in: Orienteering; General;
| # Posted 2007-01-18 12:13:55 | |
| phil: | I'm a Swiss orienteer (m, 34) suffering from achilles tendonitis (inflammation) on the left foot since July 2006. Initially, it only hurt during the first 10' of running and then disappeared. During the last months it has gotten worse: Pain doesn't disappear (but is still bearable) during exercise and might also stay or come back during rest. Not running for a week doesn't seem to make a change.
Any advice on treatment, whether I can continue to run etc.? Thanks! |
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| # Posted 2007-01-18 12:33:00 | |
| pcbrent: | Get some new shoes. Didn't used to think that shoes made any difference, But after going through the same thing myself, new shoes are the way to go. |
| # Posted 2007-01-18 14:34:38 | |
| Golfer: | I'd see a good Sports Doctor. Had a similar injury for 18 months: tried everything - physio, rest, deep massage, even acupuncture! Eventually saw a Sports Doc in Sydney and he diagnosed achilles tendinosis. He gave me a set of exercises called "Heavy-Load Eccentric Calf Muscle training". Basically heel drops!! Start with toes on a step, raise up onto your toes and then slowly drop below step level. 3 sets of 10. Start with both feet, then as you strengthen the muscle, graduate to just the injured side. I was back to full running within a couple of weeks! Have a look at this link: http://ajs.sagepub.com/cgi/content/abstract/26/3/3...
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| # Posted 2007-01-18 14:46:18 | |
| fish: | Just from my experience ...
Assuming you've not done any major damage to it in the last few days - and it's more a long term thing. lots of calf stretching, plus calf raises (eccentric stuff going down off a stair). Massage, and hot/cold treatment. I have a similar problem with minor tendonitis, if i'm slack with the stretching / strengthening I know it will get worse. And i can definitely agree that simple rest (without doing the other things to help) won't improve the situation much. |
| # Posted 2007-01-18 15:56:05 | |
| Charlie: | I had a three-year bout of achilles tendinitis about 15 years ago and killed it finally with a program of intensive icing. I was fortunate in that I was working from home and so had access to a freezer. I bought several of the re-usable gel ice packs and kept swapping them out - strapping one on for as long as it stayed reasonably cold and then getting another one. I had a very serious case, and it took about 6 months before it was completely cleared up, but the improvement was gradual and some improvement was noticeable very quickly. Mine had also migrated up into my calf, and I applied ice there as well. Those stretches that Golfer describes are very important too. |
| # Posted 2007-01-18 17:15:38 | |
| Joe: | just cured mine - 75 days. I stopped running altogether. I stopped wearing shoes with heels. I wore clogs instead. stretch the calf, Ice the area, massage the tendon. You may also want to place some kind of heel cushion in your shoe to alter the spot where the heel hits the shoe. also, there is not much blood flow in the tendon, so you may not see much swelling, but it is there. keep up the routine until you do not feel any discomfort while squeezing the tendon. I continued to stay in shape by riding a stationary bike while wearing a shoe with a soft heel. good luck. |
| # Posted 2007-01-18 20:23:04 | |
| o-pia: | I too have had this problem with my achilles one and a half year ago, so I wisited a doctor. She said I should do a midle way of trainig, not too much and not too litle. Too litle training would do so I got it again, and too much would do the healing longer. She also told me aboth the stair-practis and it helped. Mine tendoniti was gone after 3-4 mounths, but I hope I don't get it again... So, good luck! |
| # Posted 2007-01-18 20:43:29 | |
| Barbie: | The eccentric calf work Golfer described works wonders.. but make sure that you are not too inflammed to do them. Ice right after, with the calf on a stretch if possible. |
| # Posted 2007-01-18 20:48:55 | |
| barb: | Thanks for all this advice - very useful. |
| # Posted 2007-01-20 05:46:51 | |
| simmo: | I've managed it for 20+ years by using the method referred to by Golfer, and a few ideas of my own, developed from experience:
1. Avoid interval training. 2. Ice the area after every run, whether painful or not. 3. Look after your calf muscles - dencorub (liniment), massage, and Skins (before Skins arrived I used elastic tube bandage when running in winter and under my gaiters when orienteering). 4. See a podiatrist and get orthotics if needed. Wear them all the time, not just while running (I have 3 sets - one for work/dress shoes, one for running shoes, and an ultra-thin set for my orienteering shoes). 5. When you feel pain for the whole run, that's the time to take a 3-6 week break from running and increase the heel raises*, ice and massage. 6. Did I say avoid intervals? Some people maintain that hills are bad for achilles, but I've never found that. I do hills runs to give me a similar training effect to intervals. * Heel raises should be done on a step with a bent knee. It's actually the gentle lowering of the heel from the raise position that has the beneficial effect. After you have built up to say 3 repeats of 30 (several times a day), wear a back pack with a brick - or heavy book - in it, start again at 15 and work up to 30 again. Then add another brick. |
| # Posted 2007-01-22 02:12:26 | |
| buzz: | What not to do.....
