Its over. Archilles pain. cant run no more

Any advice is welcomed. been running for 4 years which has helped me transform my life for the better. had archilles pain in right foot 2 years next Febuary and pain in the left for about 5 mnths. Been running through the pain and i am unable to do it any more. cant run no distances and having to keep stopping. just wasting my time. thinking about switching to cycling which i already do but let it take place of running. really depressed not been able to run. today was my last attempt. to painful. ive read all about this injury. yet i cant get it to heal. 

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Comments

  • Time to see a physio then.

    We can't diagnose you over the internet.

  • As above:  get thee to a physio.  In the meantime though, what exercises/stretches are you doing for the achilles pain?

  • hi, I'm doing eccentric heel dips twice a day, icing and having days off running. i admit im more than likely not doing enough icing and keeping the heel dips going. gets boring  cos I'm not not seeing much results. yes i know it takes time but damn. thats my point. There not getting better. i feel like i have to quit running for at least 3 mnths and keep the heel dips ect going

  • And your logic for this treatment !
  • google

  • I am guessing his logic is Achilles + Alfredsson heel drop protocol = Recovery

     

    My observation is that Alfredsson's trials were based on achillies Tendinopothy where THE PATIENT WAS NOT RUNNING DURING THE REHABILITATION STAGE.

    The heel drop strengthening had a high success rate in patients with mid tendon damage, and low success rates for patients where the pain was close to the heel attachment. Something along those lines.

    My approach here would be to see your gp so you get this on record. Then onto physio to confirm.

    Physio can then give you a load of treatments that have little effect, meanwhile you stopped running and healing takes place.

    And if the friction massage, massage, ultrasound, dry needling, graston technique, night splint, stretching, not stretching, heel drops, acupuncture etc, etc doesn't work, the you might get lucky and have plasma injections or even surgery.

  • yes mine is mid tendon and yes i still ran. so go see my doctor and stop runningimage

  • Over the last few years I've clung on to Heel Drops as it is one of the few treatments that was peer reviewed. Now my current physio is saying to do calf raises as "things have moved on " since Alfredsons heel drops. I've got no idea where this came from, and Dr Google is confused on the matter.

    bzimage - if you see a physio, let us know their thinking.

  • Also-ran will do. Forgot today I also lift weights. Been doing calf raises for 5 mnths . So no real help there. I think the dead lifts are not helping
  • I've had achilles problems - I recently had a mild re-ocurrence, so basically almost stopped running and just went to the gym instead to strengthen all the muscles in the legs, glutes mainly (donkey kicks, leg presses, single leg dips with dumbbells, lunges with dumbbells), but quads and hamstrings also.

    I've avoided aggravating the lower leg and achilles too much by minimizing any calf-specific exercises, just giving those parts of the leg as much rest as possible. My physio suggested my achilles/soleus problems may be caused by weak glutes, so I've concentrated on strengthening the glutes and given the achilles time to recover.

    Also doing high intensity interval training on a bike in the gym twice a week. I went for a run on Sunday and my main problem leg appears to be almost sorted, still a bit stiff in the other achilles, but getting there. I seem to be as aerobically fit as before, due to the high intensity bike intervals.

    It's the first time I've stopped running to strengthen my legs while getting over achilles problems, based on my experience I would recommend it.

  • Its a fact of life with achilles problems, that its only when the victim finally stops pissing about (years sometimes) and gives up completely they it heal.

    Over use injuries are like that. They don't appreciate further use.

    I've had achilles problems twice in 25 years of running. Same process of recovery: Note how long it takes for the pain to go (3 months) then double it before running again. And then only at a starter level.

     

  • bzimage, I'm suffering at the moment and was given those heel lifts but I don't really feel much progress is being made.  That's not strictly true; I may have a relatively good 2 or 3 days but then it comes back. 

    As well as the physio and the other things people have mentioned, have you tried a podiatrist?  I was referred to a podiatrist who gave me some insoles (I was expecting heel inserts, but he reckoned the ball of my foot needed lowering slightly) so I'm trying those in all my shoes as instructed but again it's very slow progress.  Good luck.

  • I've had it on and off and Middle Aged Runner's post is on the money. I'd also add that one thing I found helpful during a particularly persistent bout was laser therapy, so if you can find a physio that does it, give it a shot.

