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Achilles tendonitis - what to do? (Read 987 times)

    A couple weeks ago I began having severe pain in my right achilles tendon when climbing steep hills. I stopped running for about a week at the advice of a physiotherapist, performing basic stretches to alleviate pain. No improvement during that time. Tried doing some slow running, as (oddly) I had noticed that sometimes it hurt more while walking than running. No improvement. Now, it is painful even to walk briskly, and if I attempt to run slowly I feel as if I am "smashing" down on my right foot...no shock absorption whatever...etc. etc. I had patellofemoral syndrome earlier in the year, which went away completely with strength and hill work, so it's very frustrating to get into another jam. 

     

    Basically the medical advice I have been given is that I can walk until it is completely painless, and only then am I allowed to resume running. I'm wondering -- what kind of recovery window am I looking at for this?  I was hoping to try out for track as a college freshman in Jan., but now it is looking unlikely I will be able to do that in my first semester if I lose a lot of training ground now. Any advice given will be much appreciated. 

      Not to sound pessimistic here but I tried to run through achilles tendonititis. I hurt it playing soccer and then trained on it for seven months. I had to stop running when I tore a calf muscle in March. Since I had to stop running because of the torn calf muscle I decided to let the achilles heal before I started running again.

      I am still not better. Best thing to do is to take time off until it heals. Eccentric calf raises are the fastest way to get it to heal. If I had to do it over again. I would not have run on it until it was better. In the long term it would have meant a lot less time off.

       

      Kevin

        Calf injuries can be tough to get over.  Try using an elliptical cross trainer for a few weeks.  It might take a couple of months to get back to normal.

        2013 H1:  7 hours/week base.  Q3: Train for goal race.  Q4:  Goal Race.

          I was unable to run for four months last year due to achilles tendonits. Saw my physio once a fortnight during this time. Recovery is typoically very slow compared to muscle injuries. A year later and my achilles still aches each morning, but warms-up after a couple of minutes on my feet. I have run two 100km races since the injury, so I have confidence that it has "healed", but the ongoing morning discomfort tells me that it will never be 100% strong again.

           

          Good luck with your recovery, I hope that your's is faster than my experience.

            I was unable to run for four months last year due to achilles tendonits. Saw my physio once a fortnight during this time. Recovery is typoically very slow compared to muscle injuries. A year later and my achilles still aches each morning, but warms-up after a couple of minutes on my feet. I have run two 100km races since the injury, so I have confidence that it has "healed", but the ongoing morning discomfort tells me that it will never be 100% strong again.

             

            Good luck with your recovery, I hope that your's is faster than my experience.

            Thanks for sharing. Frankly, the idea of being permanently hurt and inadequate for running scares the shit out of me. Shocked I'd be willing to take off as much time as needed, within reason, if I can just return to running and do so injury-free. I might go crazy in the meantime, but if it means recovery, then so be it. I'll definitely be looking into some sort of non-impact cross training, though. 

              Thanks for sharing. Frankly, the idea of being permanently hurt and inadequate for running scares the shit out of me.

               

              For what it's worth, I finished a 100 mile race about 5 months after a soleus tear (grade 1), and that calf already had a history of injury, grade 2 medial gastroc from a few years prior.  

              2013 H1:  7 hours/week base.  Q3: Train for goal race.  Q4:  Goal Race.

                Hey! Yeah, it's a pain - I had this in 2009. Fortunately I "only" had to take a month off for it to heal, and it hasn't returned, though sometimes the achilles does get grumbly if I don't stretch properly. Anyway, here's what worked for me:

                 

                1. For me, the number one cause of achilles issues is tight calves. Stretch the calf muscles.

                1a. Look into eccentric calf raises. Do them religiously.

                1b. Probably not evidence-based in the generally accepted scientific sense, but I swear that wearing silly compression knee socks helps keep my calves happy.

                 

                2. Ice.

                 

                3. Get your gait analyzed and make sure you're wearing the right shoes.My gait analysis pointed to orthotics, which I tried and hated, so I ditched them and concentrated on building strength in my feet.

                 

                4. The person who did my gait analysis was also able to pinpoint other areas of weakness i.e. hips, and prescribe stretches and strengthening exercises, which I also did/do religiously.

                 

                5. Never, ever do speedwork while also increasing mileage. It's taken me like 20 years to figure this one out. Don't be like me Smile

                5a. As you already noticed, hills are also a bad idea, at least until it's healed.

                 

                6. Could your work/everyday shoes be contributing? I used to wear heels a lot, but threw fashion to the wind and started walking around in running shoes all the time, except in the office.

                 

                Good luck!

                  A couple weeks ago I began having severe pain in my right achilles tendon when climbing steep hills. I stopped running for about a week at the advice of a physiotherapist, performing basic stretches to alleviate pain. No improvement during that time. Tried doing some slow running, as (oddly) I had noticed that sometimes it hurt more while walking than running. No improvement. Now, it is painful even to walk briskly, and if I attempt to run slowly I feel as if I am "smashing" down on my right foot...no shock absorption whatever...etc. etc. I had patellofemoral syndrome earlier in the year, which went away completely with strength and hill work, so it's very frustrating to get into another jam. 

                   

                  Basically the medical advice I have been given is that I can walk until it is completely painless, and only then am I allowed to resume running. I'm wondering -- what kind of recovery window am I looking at for this?  I was hoping to try out for track as a college freshman in Jan., but now it is looking unlikely I will be able to do that in my first semester if I lose a lot of training ground now. Any advice given will be much appreciated. 

                  Dave, I can't say anything definitively (we're all different), but here's my experience: I had a minor Achilles tear in FEB2011 with subsequent tendinitis.  Once I realized it wasn't something very minor, I switched to cycling to maintain/increase fitness through the spring and summer.  In mid-April, I started back very cautiously with a jog/walk mix in 6 weeks.  Kept doing that, not breaking 20mi/week until late August.  (I did have one setback when I sprinted in cycling shoes and aggravated it.)

