoning up they wouldn't. Nor would they cover dry needling, which was his backup plan. He is now writing a letter to them but I'm not hopeful that it will change their minds. I've asked about paying to have the shockwave therapy but his secretary said it was around £500 per session . I would be interested to find out how much you charge Paul Collins, although I'm too far away from you.

So having not run for a month and not having any pain (but the lump was still there). I did a 5k and it felt better, but I could still feel it from time to time, especially as I got tired. Then I went on holiday and by the end of the holiday it was really hurting again (having not run at all). So I decided that not running was worse than running and did a 5 mile run this week and it was ok, still niggled and sore afterwards but I iced it and it was fine the next morning.

I have also got a place in the VLM so really want to keep my fitness up before xmas and then start the longer runs after then.

Consultant said I could run as long as I didn't run hills or fast and didn't do longer distances. Not sure whether I'm setting myself for long term problems or not.

(Sorry, that was long!)