Achilles tendonitis

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  • HK Pink Lady - if you live in HK you should be able to find a practitioner who does Graston therapy or a Chinese version of it.  It sounds like scar tissue might have built up which can cause the bump to remain and pull on the tendon.  (relurks from fantastic thread)

  • Wow, I wish I had read this thread 5 weeks ago.  I've been wearing a boot for most of that time. Sounds like that was not a good idea.  Also, therapist had me doing some toes raises which evidently was not a good idea either.  Also, haven't ran in 5 weeks which  sounds like a mistake as well.  I was supposed to go one more week of wearing the boot and no running.  Actually think I'll store the boot and go for a short run tomorrow.  I think my Achilles needs a little work.  Thanks everyone.  Some fantastic advice here.

  • Jay T2 - if you have definitely been diagnosed with achilles tendonitis that is a terrible collection of tips!  Toe raises are just about the worst thing to suggest.  But the fact that you could actually do them means the problem isn't so serious, thankfully.  With bad cases of AT you don't feel as if you have the muscles to do toe raises.

    Ditch the boot, toe dips are the way to go, and resume low intensity exercise on level, smooth surfaces, but don't continue to push through severe, acute pain.

    I know some people would question my continuing to run, including long ultras of 101 and 96 miles, but they were part of a carefully controlled recovery process.

    My posts are very lengthy and I was wondering if I could condense them and re-post on a new thread, but this one has found some new life.  I was surprised not to get more responses at the time, but the thread got targeted by someone who I suspect was some sort of troll.  I may be wrong.

  • Thank you so much, T Rex.  I have to say the boot, therapy sessions, and no running for 4 weeks have not helped to any great degree.  I still have the knot in the middle of my tendon which never hurt too bad when I ran but is very tender when manipulated.  What really scared me was when the doctor looked at it and said running could cause it to rupture.  That got my attention quickly and I decided to take his advice regarding the boot, therapy, and no running for 6 weeks.  I'm following your formula beginning tomorrow.  Thanks again. 

  • I'm not a medical person in any way, mind.  Things that might cause it to rupture (now, not normally) would be playing squash or badminton or mad, fell-running type descents, or anything else high impact.  I'd avoid football as well, and rugby.

    Clearly something has aggravated the tendon, but it is not always clear what. In my case I put it down to running shoes with too high backs.  It can come on as a general running injury if you have increased the length and intensity of your sessions too quickly.

  • Interesting information.


    I have had tendonitis for around 9 months. I gave up regular running for 7 months but missed it so much. I have run a couple of 15 k races without problems. However about 2 weeks ago I felt good and ran 21K. I was feeling confident and hoping to run a marathon next spring probably May. However in the last week have done short runs with foot pain int he right foot and tingling in the Achilles Tendon so planning to rest for a few days now.

    Feeling frustrated due to this and do not want to stop running.

  • I ran a marathon (quite slowly) recently with tendonitis in my right achilles, and I learned a couple of things, firstly that hopping twenty miles is really sore and best avoided, however I did run the first six miles quite happily at a reasonable pace.

    My first reaction when my achilles kicked off two months ago was that I would have to give up running or I would hurt myself. The third option is to take it easy, but keep running regular short runs. I typically do two or three miles at a gentle pace then ice and elevate as soon as I get back home.

    It still hurts a bit but I haven't had to give up, which is good. Lots of cross-training on the bike and the elliptical trainer keeps me fit too.

  • Great thread Rex. Had tendonodis for about 3 months now and under physio for 1 month. Initial acupunture and ultrasound gave some relief as did the soleus stretches. However this last couple of weeks the ultrasound just seems to a cause spongy swelling for 2-3 days after. 

    They also said no running at all, just a bit of bike work. I got so flustrated that I just sneaked in a slow 1k and now it feels quite good, no niggles during either - not even at the start of the run which is she things used to be the worst. Thing is now I'm confused by the advice not to run the physio gave me and the puffiness their treatments seem to give me.

    Aggressive massage will actually move the achilles lump around and flatten it too, however it causes some swelling the next day. 

    Any advice guys? Cheers

  • Personally, Whippets (love those dogs!), my Achilles came from tight calves and then fast miles on hard surfaces.  I have managed to sort out the problem after a lay off of a year, and self-manage it quite well using home ultrasound and a variety of foam rollers when I feel tightness coming on.  I also condition and do core/stretching work 3-4 hours a week.  

    The best foam roller by a square mile is the Rumble Roller which I cannot recommend enough.  I have The Stick, the white foam roller and the Grid but can quite happily dispense with those in favour of the Rumble Roller which is like having your own massage therapist get into those tight spots and release them while you gently roll until you feel the release.  They are quite pricey but well worth it and I would recommend it to anyone with Achilles issues which can be found to stem from the calves.  

