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Anchilles Tendinitis/heel issues - recovery time? (Read 133 times)

Blaf


    Ok, I am at the point where I have to take some time off. I went for a short run yesterday and I felt my tendon most of the run. Pain level 3 on scale 1-10. No pain when I walk or rest (other than standard morning stiffness). I also have pain when I press the tendon in one point from the back.

     

    My plan is this:

     

    • Eccentric calf raises twice a day
    • Icing once a day
    • Stationary bike as an alternative for running for now.

     

    Is there anything else that I should add to the list?

     

    I will see how it goes for a week and then I will evaluate.

     

     

    Anybody has a good or bad experience with eccentric calf raises? Apparently that is a gold standard for Achilles issues.

    Age: 52

    Runner since 2012

    Marathon PB: 3:40:32

      I've found that if I do eccentric heel drops 3 x 10 once or twice a day for 1-3 days any achilles pain disappears. I don't understand it but it works.

        Very commom. You see that in plantar fascitis also. I would not ice it.....heat is WAY better or modalities like H-WAVE that gets muscles contacting and pumping and stimulating lymphatic drainage. 

         

        I go back and forth on icing. FWIW, my foot doc (Amol Saxena, who just dd Galen Rupp's Achilles surgery) tells me to ice it after a run if it hurts.  Of course, never ice it BEFORE a run.

          Anybody has a good or bad experience with eccentric calf raises? Apparently that is a gold standard for Achilles issues.

           

          Well it's the drop part that's eccentric and what counts. If you have Haglund's / "pump bump", you do not want to drop your heel below horizontal. The reason is that creates more compression around the insertion point, as the tendon basically has to go around your bump like a rope around a pulley. Tendons really don't like this; they like longitudinal tension. The compression will just exacerbate the injury and lead to more calcification. That is what Saxena kept telling me, but it took a while for me to fully get it. There's a great YouTube video out there that makes it pretty clear; unfortunately I've lost the link.

           

          To maximize the beneficial tensile stress during heel drops try to stand on your tip toes before each drop. This angle is mechanically most efficient.

            Ok, I am at the point where I have to take some time off. I went for a short run yesterday and I felt my tendon most of the run. Pain level 3 on scale 1-10. No pain when I walk or rest (other than standard morning stiffness). I also have pain when I press the tendon in one point from the back.

             

            My plan is this:

             

            • Eccentric calf raises twice a day
            • Icing once a day
            • Stationary bike as an alternative for running for now.

             

            Is there anything else that I should add to the list?

             

             

            You can look for a foot doc that can do EPAT (sound wave) or ESWT (shock wave) treatments. I've done these several times with Saxena. He tells me that now, 90% of the cases he used to treat with surgery can be managed with EPAT / ESWT. They are not cures, but they can make a big difference. Here are some slides of his I just found that look very informative; I'll have to read carefully.

             

            https://www.amolsaxena.com/pdf/ESWT-use-in-foot-and-ankle.pdf

             

            Those are intended for medical professionals. You might want to start here.

             

            https://www.amolsaxena.com/achilles-heel.html

            Blaf


              Joann, that is my hope too.

               

              Bhearn, thanks for the links.

              I do not have Haglund’s pump bump. But I still do the drops on the floor. Today I added some weight, by holding a 20lb dumbbell in my hand.

               

              I read somewhere that drops should be done with bent knee too. I tried that, but does not look natural to me at all, so I did not finish it.

               

              About shockwave therapy, someone else told me that it might help. I will have to look who provides that here in my area. But first I want to see if eccentric drops will help.

              Age: 52

              Runner since 2012

              Marathon PB: 3:40:32

              Blaf


                This post on letsrun.com has lots of info: http://www.letsrun.com/forum/flat_read.php?thread=5361979

                Age: 52

                Runner since 2012

                Marathon PB: 3:40:32

                  I read somewhere that drops should be done with bent knee too. I tried that, but does not look natural to me at all, so I did not finish it.

                   

                  Huh. My PT told me to pay attention and make sure the leg is totally straight. Pretty sure the idea there is that half the AT fibers come from the soleus, and half from the gastroc. With bent knee you are not putting full tension on the gastroc fibers. OTOH with straight leg you are not putting full tension on the soleus fibers... so, I don't know. Also the AT rotates 90 degrees from the musculotendinous junction to the insertion. Which means to me that which muscles you want to emphasize might depend on where the injury is.

