I think if you have caught it early you should hopefully be able to treat it successfully. I would suggest resting for a week with no running and minimal walking. Cycle of swim if you can to maintain fitness. Doing the squats/ core work is a good idea too
If your achilles pain is insertional. You feel it at the point of attachment at the heel then the general consecious is that eccentric heel drops may aggrivate it and doing concentric calf raises (feet flat on the floor) may be better.
New running shoes may be the answer. If you haven't had a gait test I would suggest getting one done so you can be sure you have the correct shoe.
I would also be icing it at the early stages of injury.
Hi Also-ran, from what I have been told surgery is the last resort if all conservative methods have been tried and failed. That includes at least 3 months of the eccentric stretches and seeing no improvement.
My understanding is that once you have surgery (Which I have also been told has an 80/85% success rate. Coupled with being in a boot for approx 8 weeks) and should that be unsuccessful then all the conservative treatments would then be pretty futile.
Out of interest have you tried that stretch I mentioned in an earlier post with stretching the toes using a resistance band?
Are you doing the eccentrics by starting off on tip toes with both legs. Lift the good leg and lower on the injured one only. Then place both legs on the step to raise up to the starting position?
Does the achilles tendon hurt when you squeeze it between your index finger and thumb?
Where exactly is the pain felt?
I use 20KG in a ruck sack. If bodyweight causes no discomfort then you could try adding weight gradually.
Dan - Alfredson's heel drop protocol was targeted at mid portion achilles sufferers. I'm not sure if it was researched for insertional problems, or if it was I don't think it proved to have much success.
NCoa - no I'm not doing that stretch although having looked at it I think it was included in a rehabilitation program I had a few years back. I'm 100% conforming to my current physios flavour of treatment which seems to be as effective as nothing.
Please may I have some advice on this issue too? I have never had any Achilles problems at all until last week when I did a XC race that was a lot hillier than I am used to running (and a lot hillier than I expected!). Finished with a slight pain in my left Achilles, iced it, felt fine the following day. Took a week off running to be on the safe side and last night ran a very easy, flat 3 miles. Achilles began to hurt about 3/4 of the way through so I came home, stretched, iced it all night and this morning it is very sore and about twice the diameter of the other one.
I assume this is an acute injury so different from a lot of the above which seem to be chronic as a result of running style or a weakness somewhere else in the leg. Therefore ice, NSAIDs (systemic and local?) and obviously rest should be helpful for me? I have it tubigripped-up today, which helps a little. Is there anything physio can do at the acute stage and does anyone know roughly how much rest I should be looking at. Weeks? Months? Mine is slightly above the level of the ankle bone so quite high up.
I know a lot about tendon injuries in horses, but very little about people!
You're probably looking at at least a month's rest, I would say, probably more, based on my experience - if it's the first time you've done it, I'm guessing it may heal quicker than a re-occurrence of a previous condition. The key thing is, when you do run again, if it still hurts, and particularly if it's stiffened up the next morning, then it's time to stop again and give it a longer rest.
I've just done two runs again, after resting my achilles for nearly two months and doing lots of gym work, and I was completely fine the next morning both times, so I will continue to run, but not go overboard. Previously, I would run, then be a bit stiff the next morning, leave it a day or two, run again, and then be stiff again. I know not do do that any more.
Probably best not to stretch it for a short while, give it a bit of a rest and then gradually do some light stretching.
Judging from this thread and my own experience, the achilles tendon is the runner's achilles heel (pardon the bad pun).
I have to say that after 4 years of enfaced rest and almost every possible therapy under rain or sun, my own achilles insertion problem hasn't gone away.
Having said that, it is pretty much under control now. I have learned to adapt my running gait to a forefoot strike (which feels much more natural) and a more supportive shoe.
However, it is amazing the difference shoes make. I bought the wrong shoes a month ago and my left foot (the one with the worst achilles problem) was probably pronating too much. This caused a lower posterior shin splint after a 8 km run and my left ankle has been swollen (though not painful) for 4 weeks now.
I went for my first run yesterday and my left achilles gave me a couple of twangs, the b*stard thing. This passed, though, and no issues today - fingers crossed. Giving it a day's rest before I go for another short jog tomorrow.
No inflammation anywhere now, just the old injury internal scars near the heel bone, rubbing and complaining when there is too much pull, I reckon.
