3 year Achilles problem - Still original injury or everyday damage?

I've been suffering from achilles tendinopathy in 1 leg for nearly 3 years now, it came on after an increase in speed work and has been with me ever since. I've always blamed that increase for the problem but I've now not run for 2 years, I've been through a couple of periods of 2 months where I've done recommended eccentric heel drops etc and also now wear orthotic inserts after visiting a running clinic, I wear these in all shoes. I'm not doing any other sports that would put load on the calf/achilles.
Do you think that it should have naturally healed in all this time or is it more likely that there is something in my day to day walking that is continuing to damage the achilles?

Best Answer


  • Thanks for that i'll have a word with my GP and also see if I can get an ultrasound to discover if there is any scar tissue causing the pain.
  • I had a problem insertional achilles tendonitus. To cut a long story short a physio diagnosed it as a weakness in glutes and upper leg muscles which was putting an additional workload on the achilles. So now do a programme of upper leg exercises with kettlebells 2 or 3 times a week (squats, jumping squats, bridged one leg raises (without weight) and lunges. Worth trying and cutting running back at the same time before building up again slowly. Keep the heel drops going as well maybe with weights (in rucksack on back). It's worked well for me although occasionally get a bit of discomfort (but not pain) which physio said is to be expected. I can be more precise about the exercises if you'd like to know.
  • Thanks Six foot plus, i'll give the upper leg muscles a try as well
  • While focus is commonly placed upon eccentric exercise in the latter stages of rehabilitation from Achilles tendinopathy (sinking heels lower than toes under load), have you considered how important isometric loading remains during the earlier stages, thus, allowing progression to the latter stage?

    Moreover, taking into consideration that microscopic tears within the tendon probably remain the repeated cause of pain and discomfort, feeling as though something is splitting beneath the skin (as eccentric exercises are performed), why continue to put yourself through the agony? 

    As stated by Albert Einstein, ‘The definition of insanity is continually doing the same thing over and over, but expecting  different results’. 

    While I’m not at all suggesting that you’re insane, having suffered for 3 year and also sought advice of the forum, you've probably begun to question whether previous advice (while well-intended) was misguided, due to lack of knowledge surrounding the stages of recovery from Achilles tendinopathy.

    Returning to isometric exercises, since your troubled Achilles probably doesn’t take kindly to sinking lower than your toes, simply adopt a flat/level surface and simply rise on to your toes, holding the contraction for up to 30s, before lowering back down.  Also bear in mind that isometric holds don’t necessarily result increased size and mass; they’re largely designed to improve strength of muscle tissue without increasing its length (eventually resulting in greater control when performing eccentric movements).  

    Progression exercises involve bending of the knees and transfer of body weight on to the toes, allowing for greater contraction of calves, before resting heels back down on to a level surface.

    To gain greater appreciation of what I refer to, sit against a wall with knees at a 90 degree angle and attempt to maintain the position for up to 60 seconds.  While such a position doesn’t excessively lengthen the quadricep, it well and truly engages it.

    Additionally, while you may have been prescribed orthotics, which isn’t necessarily bad thing, did you also receive instruction from the seller upon how to actively strengthen the soft tissue of your feet, so that they eventually no longer become reliant upon their use?

    If not, that’s something else you ought to consider, taking into consideration our feet serve as our foundation and, thus, ought to remain as strong, flexible and mobile as possible.  If your feet currently require an aid to allow them to function, then dysfunction within them (commonly atrophied (weakened) soft tissue) exists. 

  • Thanks MiserableGit2, what you say makes sense, I've been doing some more reading around the isometric loading and that sounds like it could help. When I got the orthotics there was no advice around strengthening the feet's soft tissue, I think they make too much money from selling them! Working on that makes sense as well.
  • I am training for the Brighton Marathon at the moment. Before Christmas I got Achilles Tendonitis which is affecting my ankle. It is really mild and only causes discomfort when I walk down stairs. My ankle is stiff when I run but I can run.

    I took two weeks off running over Christmas as per my physio's advice and have been slowly returning to running in the last week. I am nervous as I still have a niggle in my ankle and don't want to make it worse. However, I have read that some people consider returning to running as part of the healing process. It's my first marathon so don't want to under train for it but equally don't want to cause myself permanent damage...

    Any advice?!!!
  • Ian5Ian5 ✭✭✭
    Munchkin-This will probably go against what most say but I am talking from my own experience.
    I got Achilles tendinitis about 2 years ago,went to physio etc,still do stair steps occasionally,but have carried on running since,the physio said as long as the pain wasnt getting worse after each run then I was ok to run and the pain should be no more than 2/10.
    1 big caveat is that I do nearly all my running at easy pace to not push it,only time I go faster is in races,during this time my PB has gone from 3:50(I think) to 3:07 and shorter distances have improved massively also.1 thing I recently bought is an ultrasound machine and this seems to have worked wonders as it's the best it's been in a long time,they arent cheap but if you can afford it it seems to have helped me.
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