                   

                  Finally here's a little puzzle about eccentric drops. When a muscle activates while shortening, it's concentric; while lengthening, it's eccentric. These do two very different things to muscle tissue. Eccentric work is like riding the brakes going downhill, burning up brake pads, in this case doing the bulk of the muscle damage. But tendon is not active tissue. Tension is tension. What does it care whether it's eccentric or concentric on the muscle? I've seen various answers to this, none of them really satisfactory.

                     

                    I go back and forth on icing. FWIW, my foot doc (Amol Saxena, who just dd Galen Rupp's Achilles surgery) tells me to ice it after a run if it hurts.  Of course, never ice it BEFORE a run.

                     

                    No doubt, you feel better when you ice. I just feel it can delay recovery leading into next work out. By how much who knows......here is a bit more insight and white paper by the company I work for (H-Wave, Electronic Waveform Lab).

                    https://marcpro.com/wp-content/uploads/2017/04/Icing-Whitepaper.pdf

                    H-WAVE - Helping Athletes Heal and Recover Faster

                    Seattle prattle


                       

                      No doubt, you feel better when you ice. I just feel it can delay recovery leading into next work out. By how much who knows......here is a bit more insight and white paper by the company I work for (H-Wave, Electronic Waveform Lab).

                      https://marcpro.com/wp-content/uploads/2017/04/Icing-Whitepaper.pdf

                       

                      Fascinating read in that post, and thanks for sharing that.

                      I esp. like the closing comment in the article in which it recommends, rather than icing: "...controlled, low-stress, non-fatiguing muscle activation".

                      That rings true from my experience. And as i tried to say earlier in this discussion: "...I did try just about everything during the months i had it. Did any of it help? Hard to say but I tend to agree with those that recommended walking on it. And i would suggest that you emphesize full range of motion when you do, even exagerating a long stride.

                      Absolutely do not allow yourself to limp of shorten your stride on that side. That just reinforces bad mechanics."

                      Again, of all the things i tried, that stretching are the only things i could tell were working.

                      Roozi


                        Thanks guys. I've taken nearly 6 weeks off and had a little hope earlier this week. I knocked out a couple of miles on a treadmill after my workout on Monday but felt it the next day. Not as bad but I could feel it. Tonight I tried to run outside and got 1/10th of mile before it kicked in. Im really hoping I can recover soon.

                        Blaf


                          Roozi, are you doing eccentric heel drops, or anything else other than resting?

                           

                          Do you have pain or stiffnes when you get up in the morning?

                          Age: 52

                          Runner since 2012

                          Marathon PB: 3:40:32

                          Roozi


                            Hi Blaf,

                             

                            I started doing eccentric heal drops a couple of days ago.

                             

                            For the past two days I've taken a conservative approach to running. After my workout last night I ran 1 mile on the treadmill at a 8mph pace and tonight I pushed it up to 1.25 mph. Im going to do this up until 3 miles and then transition to outside runs of 2 miles and work my way up.

                             

                            I also noticed that I have better results (only two runs so far so take it with a grain of salt) by striking more mid-foot instead of forefoot.

                            Blaf


                              Thanks Roozi.

                               

                              I am trying to figure out if your problem is the same or similar as mine.

                               

                              Do you have pain in your Achilles when you start walking in the morning?

                              Do you have pain when you pinch or press your tendon?

                               

                              Those are my symptoms. And the last symptom is when I start running. Pain starts after ½ mile or so and comes and goes during the run. It is not sharp pain, but it is very annoying.

                               

                              I do not plan to run until at least morning pain is gone. Meanwhile, it will be doing heel drops twice a day. I added 30lb to the exercise. Tomorrow will be and of the first week that I have been doing heel drops regularly.

                              Age: 52

                              Runner since 2012

                              Marathon PB: 3:40:32

                              Roozi


                                Hi Blaf,

                                 

                                I do feel it in the morning but after 20 mins or so it goes away.

                                 

                                I have a some pain when I pinch the point where my Achilles meets my heel. It more like its tender/sore.

                                 

                                I've been doing 2 mile runs on the treadmill after my workouts. I can tell its aggravating it a little bit but I want to see if I can work through it or build it up.

                                 

                                I might add some weight while doing the eccentric heel drops.

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