  • I've been through the Achilles misery too and would agree with Middle Aged Runner. In my case my injury was aggravated by walking so it took a long time to heal (4 years). In my case a slightly shorter leg and more supinating left foot was part of the problem, but strengthening the glutes and hams seems to have helped. I've also changed my running style to avoid heel striking, land on the mid foot and run in a more forward position (I tended to run with a slight back lean). Not out of the woods yet, but infinitely better. Good luck.

  • Eccentric, concentric, reactive, degenerative tendons....the words and explanations are endless, as are the views and models of care from a variety of practitioners. It's not cool, but it's what (unfortunately) happens.

    Common sense must prevail.

    If running is making you worse, then you have to stop. You need to then understand what is it about your running that is causing your Achilles to break down - and there are lots of variables.

    This is the cause, without knowing this, you're an ex-runner.......

  • Mercedes has mentioned above about changing running style and landing mid-foot, which I agree will help with achilles problems - strengthening the upper legs, in my experience, will help with driving forward more efficiently as you run, particularly as you pick the pace up - my knees seem to come up higher now and it seems more natural to automatically land mid-foot when my feet come back down (I noticed this effect a while back when I was just doing walking lunges, the extra gym work on the upper legs has helped further I think).

    Also, I changed from a more clunky support shoe, which I don't think I needed really, to some lighter New Balance shoes with a lower heel-to-toe drop, and that helps to land more mid-foot as well.

    The conclusion this leads to is, as you get older anyway, strengthening the legs with gym work, or at least somehow with dumbbells in the house, will make it easier to run more efficiently, faster and help to prevent or reduce the severity of injuries. I have eventually got the message after years of just running and not doing anything else.

  • I might as well just have given my money to Dr Paddy over the years as to another practioner. Luckily for me I am being treated privately this time around so I'm not sweating over the money being shelled out on various treatments. I did see if Dr Paddy was on the list of approved practioners for the healthcare scheme, but alas not.

  • Six Physio wrote (see)

    Eccentric, concentric, reactive, degenerative tendons....the words and explanations are endless, as are the views and models of care from a variety of practitioners. It's not cool, but it's what (unfortunately) happens.

    Common sense must prevail. If running is making you worse, then you have to stop. You need to then understand what is it about your running that is causing your Achilles to break down - and there are lots of variables. This is the cause, without knowing this, you're an ex-runner.......

    Six P, these people don't have common sense, they have money and choices. Running is but another commodity much like a tin of beans or a Starbucks. They pay their money and they demand satisfaction. 

  • image Maybe they are also misdirected by the 'practioners' ?  There are greedy consumers and greedy suppliers in this game. Some good, some bad.

  • I have been suffering with chronic non insertional tendinosis for over two years. I haven't really ran since October after finally giving up being stupid and trying to run through the pain. My right Achilles is thickened to nearly double the size of my left and has a lump of scar tissue on it.

    I have had two bouts of physio from different physio's. Neither prescribed the Alfredson Protocol of eccentric heal drops. The first told me to do 200 with both feet hanging off the step, up and down as quick as possible. The second told me to go up and down solely on the injured leg. Both also said I could continue to run as there was no evidence that when it is chronic that it does any more damage.

    Needless to say I didn’t get much relief from the physio.

    I was the n referred to see an Orthopaedic Surgeon privately who gave me an MRI scan. Told me the damage wasn’t that bad and recommended shockwave therapy then  surgery if that didn’t work. Unfortunately I couldn’t have the shockwave therapy as I never had enough outpatient funds left to cover the cost.

    So I then went the NHS route. Saw another Orthopaedic Surgeon who referred me to have the tendon sheath stripping procedure done. Which is an injection in to the sheath of cortisone and saline. That did nothing. I am still under his care and contemplating whether I should have more injections or surgery. Although he told me surgery is80% success rate and that I may have to accept the fact I may not run again.  I am 38 so obviously find that a bit gutting.

    I continue to do the Alfredson Protocol but religiously now. I do it with about 20KG in a ruck sack. It irritates the Achilles but also provides relief and I do see slight improvement.

    I also bought (out of desperation) the Bauerfeind Achillotrain pro which helps but for £100 I can’t say I highly recommend it if your injury is chronic like mine. It certainly is no cure.

    I also tried buying my own Nitro patches as they aren’t a prescribed path of treatment in the UK. My Ortho was ok for me to try this. They gave only mild improvement. Initial headaches when you first start them and eventually it caused irritation on the skin so I have ceased using these for now.