    Graston worked a treat in reducing the scar tissue so my bump is very small now and no longer pulls so affecting my movement.  When I initially had it I would have bruising and major soreness as the Chiro who did it had no mercy but I found this was really the only way to do it.  Best of luck with it all!

     

  • I also had acupuncture but although I had it once a week it wasn't enough to counteract the issue which never went away until I started getting more aggressive Graston therapy and addressed the tight calves,  I did also get customised orthotics from a local sports dr/podiatrist which made a major difference.  I do think unless you identify the cause, the treatments will have short-medium term effect at best and then the problem could return.

  • Thanks MsE, lots of info there. Yep the dogs are great but not the best running companions - its all about short burst for them!

    Got to say I think I over did the massage on the lumpy bit - flattened it out at the time, but caused quite a bit of swelling and stiffness the next day. I'm not entirely sure if this is good or bad? I'm thinking possibly good as the body maybe dissapating the broken down scar tissue - then again possibly bad as swelling and pain tends not to be good!

    My condition came on after moving to a hilly area combined with shoes that I now think were not supportive enough. The extra stress of the hills didn't affect my leg with little pronation, but did affect the leg which pronates considerably more. So more supportive shoes for me (both sports and everyday) and we'll see where we go from there.

    Gotta say I'm finding this condition rather expensive!

  • Whippets-have you tried extra corporeal shock wave therapy? Google it for an explanation.Ive suffered with AT since April (left) and September (right)and the shock wave therapy enabled me to return to running.I still have swelling in both and some days its painful but over the last 5 weeks Ive gone from 0 to 10 to 23 to nearly 40 miles pw. Ive still got a way to get to full recovery but this treatment plus stretches and cross training are making a big difference. Im not convinced total rest is the best solution apart from the initial week or so of it coming on and I feel running with it helps although I heed my physios advice and never allow the pain level to go beyond 4/10-mild discomfort.

  • Thanks 2old, by coincidence my physio suggested that last night. Not that she has the machine to do it herself. She also suggested that it would cost about £150 a time and may need 3 treatments! Think I'll have to go to the GP and try to get on a waiting list as I simply cant afford that (if her estimate was accurate). In the meantime stretching and a very gradual return to some light running I think as keeping it moving seems key for me.

  • Whippets- that's expensive..no wonder BUPA are not keen. It is worth it if nothing else works . My physio thinks he's probably going to try acupuncture on me to address the swelling. i had the misfortune to trip on a grid which had the lid missing tonight..I was worried I'd aggravated the AT but they seemed to be ok. I was also worried I'd aggravated my broken wrist and I will see how that is tomorrow. 

  • Deep tissue massage of the tendon will cause some inflammation for 1-3 days afterwards - depends partly on how skilful your therapist is - and I would avoid running on those days.  Do your runs midway between massage sessions.

    I personally don't rate ultrasound, but that is from a non-professional point of view.

    Don't stop running, but do stop sitting for long periods!  Low intensity on level surfaces.  Heel raises (inserts) in your shoes if that helps.

    Above all, be patient.  You're in for the long haul with this.  It may mean a year or even longer of underperformance but you'll be back, and a lot wiser about injury prevention and cure.

  • "but do stop sitting for long periods"

    Agreed. I sit at a desk all day and the biggest improvement to mine was getting up every 30 mins for a walk and stretching it whilst sat down.

     

  • T Rex-agreed about sitting long periods .What did you do when asleep as when I wake up my achilles are like concrete? Not sure about heel inserts as I think they shorten the achilles which then leads to pain in the heel for me  when stretched whilst running or other extension type efforts

  • Have you got a night splint 2oldnever?  Keeps the foot flexed and stops the achilles shortening during sleep.

  • For a year I avoided any activity that involved overly working just the calves (eg at ballet/bar class I kept feet flat on the floor) and now, having recovered, still avoid high heels and sitting on the balls on my feet.

  • MsE- no I don't gave a night splint though I've heard about them. Where can I get one? Thanks

  • suffered from AT for the past two years or so, I think that I have finally got rid of it. Physio and insoles, researched the internet for insoles and found silly prices but bought some from Lidl and it seems to have worked. No pain whilst running and can walk the following morning rather than hobbling about for five minutes.

  • Sleep with your feet off the end of the bed (which I do anyway)?  Night splint sounds like would be a good idea.

     

    You will have to accept that first thing in the morning is likely to be a bad time and move around slowly to start with.  At least overnight any swelling will have gone down a bit.  Try sleeping with your foot elevated as well on a couple of cushions.

     

    I agree about the heel inserts in shoes - they might offer short term comfort (e.g. if doing a race) - but better off without them for the long term.  You must do anything you can that extends rather than contracts the achilles.

  • Had a quote for shock wave therapy this week and was shocked, £180 for initial consultation then £900 for 3 sessions! No way I can take that up, has anyone else had prices for comparison?

