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?
Thanks!

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Answers

  • 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. 


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