Partially rupture achilles and think its just tendonitis. Stop running for a couple of months - eventually stops feeling sore. Do a couple of gentle training sessions - no problem. Do one last race for the season and snap the thing completely - not much fun :-( Get it checked by physio or sports doctor if you can. |
| # Posted 2007-01-22 13:28:15 | |
| phil: | Thanks very much for all these helpful hints. Have scheduled an appointment with a doctor to check... |
| # Posted 2007-01-24 05:56:38 | |
| ebuckley: | One thing not mentioned above (but could probably be derived by checking the birth year of the respondents) is that all inflamation related problems take longer to heal as you get older. At age 34, you're just starting to get into that. You'll have to start being more patient with both injuries and normal post race/workout recovery if you want to keep problems from getting worse. |
| # Posted 2007-01-24 07:33:18 | |
| fletch: | Don't have anything useful to add, but I'll go try those exercises coz my achilles (both) have been bugging me for 12 months (but I haven't done enough training to make them too bad)
Cheers. |
| # Posted 2007-01-24 08:34:53 | |
| Tooms: | And don't forget that you're of an age now that "inflammation related problems take longer to heal" or should it be heel? :-) |
| # Posted 2007-01-24 16:11:29 | |
| JennyJ: | I don't think anyone's mentioned this but just cutting in a straight line down the heel of your shoes can help a lot. |
| # Posted 2007-02-12 20:37:39 | |
| ndobbs: | I've minor (at least, not hugely painful) Achilles tendon problem since 10 days ago (maybe did the damage at my first ever hill interval session on the wednesday, in any case after orienteering on sunday 4th I had it).
went for a jog on Wednesday to see how it was. Didn't feel better (no pain, but could feel it), friday I tried again fo r50 minutes.... after it had regressed. Apart from that I've been cycling on average an hour a day, and since I read here that heel drops were a good idea on friday i've been doing those and stretching. however that heel drop study was for long-term sufferers... i'm only short-term, so far... someone in my running club said no running, no cycling, no heel drops, just ketum (ketoprofene) for 15 days... is this reasonable? |
| # Posted 2007-03-15 01:06:02 | |
| phil: | it's been 2months that I started this discussion, so time for an update:
Went to see a doctor, who diagnosed a minor tendonitis: Did a lot of strengthening (heel-drops), stretching, only a little running and a lot of alternative sports for one month, then slowly increased the volumes. All that seems to have worked out, I sometimes still feel the achilles, but it no longer hurts or prevents me from training. |
| # Posted 2007-03-15 15:30:20 | |
| ndobbs: | so from me too...
two weeks ago I was back running essentially normally... easy running but didn't get negative feedback from the ankle. Then on the Monday morning I did 30 mnutes cycling fastish and started feeling it bad again. I've had ten days off doing some heel lifts and stretching before going to bed the last few days, will try a jog in a day or two if all goes according to plan. Unfortunately complete rest has been impossible as I have to walk 40 minutes minimum each day I go to uni... and it's not completely flat... and no cycling more than 10 minutes for me for the next 4 weeks... it's horrible, spring has arrived and the weather is fantastic. |
| # Posted 2009-06-18 06:39:04 | |
| manolo: | Hi all and thanks for your comments. I have been running for 1+ years and lately I decided (or body asked for :) ) to increase my running from 3 miles (5K) a day 5/6 times a week to 6 miles (10K) 2/3 times a week and the other days stay with the 5K. I guess I just overused my Achilles tendon and got injured...I went to the doctor and she said to keep running, avoid hills, slow my pace and distance and basically listen to my foot...if it hurt stop, ice it, etc. She gave me some stretches, very similar to the eccentric ones...When I got the injury I stopped running for 1 week, then ran again after getting a little better but then it felt like the injury had regressed. Today I'm not sure whether I should stop completely from running or just take it really slow and not run 3 miles but maybe just 1.5 (half)... I will start doing the eccentric stretches tonight. I have applied a lot of icing and seems to stop the pain a lot, although I rarely feel pain during the day...just when touching the injury.
