Painful Achilles

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15/05/2012 at 12:33

Hi all, I've been suffering for a week or two from pain around my left achilles tendon. It isn't the main tendon but more where the white arrows are in the picture below:

http://s4.runnersworld.co.uk/members/images/683349/gallery/1004_5.jpg?width=350

The pain eases when I'm running but comes back afterwards. If I lift my big toe on the same foot the pain passes through to the indicated area.

I've tried strapping it to reduce the movement, i've tried stretching.

I can't really afford to see a specialist at the minute, and I normally find that they always 'need' for you to go again.

I ran Brighton Marathon without pain and I suspect new support trainers were the cause. I've recently changed those and other aches and pains have gone but this one remains.

Any ideas? anyone suffered the same agony? any solutions?

Edited: 15/05/2012 at 12:35
15/05/2012 at 13:39
Posterior tibialis tendonitis perhaps? I had a similar thing a few years ago but without the pain when lifting up my toe..... I got an extra pain on one of the bones in my midfoot though. I didn't run for a couple of months and it settled, saw a podiatrist who said it was because my left leg is shorter than my right so I pronate more on that side which was putting excess pressure on the tendon. All was fine and had started to up my milage recently when it started to niggle again so I've just been holding my mileage where it was and doing lots of calf and post tib stretching which seems to be keeping it from getting worse....... wo maybe mine wasn't caused by leg length difference? Who knows!
15/05/2012 at 13:47

Thanks for the reply.

I've just look Posterior tibialis tendonitis up and it pretty much describes my problem.

I seem to be spending more time resting than running these days.

15/05/2012 at 14:04
Yeah, its a bugger, mine felt absolutely fine for weeks and then just got a little twinge and has felt tight for the past week...... Hence all the stretching. I'm just hoping that knowing how it felt last time has let me catch it early.

Check out these:

http://www.livestrong.com/article/312900-exercises-for-post-tib-tendinitis/

http://standingontop.com/blog/runner-communities-barefoot-running-posterior-tibial-tendonitis-1-runners-world-forums/

Let me know what advice you find...... Would love to be rid of it!
15/05/2012 at 14:07

I have had that too, exactly where you are describing. took 2 weeks to get rid of, with ice, massage, and don't walk around flat footed, get some heels on!

15/05/2012 at 14:23

I've read somewhere about walking around barefoot. I do it all the time at home.

Is it a re-occurring injury for you Max's Mum?

15/05/2012 at 14:33

Hi, it was in January and I havent had it since. Even after the VLM.  Normally walking about barefoot is fine, just try not to just while the tendon is getting better as it just makes it worse. I run most of the time in barefoot shoes but this i think was caused by another shoe rubbing against the tendon and aggravating it. It was slightly sore for a week or so, then suddenly i couldnt run on it and could hardly walk!

One tip, i found that the little stick on gel patches sold for migraines worked wonders in relieving the pain and also padded the area against shoe contact.

15/05/2012 at 14:39

Thanks for the tip. I'll try that.

I brought a pair of Brooks Trance 11 support shoes before the Brighton Marathon but failed to wear them in in time for the race so ran in my old one's. I tried again post Brighton and found they we're killing my calves so I took them back. They were my first pair of support shoes and I think they restricted too much movement.

I suspect they are the cause of my problem and I've just been making it worse.

My new Mizuno Wave Inspire 8s have relieved the calf pains so fingers crossed.

Its a nightmare injury because it's one of those that you don't notice when you run so theres always a temptation to go out.

15/05/2012 at 16:52
I'm hoping mine is calf related this time as it seems to be better after stretching. Not walking barefoot is interesting, as I always tend to do so at home.
15/05/2012 at 22:33
Hi,
The pain with lifting the big toe is interesting, I wonder if there is an issue with the flexor hallucis longus tendon. It runs very close to Tibialis posterior and would be stretched when you lift the great toe.
Try balancing on your sore foot (if it's not painful), see what happens to your toes, do you claw your big toe for extra stability? What happens to your arch when you balance? Do you overpronate? You might be using flexor hallucis to give you more stability and it's become inflamed as a result.
Let me know what you find!
Tom
16/05/2012 at 08:24

Hi Tom.

If I balance on my left foot there is minimal pain and I don't appear to be clawing my toe.

I do slightly overpronate and have high arches so I am naturally struggling to maintain the balance. I don't have this problem with the right foot.

Many years ago I did sprain my left ankle pretty badly when playing football but I've been away from that game for four years now.

Another thing, and this may seem strange, I have noticed when I walk barefoot that my left big toe lifts as I walk.

Gaz

16/05/2012 at 09:57
Hi gaz, I have normal arches and wear neutral shoes with the addition of a wedge in my left shoe to compensate for my left leg being shorter than the right.

The times that mine has flared up has been after wearing thin soled shoes or trainers following a run.

Think I'm going to get some orthoheel insoles from boots to shove in my work shoes to give me a bit of support throughout the day as I work with children so spend all day crouching and kneeling down.
16/05/2012 at 10:15
Tom - will calf raises help ptt? If so would you be better to do these with straight feet, pigeon toed or with feet pointing outwards?
16/05/2012 at 12:19

think Tom is right about the Flexor Hallucis Longus and the big toe

http://www.triggerpoints.net/triggerpoints/flexr-digitorum-and-hallucis-long.htm

16/05/2012 at 14:04

So its obviously a tendon and needs rest but should I be stretching it? not stretching it? Should I get a massage on my calves?.

I find it difficult sitting still.

16/05/2012 at 14:15

The link above was for forty44, sorry!

I don't think there is need to sit still, I went out walking, and attempted to run (more like hobble) but couldnt walk around and touch my heel to the floor (hence no barefeet) without pain. I used 'normal' running shoes and also put in heel raisers! prob not the best thing but i had started my marathon training and didnt want to stop (idiot!). I found that with that, ice, ibuprofen gel, and gentle massage of the tendon, things started to ease up after a week. Then i took the heel raisers out for another week. Then started stretching once it wasnt really painful. carried on with the cold gel patches and ice packs, and massage. The following week i went back down to minimalist shoes (not barefoot) and didnt get back into the barefoot shoes until about week 4. . . . very tentatively!

Of course you may find something different works as i am no expert!

16/05/2012 at 14:20

actually i got a bit mixed up who had the big toe problem, sorry!

if its the muscle attached to the tendon that is the problem i would say stretch

if its the tendon itself i would say don't stretch (at least not yet)

16/05/2012 at 14:23

I think it's difficult for us all to figure out how to control these things without professional help. But it's nice to hear how other people have coped with similar issues, so thanks.

I'm currently three weeks into another marathon training schedule. Last week I hit 42 miles for the week and looks like i'll be dropping back down again this week. So frustrating.

16/05/2012 at 14:59

Is there any swelling around the tendon? if not I doubt that the actual tendon is your problem. it will probably more likely be the muscle that is attached to it. But as you say, always best to get docs advice!

 

16/05/2012 at 15:07

No swelling. I'll try stretching it more and maybe a light jog tonight.

I am working to a new schedule which has some very slow recovery runs. When I first went on one of those I did seem to develop some pain in my lower legs from holding back.

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