  • Hi all,

    Achilles Tendonitis is a real condition but there has to be a root cause for it. Our bodies are built to run and jump and climb and withstand constant impacts on a daily basis without breaking down. And the achilles tendon is the strongest tendon in the entire body! 

    I think it's important to say that pain is the bodies way of telling us that something is not right. Tendonitis, which is basically inflammation of a tendon, happens for a reason. Usually it's because that tendon is not being used the way it was designed to. It may be having to work extra hard to compensate for other parts of the body which aren't doing their jobs properly. So you can massage and stretch that tendon but unless you address the root cause that tendon will get tight again or reach a point where it sustains an injury - tear, strain, rupture etc

    So what is the root cause of Achilles Tendonitis? Often is that there is some misalignment in your posture, and kinetic chain, so that you are not using your hips, knees, ankes and feet the way they were designed too. Basically, they are out of position so that when you run or walk or cycle certain tissues are becoming overworked, chronically strained and 'give out', because they are doing work they were not designed for. With the achilles tendon this means there might be excessive friction and strain through it causing the constant inflammation.

    Stand in front of the mirror and see if your feet and also your knee caps point straight ahead or do they face in or outwards at an angle. 

    They should point straight ahead. Them being at an angle means the legs will not operate as they were designed to.

    Also, stand up and close your eyes. Do you feel the weight evenly balanced on both feet and evenly on each foot? Or is one side more dominant and is the weight more on the inside or outside of the foot? Again, if it's not evenly balanced it's a sign of dysfunction.

    Putting on straps, or changing sports, or altering your running pattern might help temporarily, but often, the pain returns even with your reduced activity either in the same location or somewhere else, as you haven't addressed the root cause.

    So in summary, go after the root cause so you get a permanent solution and can use your body the way you want. 

    Take care and feel free to ask me any questions.

    Ameet Bhakta

    Postural Alignment Specialist

    www.healththroughposture.com

  • Hi t Rex I have read all your thread probably at a good time ( feeling really low about my achillies) your thread has given me real hope, I'm now 4 months in to A T have not run since August, having massage treatment on weekly basis and stretching also heel dropping.The  lump is still there, though sponginess seems to have gone.I am riding my bike a couple times a week and use cross trainer to no pain to achillies.I will start gentle running in jan 2014.This has been the worst injury I have ever had and until I read your post thought I would never run again.I really need running in my life it has helped me through some real tough times.I don't get the same from a bike.

     

     

  • You can try king brand products? They have a treatment to help heal tendonitis and keep people running. I use it for PF and it works great!

    http://www.kingbrand.com/Achilles_Injury_Treatment.php?REF=39PV8

    Hope this helps!

  • LFC forever - glad you managed to get through all that reading.  I'm going to do something about it in the new year - too busy at the moment.

    Sounds like you've been very sensible, and I'm sure you'll get back to where you were eventually.  Try running before Jan if you want - do one short one a week to start with midway between massage sessions.  You could even do it on the treadmill (what am I saying image ?)  It'll be warm in the gym.

     

    Trying to think how good cycling would be for it.  Not sure. I wouldn't get out of the saddle, anyway.

    It's a vile injury that seems to strike some people for a very long period indeed.  My sports massage therapist said mine was the worst case of it she had ever seen.

     

    You need to try to discover what the cause of it might have been.  Not always obvious.  Suddenly increasing training intensity, especially downhill running?  Your shoes?

  • Just re-read the whole thread.  More entertaining than I remembered it being, and a bit long-winded in places. Great contributions from other people - all alike doing sensible things and being very patient.  And I'm glad to say all the what I think now were mischievous posts have all disappeared.

    Update - no re-occurrence in the bad foot, even after this summer's Ridgeway 85 and then, less than two weeks later, the 10Peaks Brecon Beacons 55, two gruelling events.  The latter had 17000' ascent (and therefore also 17000' descent ...)  

    I suppose the UTMB would really test it but it's not an event that appeals.

  • Hi t Rex thanks for the reply December is very busy month for me with work with no time off now until Xmas day so that was the idea of starting in jan.

    The lump is still there and can be tender when massaged in certain ways,again this is why your thread mentally helps there is still hope. I wear brooks adrenaline gts for road shoes and inov8 for off road.Both shoes new this year.

    I have had lower back trouble this year and cost fortune in chiropractor bills,this had made my body out of sinc definitely not helping the cause.

    Great to hear you hitting big miles and races again gives me hope. I would be over the moon just to do 10k the way I am at the mo.

     

     

     

  • Lfc - I had the AT problem for 18months, and like you, I thought I would never run again. The worst it got was waking in the night and the pain keeping me awake, not good.  I had physio, all telling me the same, rest up and stretch. Nothing helped. So I decided I'd try my way, and in am quite sure I'm over it. I ditched toe raises, just didn't feel right when I was doing them. I done heel drops, heel drops and heel drops, always making sure my calves and Achilles were kept warm by wearing the most ridiculous woollen socks ever

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