I am 35, m and was planning on running my first marathon. Looks like that's not going to happen. One thing though is that I want to heal and for good, I've never gotten injuries but I guess I "skipped" stretching even on winter days when I woke up at -10 F (-20 C) :) I guess I'm not in my 20s anymore. ndobbs after 2 yrs, what happened to you? thanks! |
| # Posted 2009-06-18 07:16:20 | |
| Stryder: | Ice, "the stick" for tight calves, and eccentric calf raises. I have a bias against orthotics, and more towards proper form. But, the eccentric calf raises are vital. 3 x 15, 1-2 x daily, both with straight leg and bent knee each. Do not run so far as to feel worse during the run. Be vigilant and patient. You will recover. Stay away from hills and speed work, run easy. |
| # Posted 2009-06-18 07:16:38 | |
| Mounty: | Find a podiatrist/physio that looks not just at your feet to assess your theoretical correction, but the whole biomechanical picture. A bout of achilles tendinitis for me traced back to asymmetrical hip flexor tightness. Bonus of getting it corrected was that I got faster too.
Heel drops & stretching are very good for building robustness in the area. |
| # Posted 2009-06-18 07:16:54 | |
| O-ing: | Tendon injuries can be very difficult to sort out. I've lost 2 years to an achilles injury (1983 and 1990), snapped my patellar tendon (1998) and had surgery on the other (2004). In between I had surgery on another achilles injury in 2001. To try and avoid surgery I've tried all of the above exercises, ice etc. with varying success. The achilles surgery worked like a dream - I was back running in 6 weeks and had no more issues with that side till late last year - but I beat that one with cortisone patches (under medical supervision).
In short - take them seriously. Don't make them worse. Don't be lulled by the pain going away when it warms up - you are damaging it. If your achilles is sore to touch you have a serious problem. A marathon would be just about the dumbest possible thing to do (in fact I think its pretty dumb anyway). |
| # Posted 2009-06-18 08:28:01 | |
| bct: | I've heard that tendons can take a lot longer to heal than an equivalent muscle injury because there's less blood flow in a tendon.
My experience is that icing is good, but be sensible and don't ice too much. I've been rolling the sole of my bare foot with a tennis ball; that provided some relief and I think it helps keep the fascia from getting too tight. I've also been sitting in the "3rd world" or "glutes to calves" squat that lets you get a deep stretch without putting too much load on the ankle. You could try running in lighter, thinner, more flexible shoes to help strengthen the whole lower leg. I've slowly worked up to running 30-40 min per week on a grass field or dirt trail in waffle racers. Some people run barefoot on the track and a lot of people are using the Vibram Five Fingers now. Be patient and take your time. You might need to spend a month just walking a lot. I think I'm at 95% and my achilles still don't like intervals much. 200m on grass is okay so far. |
| # Posted 2009-06-18 21:33:43 | |
| acjospe: | One thing nobody has mentioned is that it is helpful to heat the tendon before running, to have it properly warmed up so that you don't just jump into things and injure it further. Then a lot of stretching after the run and ice after that. The physio I was seeing held that warming up the tendon before the run was crucial, and it worked for me. |
| # Posted 2009-06-19 06:33:21 | |
| manolo: | Thanks for all the interesting comments/suggestions. After doing a lot of research online and after going to the Dr., I can see the huge variety of personal experiences and feelings towards treatment, strengthening, stretching exercises, etc... I do believe every case is different like all of you probably know and I guess the more I learn the better I can pinpoint my issue here, including considering going to a podiatrist/physio to get an overall picture.
About my last 24 hrs, I have applied ice every 2-3 hrs and this has helped a lot but I will gradually decrease the icing a little within the next days (always apply after the stretches or any running activities of course)... I have done the eccentric stretches 3x15 bent/straight knee 3x/day and they feel great. I still think I'm going to wait a little more to start running again, at least until all the pain is gone...and then progressively check my running activities by starting with short distances and gradually increasing if the foot gets better. I have to admit I my lack of experience (with a touch of stupidity too), the fact that I was doing decent running times for 5K and 10K plus thinking my chances of getting injured were very low (at least not soon - while in my 30s) were going to keep my safe...Oh well, now I'm taking this very seriously...even though I accept not being able to run is killing me... I'm just mad I let this happen to me to take it more seriously... Thanks again - I'll keep you posted of my progress. Manolo |
| # Posted 2009-06-19 08:08:40 | |
| fletch: | Didn't see this mentioned in the later part of the thread, so one more thing to add if things don't improve is that recent studies suggest improvement in some tendon issues with the use of what is essenitally an angina patch to promote blood flow in the tendon. (I've heard of this used mainly in patella tendon rather than achilles). I tried it and had to give it up due to the side effects (constant headaches) but works for some.