    I read this article recently http://www.takethemagicstep.com/coaching/families/health-management/managing-achilles-tendon-injuries/

    Nothing really ground breaking in it but one thing it mentioned which I had never seen or heard before was a stretch for lessening stress on the Achilles tendon using a resistance band and you use it to pull up the 2nd to 5th toes and using these toes push down against the resistance. Explained a lot better and a diagram on the page.

    Whether it is placebo as it is early days but I have noticed that walking about now my Achilles is not starting to feel any irritation as it was before.

    I will still not run on it as when doing the eccentrics of a morning there is stiffness and discomfort. Until, or should I say if this ever dissipates I will only then begine to run again.

    It is such a frustrating injury. I just wish I had stopped running and treated it when it was in the early acute phase.

    Good luck with yours.

  • NCoa



    That's totally uncool! What part of the country are you in? I'm sure I can give you the name of somebody who could give you some more insight.



    The long term outcomes from surgery are very poor....
  • Hi Six Physio,

    I am in Liverpool. The first physio I saw was the Spire Hospital the second was called Aigburth Physio. The Orthopedic Surgeon I am seeing now is also based at the Spire hospital.

    To be fair he is saying surgery as a last resort. Unfortunately they can't offer Shockwave Therapy on the NHS. Privately it seems they will only cover it when it is given by an Orthopedic surgeon which they estimate £500 a session and a 4 session course plus physio. So if you have a limit as I do on Outpatient that is a no go.

    What is your opinion on Shockwave therapy? I was considering getting it from a Physio that provides at at Physio prices in the St Helens region.

    Thanks

  • Apparently Richard Norris at The Physiotherapy Centre is top notch.



    SWT is a little hit or miss. We don't rate it because we don't need to use it. The reason why your achilles breaks down needs to be established. SWT can't and won't do that...
  • Thanks Six Physio,

    I think I will give them a call. Don't want to call my running days quits just yet.

  • i have had tendonopathy for about 4 years.

    what helped me was

    - rest

    - switching completely to non-impact sports (swimming / cycling) so i did not decondition

    - physiotherapy to get a diagnosis

    - firstly improving join motion by moving very slowly, stretching afterwards, then work on strength

    shockwave therapy - i payed £40 for a 45 minute physio initial appointment and they just used to do it then for free during the appointment. it doesnt work but unlike surgery or cortisol - it doesnt damage. £500 for 4 treatments - that is a joke, you are a fool if you are paying that ! 

    physio - they are not all the same level of competence and so i only really go to get a diagnosis, the rest i can do myself so i never bothered with the review, especially when i was not much better. also some like to get you paying for long courses of 'treatments' - shock wave therapy, acupuncture - its boost their business.

    orthopods - LAST resort. if you cant run and you think surgery is the answer it is not.

    when i first injured i could not even walk. physio did not work. it did not work much better the second time. i then tried three years later as an after thought and it seemed to work better.

    to be honest what helped me the worse was trying an non-impact sport - swim, go to the gym and do another sport like cycling. this is probably why i was slowly recovering.

    i only started again running very slowly after i had another injury from another sport but it is my secondary, not primary sport. it is good to mix things up. i can run but your tendon is likely to be permanently injured. i have some pain so i know competition is over for me but i compete in other sports now.

    taught me a lot. i know my limits and after major tendon injury you have underlying permanent damage. this is not a reason to go through ever test, investigation or have surgery. 

  • Greater Than Sign image. You are very clear that surgery is not a good option. Out of interest why do you have this view. I am interested as it is one course of action that is a possibility for me. I'm interested in the pros & cons.

  • I can literally feel your pain in so many ways because I too for now have been suffering from soft tissue injuries for years now and have tried all ways of resolving the issues but with very little success.

    However along with all the other good advice you have received I would say rest it as long as you can by swimming or cycling and then when it begins to feel a little bit better take baby steps to back to some sort of running.

    I now wear compression leggings and try to run Chi style and whilst I cannot go far it is at least running of some description. I am lucky enough to own four bikes which I use but none of them can compensate for going for a good run. Best of luck.

  • Hi Also-ran, from what I have been told surgery is the last resort if all conservative methods have been tried and failed. That includes at least 3 months of the eccentric stretches and seeing no improvement.

    My understanding is that once you have surgery  (Which I have also been told has an 80/85% success rate. Coupled with being in a boot for approx 8 weeks) and should that be unsuccessful then all the conservative treatments would then be pretty futile.

    Out of interest have you tried that stretch I mentioned in an earlier post with stretching the toes using a resistance band?

    Good Luck

     

     

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