Painful Achilles

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:

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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?

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Comments

  • 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!
  • 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.

  • 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!
  • 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! image

  • 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?

  • 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.

  • 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.

  • 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.
  • 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
  • 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

  • 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.
  • 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?
  • think Tom is right about the Flexor Hallucis Longus and the big toe image

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

  • 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.

  • 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! image

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

    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)

  • 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.

  • 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!

     

  • 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.

  • I think stretching might help you, mine isn't swollen either and I've been stretching it a lot which seems to have helped. I just stretched off after a run before but now I'm doing calf, hamstring, quad and piriformis stretched every day
  • And you've been running with the injury too?

  • Hey, this thread's been busy today!

    Gaz, a few things from what you say stand out. Your big toe lifts when you walk barefoot, sounds like you might need to see a podiatrist and work out why it does that. Could be just habit or stiffness in the toe joint and "first ray" (the big toe and the joints at the base of it). You may need a custom built orthotic to help with this.

    You also have a history of injury to that ankle that might have caused some ongoing stability issues - hence why your flexor hallucis or tib post are having to work hard.

    But and this is a big BUT it could just be your training schedule. Have you rapidly increased your mileage or stuck to the 10% rule? We all have things going on biomechanically, those things I've mentioned above could be of little significance, it may just be too big an increase in training.
  • Hey there, yes I've been running, taking it slightly easier than planned but still running. I did 6miles on Sunday then 5 tonight, just at a lsr pace. Stretched before and after and felt fine during the run, still feel fine and been back an hour or so. What's interesting is that when doing a soleus stretch yesterday I really felt it in my ptt, same stretch 3 times today and didn't feel a thing in my ptt so maybe it was just a bit tight?



    I've been doing some calf raises too but not sure if that's something that will help or hinder as although its going to strengthen my calves it makes them tighter in the interim..... Hoping for a bit of advice from Tom there.......



    Are you running or resting?
  • And I think last time it flared up was because of an increase in milage and seems to ne the same this time.... I'm sticking to 10% but maybe I just need to be even more cautious than that!
  • Hi Forty_44,

    I would stretch gastroc and soleus, especially if they're feeling tight. That will also stretch tib post a little too. Static Stretching is usually best done after exercise/ running hold each stretch for around 30 seconds. Use a dynamic warm up per running with dynamic calf stretches.

    Your calf raises should help strengthen tib post, although most of the work will be done by gastroc and soleus. When you do your calf raises, try and make sure the heel doesn't turn out, in fact you could try and work tib post a little harder by turning the heel and foot in a little as you lift, as long as it's comfortable.

    Mixing calf strength work with stretches should ensure you gain strength without losing flexibility.
  • Cheers Tom, just done a few more calf raises turning my heels in on the lift, definitely feel it in the post tib more..... Thanks for that one. I'm not well up on dynamic stretches, do you know any good websites that show examples of good static stretches and which would you suggest are best for calf / soleus / post tib?
  • Cheers..... Nice little cheeky link to your blog there too which I ended up reading some of because my phone won't play the stretch video!
  • I didn't know that link was there to be honest! Worth using your computer to watch that video (if your phone won't do it) it's a good one.
  • Tom, I wouldn't say that I've increased my mileage rapidly but I did take a two week break after the Brighton Marathon and then jumped straight back into my old routine (30-45 mile weeks). This coupled with the new support trainers definitely had a negative affect on my body.

    I've avoided running since Sunday and spent much of yesterday stretching my calves. I opted out of the running club last night and went for a swim. My ankle felt like it was back to normal afterwards. Its a little sore again this morning but it is getting better. I have a massage booked for this evening as my calves felt a little lumpy when rolling them over my foam roller.

    I do think that my big toe thing is a habit as I've always done it and it's never caused any problems.

    As for supporting my ankle, I tend to avoid strapping it as I want to avoid developing a weak leg and the full support shoes we're just too restrictive. Should I be looking into insoles?

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