Forums >Health and Nutrition>Achilles/Calf Issue
Hello,
I received some great advice here about a year ago on how to deal with sciatica. I started more leg strength training and noticed improvement quickly. The single leg squats in particular seemed to help. I now have no sciatica issues.
So, in a similar vein, I'm asking for advice on my left Achilles/calf. Briefly, my running history (started February 2019) indicates I have a structural weakness of some kind on the left leg because I never have issues with my right Achilles or calf. I tried doing calf raises as part of the leg strength training mentioned above but my Achilles/calf didn't react very well so I stopped them. I've gone long stretches with no problems but about 6 weeks ago, the pain came back 3 miles into an 11 mile run. I didn't think too much of it as it had been a long time without an issue. Since that run, it's varied in its discomfort. Sometimes I don't feel much at all but then other times there's actual pain. Sometimes it's lower down the leg and other times more towards the calf.
I've started to notice that the squats seem to aggravate it so now I've backed off on those as well.
I read that level surfaces are better for Achilles issues. When I run on pavement, it does seem to cause less issues than my usual trail running. It's strange though because I run mostly on a rail trail that isn't that bumpy.
Last week I had to miss a run because of it. (I only run three times per week so I have plenty of off days built into my schedule.)
I've now run thrice since that missed day and it seems okay but I can detect a slight twinge in the area.
I've tried both foam rolling/stretching and doing neither. It seems that the former aggravates the problem.
Is there something I may be missing? I'm worried that the leg exercises will make it worse but OTOH, strength training is important for injury prevention for other muscle groups.
My pace doesn't seem to affect things much either way.
Thanks for any tips!
Personal Records:
5K - 20:07 ran in September 2021 (The second half split during the 10K run listed below.)
10K - 41:10 ran in September 2021
8 miles - 56:15 ran in November 2021
Half Marathon - 1:39:06 ran in September 2020
Google eccentric heel drops. Worked wonders for me, YMMV
Ray
Thanks.
From what I researched, there seems to be a difference of opinion as to whether you're supposed to allow the problem foot to bring up your body's weight by itself of whether you're supposed to use the non-injured leg to help bring it up.
I did one set of 12 using both feet at once and lifting my body weight with both legs. I'll see how my body reacts. If it has a negative effect, I'll try just lowering the injured leg and not raising it.
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For the heel drops, I go with the body weight carried by the non-stretched foot...that is no push up, only stretch down. And I have to stay fairly diligent to get after it whenever things start to twinge and complain while being extra careful on hills to shorten stride.
Acceptable at a dance, invaluable in a shipwreck.
Thanks. I think I'll go with that next time and at least see how it reacts to only lowering and not having to raise my body weight.
What about drop heights in shoes? I was seeing that for Achilles issues, it's better to have a high stack height. My shoes range from 4-6 mm drop. That's small compared to some. I'm wondering if I need to explore different shoes...
How long does it take for you to start seeing increased strength and reduced discomfort? I have been doing 3x15 eccentric heel drops twice a day for a week or two and I think it's starting to improve but not precipitously.
I found success with laser therapy. Not covered by insurance but saw noticeable improvement after 6 sessions. Doc said that was enough to jumpstart the healing process.
Jason -- over the years I haven't targeted shoes as contributing to my Achilles issues. For me it seems to be an overuse / workload / tight calf / striding-for-pace issue. I had a period of about 18 months where I was battling Achilles or anterior tendonitis. It drove me to get to a shorter stride, which was happening anyway with age. (now I have the full-on grandpa stride)
Sometime in the very long ago past someone here recommended a workbook called something like 'Treat Your Own Achilles Tendonitis' by Jim Johnson. I grabbed a copy for something like $8 -- and that's where I got the "never push up with he bad foot" when doing heel drops direction.
Lane -- if I catch it early and back off workload, add icing & heat treating, it usually takes 3-4 days. I'll use an ankle brace to limit range of motion which helps a lot.
The issue may actually be that your left side is the stronger of the two, and the soreness is because it is overcompensating for a weaker right side. For that reason, if you're doing any strength exercises, I'd suggest making sure you target both sides, rather than just the sore one.
3,000m: 9:07.7 (Nov-21) | 5,000m: 15:39 (Dec-19) | 10,000m: 32:34 (Mar-20)
10km: 33:15 (Sep-19) | HM: 1:09:41 (May-21)* | FM: 2:41:41 (Oct-20)
* Net downhill course
Last race: Waterfront HM, 7 Apr, 1:15:48
Up next: Runway5, 4 May
"CONSISTENCY IS KING"
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I have had and treat achilles issues often. I don't think you have tendinosis. I would go back to calf raises but do them on floor to start with with very slow reps, pause on top and also do sets with knees bent from standing position to target soleus as well. Do with one leg if no irritation. Start with no weight and progress. Do a lot of one leg balance work and keep doing your hip/glute work. I am not a fan of over stretching and over rolling. Spend this time on strength and mobility work. Also I don't care for doing full range strength work for a tweaked achilles/calf. In many cases these things irritate and prolong the problem. You want to help or coax body to heal and not put obstacles in way. A week off from running (an irritant) with cross training and walking and heat (never ice) on calves/achilles often can usually resolve these tweaks. I also am on board with getting a different pair of shoes to mix in too. Also, heat up the calves and achilles before runs and between. A 5 min walk before a run too. Hot water soaks, heat wraps (I like far infrared heat too). Do often.
If you do take a week off, then give yourself 2 - 3 weeks of very gradual progression to get back to where you were. Just slow runs with some walk breaks at first. I also like to consciously think of shortening the stride a bit to. Just don't jump right back into the normal plan. You need to get in some short discomfort free runs in to give you confidence. You get pretty fired up to get through a run with no discomfort even if it is a just mile or two the first day. That is a win. Take a day off and then progress from there. This is the SMART approach to handle your issue. Good luck.
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Thanks everyone. I'll see how things progress.
I was trying to do the "Alfredson Protocol" which is basically just tons of eccentric heel dips which was very unpleasant and didn't seem to be resulting in any progress. I followed the advice bolded above and it's like day and night - discomfort is not 100% gone but mostly gone and improving after only a couple days. Thanks internet stranger!
What you can do is to spend this time on strength and mobility work.
There are 3 exercises I'd recommend:
1. Eccentric heel drops (google these), come back up with help using your good Achillies, it is okay for there to be even moderate discomfort, that is part of the process but stop if the pain is excruciating
2. Reverse lunges (google this), basically helps strengthen hips and glutes
3. Box step up tp knee drive (google this)
Has anyone personally found whether stiff sole or flexible sole shoes are easier on the achilles? Dr Internet is all over the place on that question.
There is some consensus that higher drop, like 10mm or more, relieves some stress on the achilles, but there are a few counter-arguments as well.
Of course the results were filled with stores insisting that you need $500 custom insoles, because millions of years of evolution has resulted in a foot that you cannot run on without them.
60-64 age group - University of Oregon alumni - Irreverent and Annoying