Eccentrics and stretching did the job for my achilles. Now just have to sort out my patella tendon wkilst still ahving to teach AFL and badminton at work. Hmmm. |
| # Posted 2009-06-20 06:18:34 | |
| manolo: | Fletch - good luck on your patella tendon and thanks for your input.
I did my eccentrics today (morning and evening) and iced after each time. I worked from home today so I had more rest. I feel better and can definitely feel the stretching on the Achilles especially when I do the knee-bent repetitions as my injured area is way down in the tendon where the Achilles widens to join to the ankle. I can feel a little pain still compared to my right ankle which seems easier to handle during the exercises. There's one thing I need to ask... how do you know you have healed? Is there a definite "oh yeah today my Achilles is healed and I can start running again..." or there's no such thing...? I mean I can feel better but as of today the stretches still reveal a little pain and some uncomfortable feeling... When would you say you felt like you could start running (slowly - shorter distances) and it worked well? Thanks for sharing your experiences. Manolo |
| # Posted 2009-06-20 17:43:45 | |
| fletch: | I never stopped running. When it was first an issue, it was sore till I warmed up, then went away, when it got worse ditto, but came back later in long runs. Was sore to touch/squeeze for ages, even after it stopped bothering me when running. It was just a gradual process, where the pain was less severe while warming up and disappeared earlier. I was back doing speedwork before it was 100% pain free, so obviously some sesions you expected a little more discomfort. My doc told me to do the eccentrics whether it hurt or not at the time. (different to any other injury I've had) and seemed to be of the opinion that I cold pretty much run as much as I cold tolerate as long as I did the rehab. I honestly can't tell you though how much of the improvement was from the rehab and how much of it was changing shoes to ones which sat lower on the heel/achilles area. It may just be that removing the constant irritation from my previous shoes was enough to get me turning the corner to recovery independently of rehab? |
| # Posted 2009-07-10 06:33:41 | |
| manolo: | Well, it has been almost 4 weeks since I last wrote something so I guess I should probably update this discussion.
I started running a week ago (3 weeks after I had my injury and stopped running completely). I ran 3 miles in 24 minutes and it was a comfortable pace. I have been running every other day since then, bringing down my time to 22 minutes which is a comfortably hard pace. I can feel something weird on my injured Achilles, but not pain, just a weird sensation. I have only ran 3 miles and this weekend I may run 4, 5 or 6 if keep feeling better, and of course at a comfortable pace. My achilles does not hurt, and I can barely feel pain if I touch it. I have been doing the eccentric stretches 2 times a day (morning and night) and applying ice at least once a day, usually after the stretches at night. I think the rest + the eccentric stretches have been the reason why I had recovered...Still though, I need to come back to be 100% recovered and even though it may take ages like fletch wrote, I think I'm getting there. I'm stretching before and after running...Hopefully this will help someone. I know every person's injury is different but I have found that most people agree on some combination on these four things, shoes change, rest, ice and eccentric stretches. |
| # Posted 2009-07-12 07:00:30 | |
| manolo: | Ok I ran 6 miles today, I felt as good as ever. My time was not the best, 46 mins but it was done at a comfortable pace which is what I wanted....Eccentric stretches u're the best! |
| # Posted 2009-07-16 06:18:07 | |
| manolo: | So my achilles tendonitis is gone for good. No pain whatsoever. The last week and 1/2 was a fast recovery, and I feel like I have strengthened it a lot. I stopped applying ice like 5 days ago and I still do the eccentric stretches and will continue doing them twice a day until I finish the 12-week period. Then, I'll probably do them always as part of my warm up...
So the total time for my recovery was around 4 weeks. Hopefully what I wrote helps someone. Good luck! |
| # Posted 2009-07-29 10:38:51 | |
| theskyking: | I'm new here. Originally jumped off a deck 15 years ago when I was a kid and had minor achilles injury, but it went away. Then more recently, I've irritated it a bit. Then 6 months ago, sprinted hills. Since then I have had moderate pain all the time and unable to do any activities. I'm at a cross roads now - doc wants to immobilize in ortho but I feel instinctively this is not a good idea. For some reason I am drawn to the idea of the eccentric exercises - I've heard nothing but good about them. Will try to keep everyone updated... |
| # Posted 2009-08-12 06:39:08 | |
| manolo: | TheSkyking, Please keep us posted. I feel my achilles better than ever to be honest. I hope doing these exercises will work out for you! I will love to know that this finally helped you heal whatever prob you have! |
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