I agree, changing shoes can help with achilles problems - if someone already has a pre-existing achilles problem, using the wrong shoes could make the problem worse or at least prevent the problem from getting better. It's always worth trying a different shoes just to see if it helps in any way.
In my experience, a combination of strengthening my legs and using a lighter, less structured shoe, with just a touch of support and a different heel-to-toe drop, means I now land more mid-foot than heel, and feel like I'm spending less time in contact with the ground, which can only be a good thing.
Here's my experience. 2009: averaged over 40 miles per week - 2200 miles. February 2010 got discomfort in both achilles. Rested for a couple of months. Seemed ok with slow jogging. My big mistake was running a 10 mile race in July which set me back a long way.
Tried running again at the start of 2011 (walking ok by then) but had to give it up after a couple of months ever though I was only running a couple of slow miles. Tried again in October 2011 with more success. Managed a year and a bit of fairly slow running. Less than 20 miles per week, no races. Initially running faster caused problems but the achilles problems gradually improved. The main problem was pulled muscles, presumably because of lack of condition.
Skiing accident in January 2013, started running again in July (could have started earlier but lack of motivation). Gave up running again in January 2014 for three months. Since then running a bit more, maybe 25 miles per week, even a few races. Doing 21 something for 5k rather than 18 something. Currently 5 kg heavy than I was 5 years ago.
Only thing I've really done for my achilles is to rest it. No other treatment. Seems ok now but being cautious.
Just to throw in my recent experience and how I recovered, i damaged my right achilles in August last year. I had a few more races to run so cut back the training and turned up and ran anyway. I felt fine once I got going, I just hurt in the morning. I'd already decided that come October I'd rest until the new year ready to go again.The pain improved, but I still had stiffness and discomfort in the morning. It lessened little by little each day but wasn't going. I still couldn't run without aggravating it.I found that I still had some weakness there, which was easy to test - stand on one foot and lift yourself onto your toes, compare with the healthy side. It wasn't until March that this weakness fully resolved.But I still had pain, I went to a physio (not my normal one) and we started doing some heel drops. I could have done hundreds of these without any weakness or pain but all that happened was after a few days my achilles was more painful although not weak.I visited my usual (more expensive physio) a few weeks later and we started on some more basic exercises and again everything was ok, but the pain was still there. But it was something else we discussed that got me thinking and seemed to improve my condition.Apparently the tissue around the injury can get into a cycle of inflammation and it can be hard to break, so I was asked to massage the area to break down the inflammation and break this cycle. You pinch the area tight and move your fingers up and down the achilles. I used some voltarol gel to aid this and reduce the inflammation and voila in a few days the pain had gone.I started running, just a mile and still no problem. I went back to the physio and explained what had happened and that I felt it was just the aggravated tissues as opposed to an actual injury and it was agreed I start running again.In training for half marathon for the first time in a year now P.S. Really important that I say, this isn't some miracle cure, but that you need to find out whether the achilles is healed and strong or whether it is just a bit angry from swelling and inflammation. If it is still weak it needs rest.
I have had Achilles insert pain slightly when I walk. I developed it 5 weeks ago after a training run the following morning. I carried on running but cut my mileage a lot but no improvement, as it would be fine for a run then the following morning sore slightly. I haven't run for three weeks and stopped cycling as that also makes it sore. So I after some advice please as physio Said its minor but its not improving,p and don't know what to do.? I have stopped squats and leg work outs to.
Yiannis If simple leg squats are enough to irritate your achilles insertion I think complete rest for a few weeks and ice on the heels might be appropriate. Also, you should talk to your GP in case you have a fracture in your calcaneus.
It doesn't hurt when I do the squats but is sore the next day
After suffering for over 5 years with achilles problems, I have found there is no magic bullet. The approach that has worked best for me is in the short term, total leg rest (swimming and upper body exercises being the only exception) and deep massage of the calves. In the longer term I have retrained my running gait to a mid-forefoot strike as, in my case, heel striking exacerbates my injury within seconds. I did have a hairline fracture in my left calcaneus, I didn't have it checked and I struggled with constant pain (even from walking) for nearly 4 years. I'd advise anyone not to muck about, have your injury checked as soon as possible and rest your injured leg for at least a month before you start running on it again. It not a pleasant prospect, but better than hobbling your way about life for half a decade.
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