                   

                  What I did:

                  • slight heel lifts in my everyday work shoes for ~2 weeks, just to take some stress of it;
                  • wore a compression sleeve on that leg every run for months.  Don't know if it helped during the run, but I do know my lower leg felt worse/stiff/sore in the evening and the next day if I forgot it.
                  • eccentric calf exercises -- lower as slowly as possible, normal-speed rise.
                  • was paranoid for months about where I put that foot down -- avoiding any sort of upslope that might stress the tendon.

                  On the bright side, I had a tear, not just tendinitis; it's been totally healed for months; I've run several races (including some pretty hard); and I don't even think about it anymore.  If you can cycle or something highly aerobic, you'll be surprised at how much of your running fitness you can maintain.

                  “Everything you need is already inside.” -- Bill Bowerman

                    Dave, I can't say anything definitively (we're all different), but here's my experience: I had a minor Achilles tear in FEB2011 with subsequent tendinitis.  Once I realized it wasn't something very minor, I switched to cycling to maintain/increase fitness through the spring and summer.  In mid-April, I started back very cautiously with a jog/walk mix in 6 weeks.  Kept doing that, not breaking 20mi/week until late August.  (I did have one setback when I sprinted in cycling shoes and aggravated it.)

                     

                    What I did:

                    • slight heel lifts in my everyday work shoes for ~2 weeks, just to take some stress of it;
                    • wore a compression sleeve on that leg every run for months.  Don't know if it helped during the run, but I do know my lower leg felt worse/stiff/sore in the evening and the next day if I forgot it.
                    • eccentric calf exercises -- lower as slowly as possible, normal-speed rise.
                    • was paranoid for months about where I put that foot down -- avoiding any sort of upslope that might stress the tendon.

                    On the bright side, I had a tear, not just tendinitis; it's been totally healed for months; I've run several races (including some pretty hard); and I don't even think about it anymore.  If you can cycle or something highly aerobic, you'll be surprised at how much of your running fitness you can maintain.

                    Thanks so much for your advice, and for sharing how you recovered from your injury. I've seen lots of recovery plans out there, but I think I'm

                    going to just copy this one if you don't mind, seeing as it has actually worked for someone. I think I might benefit from some hill cycling in particular, as that is a good way to increase the heart rate and just burn some energy while I am waiting to recover. Brisk walking might also be a good idea, provided it's not on uneven terrain (that does still hurt me). So, after a few months of this, I feel I can run slow, I'll intersperse that with walking as you suggested until it gets better. 

                     

                    Again, it sucks, but not as much as a permanent injury - that would be something I would have a hard time with. Thanks again. 

                     

                    dave 

                      Hi Dave! I too suffered from AT after increasing mileage too rapidly while training for my first marathon in 2009. I (stupidly) choose to run through the injury before completing the marathon and then bring next to crippled afterwards. It hurt to walk, to stand, to go up and down stairs, etc. I knew something bad was happening. My PCP confirmed my suspicion of AT and referred me to a physical therapist. The PT had me in for 3 office sessions, prescribed me a series of stretched and to stay off the feet until I was healed. I had one round of electrophoresis with a topical steroid. All in all, I was out of running for a good 4-5 months before I could handle a run again. Even once I was back on my feet, I would experience tightness and dullness in the tendon. To this day, the tendon can flare up occasionally. It is especially important to stretch, as my PT explained in my case, the cause was tightness in my muscles all the way from my hips right down to my feet. I was basically stiff as a board and putting my body through all these miles. It manifested in my AT. I am happy to say that I recently completed my third marathon (though last for a while for personal reasons) and if it weren't for stretching, I know my AT would flare back up. Staying off and stretching are the two best things you can do to get rid of this AT. It sucks. But not ever being able to run again sucks more! Best of luck to you, I wish you a speedy recovery!

                      2012: Just run.

                        Hi Dave! I too suffered from AT after increasing mileage too rapidly while training for my first marathon in 2009. I (stupidly) choose to run through the injury before completing the marathon and then bring next to crippled afterwards. It hurt to walk, to stand, to go up and down stairs, etc. I knew something bad was happening. My PCP confirmed my suspicion of AT and referred me to a physical therapist. The PT had me in for 3 office sessions, prescribed me a series of stretched and to stay off the feet until I was healed. I had one round of electrophoresis with a topical steroid. All in all, I was out of running for a good 4-5 months before I could handle a run again. Even once I was back on my feet, I would experience tightness and dullness in the tendon. To this day, the tendon can flare up occasionally. It is especially important to stretch, as my PT explained in my case, the cause was tightness in my muscles all the way from my hips right down to my feet. I was basically stiff as a board and putting my body through all these miles. It manifested in my AT. I am happy to say that I recently completed my third marathon (though last for a while for personal reasons) and if it weren't for stretching, I know my AT would flare back up. Staying off and stretching are the two best things you can do to get rid of this AT. It sucks. But not ever being able to run again sucks more! Best of luck to you, I wish you a speedy recovery!

                        Hi, thanks for your reply! I've since discovered that it wasn't tendonitis but some sort of  strain internal to the foot and near the base of the fibula. I encounter pain when I roll my right foot outward with the outward side resting on the floor. It's also impact-aggravated, hence being unable to run. 

                         

                        Over the past couple weeks there has been some progress with the pain. All I do is easy walking and using an elliptical cross trainer to maintain cardiovascular fitness. I'm not going to even think about running on it until there is no pain whatsoever from everyday use.

                         

                        It's got me down, but I've taken it as a lesson with regard to how I was going about things...