Forums >Health and Nutrition>Ice or Heat? Achilles Tendonitis
Hello,
Got achilles tendonitis out of the blue five years ago (was not running) on my right foot and it "healed', but really never went totally away, at time always some tightness but not really much pain at all. Have relied on eccentric heel drops when it did flare up and that has worked to this point. Since I started running have had about three separate flareups with it, again nothing major just more of a nuisance. Most times it hurts when I start running but after a mile or so it seems to loosen up. Training for a mile race in June so doing some intervals on the track & road for the first time which puts a little more stress on the area so my questions is if ice or heat is better after a run?
Thank You,
Jay
I wish I knew. I have reoccuring AT after an injury 6-7 years ago, and it flares up when I do any speed work.
I've tried all the normal recommended stuff; including ice and heat. I've also read the latest studies saying ice is actually counterproductive to inflammation and healing, and that icing is the exact wrong way to go, but it does dull pain. (traditionalists can chime in about their anecdotal icing experiences now). You WANT inflammation, that's the body's way of fixing itself. Heat might speed that process along. (might).
Tendons don't stretch, that's why they work and why they get damaged. You cannot stretch a tendon, but you can stretch the muscle attached to it, a bit. But inconvenient recent studies show that stretching isn't very effective, either! They are ruining all our Beliefs; icing/ice baths, cupping, NSAIDS, and stretching don't work, what's next? We shouldn't run in order to get better at running?!
Reducing aggravation to the AT so it doesn't get inflamed or painful is 100x more effective than trying to treat it after it gets aggravated and painful. Keep the speedwork to a minimum, maybe once a week at most. Take the next day off from running, a planned rest day. Substitute hills for sprints to build strength. Warm up adequately. Don't go 0-full speed in a few steps, ease into and out of your top speed to reduce shock to the AT.
A good warmup before speedwork I learned from Mike Manley is 100-200m starting at a slow jog with each individual step being faster until you reach full speed at 65-130m, and then slow down the same way, but in about half the distance. Such slow and constant acceleration is hard to master.
60-64 age group - University of Oregon alumni - Irreverent and Annoying
Just my 2cents. I say heat. Tendons already have low blood supply, so icing restricts blood flow which will slow healing. Heat on the other hand, helps open blood capillaries which should aid in healing. I discovered this while treating PF.
YEAH! I concur.
Thank you for the reply and after last nights run I 100% agree with the gradual build up to interval pace. For whatever reason I can run slow, medium and tempo pace but intervals or above race pace for short periods seem to cause problems physically. Training for a mile run sponsored by Adidas in Back Bay (Boston) on 6/16 and but realize this probably is not best for me but appreciate the feedback. Will slowly try to build up to "interval" pace the next few weeks of training.
I'd love to be able to race 400-mile this summer, but with my achilles I can't train properly for anything shorter than 10k, and I'm horrible at anything longer than 3k. I think I might try doing one speed workout about 10 days before a track meet, and go all out at the meet. It's not "proper training", but it's better than limping around for a month by over-doing it like I did last year for the Oregon Twilight masters 3k. I learned to space my speed workouts farther apart after that, if I do any at all. There are several people who "train slow, race fast" never doing any runs close to race pace, let alone faster.
SMART Approach
You probably have a component of tendonosis vs tendonitis at this point which is why you have recurring soreness. Certainly, stay away from ice. Moist heat is better and definitely do before runs. I personally use H-Wave exclusively before and after runs and am 100%?pain free for first time at age 53. I also treat patients with H-Wave (prescribed by sports docs/DPMs) and it is widely used in pro and major college sport teams. I treat the worst cases of plantar fascitis and achilles tendonoisis at my work with solid results controlling pain while also rehabbing injury over time while it focuses on active recovery/muscle activation and increasing circulation to tendon and then angiogenesis and new tissue growth. The ultimate outcome will be remodeling the brown diseased tissue into vibrant red tissue in tendon. Movement is medicine but do no harm first. I have gone through chronic tendon issues and they are no fun at all. I swear years of icing contributed to it. The body is designed to self heal and we need to do the right things to help it along. A lot of misinformation out there.
Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery
Structured Marathon Adaptive Recovery Training
Safe Muscle Activation Recovery Technique
www.smartapproachtraining.com
the REAL JZ
I had a full rupture of my Achilles 14 years ago. It wasn't running related per se but I can share my experiences since. Outside of rest there are a lot of different things you can do and probably an article or other Internet lore to debunk everything you are told. If you haven't seen an Ortho, and maybe a sports med or specialized ortho in foot/ankle then I'd go see one.
One easy thing you an try is to add some inserts to your shoes that give you a little more lift on the heel so you're not firing the Achilles so much. Put these in your everyday shoes for work, etc. and in your running shoes too. Anything to lighten the load on the tendon. I don't use these much anymore - only when I have a flair of pain (and that comes in the other ankle....gait is all screwed up since the injury/surgery).
I can also attest to the points already noted about training slower. I slowed down my easy workouts leading up to a half marathon last month and trained for 12 weeks leading to the race completely injury free. I also ran my best half (1:37:22). I used to think an 8 minute mile was my easy pace...it's hard to run slower but the benefits are real.
2019: Run my first marathon.
"Who you are will show in what you do"
I have very weak, loose ankles resulting in a ton of rolls, strains and sprains over the years. That also leads to a lot of tendonitis as well plenty of opportunity to try different therapies.
Heat is much better then ice for me for the acute injury. Others have pointed out the importance of blood flow so I won't belabor that point. What I do find is that with Ice the swelling is reduced short term allowing me to feel better and keep going. With heat I swell up more, sometimes to the point of needed crutches for a bad sprain. However, after 2-3 days I can tell that I'm actually healing faster. The only time I would ever use Ice is if i suspected active bleeding into the tissue.
For the longer term effect of the tendonitis I still find that heat keeps me feeling looser in the affect joint which seems to put less stress on the tendons and ligaments. If I have problems that persist for several weeks I'll treat that with several days of Meloxicam. Works much better then Ibuprofen even though they are both NSAIDs. Often after just 2-3 days of Meloxicam I'll be back to normal.
I'd read about Jello before, but forgot it. Here's an article concerning research into rehabbing tendons and ligaments that so fas seems to be twice as effective than NOT eating Jello.
https://www.outsideonline.com/2392880/gelatin-injury-prevention-recovery
I don't eat much Jello, but I do supplement with collegen. I started for my hair, skin and nails, but I have noticed that the recurring tendonitis I have had in my elbow for years stays away when I keep up with it. My hamstring like to give me trouble too and is much improved with the collagen.
There is an oddball in every crowd and I guess it's me. Generally speaking, I am not a fan of icing anything. But I came home after a long run one day to egg sized knot on my achilles, and it HURT. That flareup occurred about 8 weeks out from a marathon. After much research, I decided to ice it using a frozen bag of peas for 10 - 15 minutes a couple of times a day. I took two weeks off completely from running while doing so. When I resumed running, anything faster than easy pace agitated it, so I didn't run anything faster than easy pace. I iced it post-run for a couple of weeks and was able to cover the distance without any ill effects, albeit at easy pace. YMMV