What movements are ok for Achilles Tendonitis?

Oj, I know there's a bout a billion threads about bad Achilles'. But I'm trying to work out what cardio I can do with my Achilles Tendonitis and couldn't really find any adequate answers on the forum (or online). I

I have not done any cario for about 3 weeks now and it's driving me mad! I saw a physio about 2 and a half weeks ago and he gave me exercises. I put ice on it regularly. He said I could probably use the fit glide/elliptical trainer or exercise bike on low resistance. But I'm so paranoid about this achilles and it not healing I daren't use them. Apart from impact, what kind of movments of the foot are bad for Achilles Tendonitis and which will not aggravate it? I did try the elliptical machine once but it's hard to know if it aggravated my achilles because the pain in it is not very consistent. I do notice on the Elliptical Machine that, though there is not the impact of running, the heel does lift slightly each step.

 

HA! This probably sounds like a paranoid rant but I've seen the trouble so many people have had on this forum with their Achilles I'm just terrified it won't get better.

Comments

  • Hi,

    With Achilles tendon problems the issue isn't necessarily what you do, but how much you do of it. Loading the tendon actually encourages healing, so using it normally is good for it, it's when you do too much for the healing tendon to cope with that it can get worse.

    I would use your pain as a guide. You can cycle, swim, use the elliptical machine etc but start off with a small amount and gradually increase as long as it's not painful.
  • Cycle but dont get out of the saddle
    Swim but dont kick off from the wall

    Its all about the loading as Tom says, use it as it stimulates the blood supply but dont overload it

  • Thanks for the reply. I suppose the exercises the physio gave me (like heel drops and leaning against the wall) stimulate blood flow as well as strengthening calf. However, I am finding that they aggravate/make sore the Achilles on my UNDAMAGED foot but they don't really aggravate the bad foot, Is this common? I don't want to damage the other Achilles.

  • I'm in a similar place with my Achilles but I've not been as careful, on the bike, cross trainer, rowing machine, swimming etc as I can't bear the lack of cardio. I'm not getting pain but it is tender to the touch at the end of a day.



    Sound like I'm overdoing it? Should I be waiting until there is no tenderness at all before gentle running again?
  • Should say I did rest completely for a few weeks first, and have massage on it. It recovered from very painful every morning to this evening tenderness stage. One or two friends have said just learn to manage the discomfort but I'm unconvinced.
  • Presume both of you are being careful waking up first thing?



    Tennis ball by bedside, roll it around foot to get blood moving. When you wake up it's most painful, almost to the point of limping for some people. Then whilst getting showered etc, do your heel dips and sneak them in throughout the day during day.



    No barefoot around the house, slippers or sandals helps. Walking on hard floors not good. Be careful with the shoes / boots / heels you wear generally also through the day.



    And hmmm... There is very little blood flow to the Achilles so I'd actually say push it and do some proper biking, spin class etc... You want to stimulate it. It's less impact than running certainly. Perhaps do some pump weights classes to strengthen up whilst you can't run?



    Running maybe not. Certainly not road based, try walking the route first. Trail, soft grass best. Problem could be from your trainers anyway.
  • I've stopped dojng the calf strengthening exercises. My good foot now hurts more than my bad foot because of the heel drops. And i don't mean in an achey way, which would be understandable. My undamaged tendon is experiencing a sore, burning feeling.

  • Hi Ambient_Century,

    Sounds like it would be good to review your exercises with your Physio. The heel drops are designed to load the Achilles in a way that stimulates healing and makes the tendon stronger at dealing with load.

    It might be that you need to vary how many you do, or how far you allow the heels to drop. Also are you doing it barefoot or in shoes?

    I've written a blog on Achilles, load of info here;

    http://runningphysio.wordpress.com/2012/04/06/achilles-tendinopathy/
  • Thanks for the advice. I'll have a look at your blog.

    To be honest, I canm't really afford to keep going back to the physio everytime there's a problem. But I know that the exercises are important. I may just exercise my bad foot for now, though I know that it's not recommended to exercise one leg and not the other. Maybe just try doing the pushing against wall exercise as this seems to put less stress on my tendon as other exercises. Grrr....I don't know, it's very annoying.

     

    I was wondering if I should start applying heat to my bad Achilles? I've been applying ice for the last few weeks. But the swelling must be down by now. I never had any real visible swelling on the skin. I mean, I still feel pain on it but does that mean it's still swollen? Would maybe trying to encourage blood flow with heat be better at this point?

  • How long have you had it?

    Did you "offload it" before you started with the heel drops?

    I wonder whether actually you might be best offloading it for a while to settle symptoms before doing these exercises.

    I've found taping really effective for this.

    Heal may help a little, if it's been weeks and there is no swelling ice is less likely to help.
  • Well, thanks a lot for the advice Tom. Much appreciated. It's very frustrating indeed having all this guesswork! I have no idea whether to put ice on it or heat. As regards swelling, i never had any visible swelling really but there must have been some. If my Achilles is still a little sore, does that mean there's still swelling? Also very annoying with the exercises hurting my good foot. I'm styill exercising my bad Achilles, which i know is bad, just exercising one leg. But I'm not sure what else I can do....I don't want to stop doing them as they seem to be very important.

  • I had the same problem, with both the right and left tendon having become painful. The solution I found for my heeldrop exercises: put a yoga brick (or anything of similar form and volume) under your "not exercising" foot. You will then be able to push you up on the toes of your "exercising foot" through a movement of your "not exercising" hips and knees, sparing the achilles. Once you're done with one foot, move the yoga brick under the other foot ...

    (MY problem is rather that the heeldrop does not work really ... )

  • It does not matter if the swelling has gone, you apply variable heat to encourage the blood flow. It is this that makes it such a slow healer and is much more important than any heel drop or calf exercises. Its this what makes it one of the worst recovery running ailments because of the bad blood supply. Don't know why you are worrying about what to do. There are loads of fitness exercises without aggravating it. Swimming or cycling wont touch it. Not to mention core.  When you get back to running, avoid downhill.

  • Plenty of good advice offered thus far, Ambient, particularly in providing reassurance that you'll still be able to exercise while your Achilles takes time to heal. 

    Concerning the discomfort in your non-affected Achilles, if you're simultaneously raising and lowering your heels, you could be placing more of your weight through the non-affected Achilles, as you fear stressing your injured Achilles, leading to over-compensation in the healthy tendon. 

  • I had achilles tendonitis last year and subsequently had something called Shockwave therapy on it and it's fine now.  If you google it you'll see what it does.  Each session cost me £50 and I had maybe 5 blasts of it (can't remember exactly how many now) over about 3 months.  I could still x train and it wasn't long before he told me to run on it again after may be a month or so because it then strengthen it.

    Hope this helps (also having it again now for my hamstring tendonititis aaaaaarggh)

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