Forums >Health and Nutrition>achilles tendinosis
Hi folks, looking for any experience in running with what I believe to be Achilles Tendinosis. I have my first Boston Marathon just around the corner and am not sure what I should do here. I have been averaging 60+ miles/week using the Pfitz 18/70 plan which is what I have used for my prior marathons. I am really running well for me at the moment and just got a Half Marathon PR last weekend even with this issue.
As a result of intermittent issues with Plantar Fasciitis, I have already been doing a lot a stretching that my PT gave me, both Gastroc and Soleus. My PF feels real good at this time, but my Achilles is still really tight and uncomfortable at times. I am also working on doing eccentric heel drops. As a side note, I can curl or bend my toes up or down without any issues or acute pain. I have been alternating icing and heat and that seems to help.
I have seen recent reports that say you should continue to run (maybe avoid hills) and taking time off could actually hinder recovery. I have seen others say take some time off. Seen similar conflicting info on anti-inflamatories like Ibuprofen. I’ll probably get a call into my PT but looking for any advice in the meantime.
What was I chasing again?
runktrun
Eccentric loading is all the rage, and I've seen some good studies indicating resolution of tendinopathies with this technique. Strengthening surrounding musculature to minimize imbalances and asymmetrical loading is crucial, too. So don't just stretch your calves (they may not actually be tight), but also work on balancing quad/hammy/glute strength, work to engage your glutes and core, and pay attention to your shoes.
As for NSAIDs and tendons, I've done a lot of digging to figure out how I should treat my hamstring issues. As you've indicated in your thread title, you don't necessarily have inflammation (no -itis). NSAIDs can change the type of collagen and how it's laid down during cycles of incomplete healing. Google NSAIDs and tendinitis or tendons, and you'll find some mention of NSAIDs resulting in more of type II collagen (I think, I don't remember the correct "types"), which is more brittle and prone to lying perpendicular to the length of the tendon.
I've also seen some abstracts claiming that use of NSAIDs increase tensile strength in tendons that have been transected. But a cut/operated tendon may be very different from a degenerative tendon.
Ok, so the take away is that it might be smart to limit NSAID use if you're experiencing chronic tendon issues, but play around and see what works for you. I personally felt awful after a few doses of Indomethacin, which has been shown to increase the tensile strength of tendons in rats, so now I use Mobic/Meloxicam only as necessary and I don't use it after hard efforts because I'd rather my body adapts to the stress naturally.
Not running for my health, but in spite of it.
Thanks Kilkee,
My PT said my calves were definitely tight and already had me doing stretches and the eccentric dips. I am going to take a few days off as I see some bruising along the achilles tendon area after running on it yesterday which I now regret. I'll hit the pool the rest of this week and go from there while I continue with the ice and heat.
I've had AT every marathon cycle for the last 2 years, with this winter being no exception. I've pretty much followed the standard procedure: eccentrics until I can't stand them, strengthening the entire kinetic chain (glutes, hips, hamstring, foot, and ankle exercises), orthotics, rolling, night splint, and Graston.
My AT always seems to resolve within 6-8 weeks with treatment. I was told once that I could keep running as long as I can do heel raises with no pain. So, I've always continued running. I've never taken NSAIDS for AT, so I can't help you there.
This injury is very individual. It would be good if you could figure out what is causing your particular pain (i.e. tight calves, biomechanical problem, small tear, etc). Generally rest is better in the early stages. If I had it to do over again I would have rested more in the beginning rather than trying to run through it. Mine has lasted well over a year and improvements are very slow. Of course my diagnosis is that my variant of AT is complicated by bone spurs so there is that. Hopefully yours is not this variety.
Anyway, good luck and REST now, do your eccentrics and cross training, so that you will have less trouble and it will likely resolve rather than becoming chronic.
"Shut up Legs!" Jens Voigt
This injury is very individual.
That's for damn sure. I wish I had something to contribute here, but the more I learn, the less I know.
Rob_K and bhearn, hope things are going better for you guys. I am thinking of getting acupuncture this week. Will update if it seems to help the condition any...
So acupuncture helped me out. I recommend at least trying it out if you are at your wits end. Looking at your logs, it looks like both of you have got it pretty much licked, though, so that is good. I am still on a hiatus from running. At this point, I can't really lose any more running fitness since it is already back to zero so what is a little bit more time off.