Achilles tendonitis

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  • M.. TRI - That's OK, I've only just written it.

    Careful with ladders!  Can you avoid them?

  • Boinged.

  • Up date:

    No recurrence of this injury in the latter part of 2012, despite some gruelling races including Lakeland 50 and North Downs Way 100!

    No new comments on this, but I'm bringing it forward ...

  • ... for paul b 3

  • I'm wrestling with an achilles problem and have been for about 6 months.  I had a broken bone in my foot last year and such was my excitement at that finally healing that I went out and ran 12 miles and did the achilles in.

    It's not really bad - nothing like what has been descibed on here.  It's sore for about 10 steps in the morning and that's about it.  Doesn't really hurt when I run.  The achilles itself has a lump on the back of it which varies in size seemingly randomly and although it's more sensitive than the other achilles, i would say that it is "sore".

    I'm not 100% sure what to do - I don't really like hobbling about the morning after a decent run though. My strategy currently is lots of heel drops and stretches and regular 4 - 6 mile gentle paced runs so at least I can get out there and retain some fitness.  Blimmin pain though.

  • Elstead - you're doing right what you are doing.  If you can bring yourself to do it you could deepen the notch in the heel tab of your running shoes with a knife. This will help prevent irritation.  Try to keep active and avoid sitting for long periods.

  • Thank you very much for this thread - its come as a good warning for me.

    I'm starting to have concerns that I am at the very beginning of a problem and keenly wish to nip it in the bud. My achillies on my left foot has started feeling tender and stiff. To look at and touch there is no change. It feels better when I used deep ice (but not deep heat). I very rarely wear heels. My running schedule has increased but at a steady pace over a year. 

    One thing I am attibuting to the cause is the way I sit at work. I think my chair is too high so dont have my feet flat so as of tomorrow this will change. But always the crutial question - can I carry on with my training program. Approx 37 miles a week with a long run of 20miles plus (reduce every three weeks). 

    Thanks again for this thread. 

  • Thread's a year old now but reading it all again I feel it all still makes sense.

    Long periods of sitting are bad for knees and ankles.  VY - ensure your heels are on the ground and you could try resting your forefoot up on something when you're at your desk.

    Yes keep training, but I'd avoid speedwork and hard downhill efforts for the time being.

  • Only just come across this thread. I've been battling with mild AT since the sdw100 last year. Training for grandslam this year but the AT still isn't 100%. Good to read you still ran whilst getting your injury sorted. Going to have to cut the heel tab down on my trainer's then by the looks of it I had read this could help now where is the knife.........image

  • Lingster - most AT clears up in about 6 weeks but for a few unlucky ones like me and others it can take 15 months.  Keep up your running, just cut down on intensity.  Don't write off your 100-milers!

    It takes courage to cut your shoes like that and it does shorten their life span but I've found it helps a lot.  Also choose new shoes on the basis of low heel tabs, e.g. some Mizuno shoes.

  • After a hip flexor injury last autumn I've been slowly venturing out again, and loving it, until I felt a "ping" in my left Achilles a month ago. Looked into it and think it's AT, but dare I say that now I've read your thread, I'm not feeling so bad! Ok it gets sore on runs, first thing in the morning, etc., but stretching it out through the day, although comfortable, does help a lot. Having read your there'd I tried an easy 6 miles today at a much slower pace than normal, and not one ache! The tendon is still a lot more swollen than the other leg, but without going silly you've spurred me on to keep running.



    I'm sorry you've been through so much pain, but I'm afraid to say it's cheered me up no end!
  • What an insightful post. I wonder if I could get some advice...I am training for my first half marathon, BathHalf in 2 weeks time, and after running my longest distance of 12 miles last Sunday I felt a few twinges in the left Achilles that disappeared after a couple of hours. On the Tuesday, I ran 4 miles probably a little too fast and had really bad pain and swelling in the same spot the next day. By Thursday was feeling much better, still slightly thicker than the right and going down the stairs is not great. I have been icing regularly and doing eccentric heel drops daily (2 x sets of 20).



    I haven't run since and am going to the gym tonight to get on the bike and the elliptical, my main question is, should be doing anymore running and should I run the half?



    Any advice will be most appreciated...
  • Bike and elliptical were fine tonight with no pain from the Achilles.
  • That's good.  I was thinking the bike might not be a good idea.  Pedalling contracts the achilles quite a lot.

     

    To be on the safe side to cover you for your race I'd put heel raises in your shoes e.g. Sorbothane and be prepared to revise any expected time downwards.  You wouldn't want the injury getting any worse.

     

    The long term strategy is the opposite, though.  Take the heel raises out, keep the heels low all the time and do those stretches.  Come down the stairs heel first.

     

    Although the left achilles that had the injury is now absolutely fine I get twinges in the right one from time to time and I have to say I get a nagging worry it might turn into tendonitis, but hasn't happened so far.

  • T rex, thanks for the prompt reply. No real discomfort today after the bike and elliptical just a bit of discomfort when first walking that passes after a short while.



    I have bought some heel rises today and trying them in my running shoes does make a positively marked difference in feeling.



    My main concern is when to actually next run, bearing in mind that the half is on March 3rd. Should I take a full 7 days rest and run on Wednesday at a slower and easier pace? Or should I stick to the none load bearing activities at the gym?



    I have only been running for a year and wasn't prepared for just how bad not being able to get out and run is making me feel and of course, really want to run the half but don't want to create something more chronic.
  • In my experience AT is an injury you can - and I would suggest should - keep running with, even 'racing', but with the following safeguards:

    • slow the pace right down
    • avoid hard sessions such as speedwork
    • take great care descending hills.  Very important.  This will be your biggest danger.  And certainly no crazy fellrunning-type descending!
    • keep to an even surface
    • concentrate on a good heel to toe gait

    Although you will have pain in the area you should find it will ease off after a number of miles.  If the pain becomes very sharp, acute, as if you're being pinched in that area, stop immediately.

    So, no, I wouldn't rest.

    The heel raises will make you foot more unstable which is why you shouldn't use them in the long term.  If you can bear to do it you might like to consider deepening the notch in the heel tab in your shoe with a knife.

     

    How many runs a week do you normally do?

     

  • I read your comment in an earlier post about lowering the v in the back of trainers and a friend's father who is a doctor mentioned the same thing today.



    I have been running 3 times a week, Tuesday an easy run at around 40 - 50 minutes, then speed/interval on Thursdays with a long run on Sunday.



    I had been aiming for a half marathon time of just over 2 hours.



    Would you suggest that I wear the heel raises from now on for training?



    I have also made an appointment with a sports therapist for a weeks time after a week away for work.



    Thanks for the advice, I really appreciate it.
  • 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.

  • 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.
  • 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.

  • 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.
  • 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.

  • 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! image

  • 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.

  • 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.
  • 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
  • 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.

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