Note
So. I've seen the sports doctor. No magic bullets :( He seemed to think that any benefit from cortisone injections / blood injections etc was more than likely from the needle rather than whatever is in it, and seeing as my achilles have improved somewhat on their own, in the short term needling the achilles to "re-injure" in order to promote healing and realignment of collagen fibres is not worth the slight risk of tendon rupture at this point. Will be re-visited if my achilles worsen.
So.. what do I do?
Not what everything I've read has been suggesting. Apparently all that is out of date now. No apparent benefit to regimen of lowering with one foot, raising with 2, as studies have now found that the concentric contractions don't affect the benefits of the eccentric phase. Also no point in going past a neutral position, can cause too much re-injury and doesn't add to the benefit of doing raising and lowering on a flat floor. Important change seems to be to do the calf stuff as slowly and as controlled as possible.
So, rather than 3 sets of x reps on a step, I've been given 3 x 5 minutes on a flat floor using both feet for up and down as a starting point. To be adjusted (Up or down) as necessary.
Exercising that places some (but not too much load) on achilles necessary to promote healing twice per day, so either rehab exercises as above, or cycling. (which obviously doesn't involve the sudden achilles loading of foot-plant in running) Think I may be on the bike a lot. Will have to see how my knee copes. Bike fit may be coming sooner rather than later.
Need to be more strict on myself avoiding sprinting, jumping activities (no more beating the kids at basketball or demonstrating high jump and hurdles), as well as hills and interval work (no return to running in the Toomsless group any time soon and State Champs is a definite no-no :( ) which is going to make work awfully dull. These activities will more than likely re-injure past the capacity of the body to repair.
Main issue is not an inflammation response, but anti-inflammatories OK if they help maintain the rehab. Activity generally to be guided by the principle of discomfort is OK, pain is bad. Apparently this is meant to be an easy distinction to make and most people underestimate how much they can do. I'm not so sure about myself. I'll hazard a guess that the annoying discomfort that I had when my achilles started to play up that went away after a couple of minutes is OK and the "I can't even jog up a hill unless I've slowly shuffled around for at least 10 minutes becuase it hurts too much" that I was at by the end of the Easter carnival is probably taking it a bit too far.
Have decided in the interests of not pushing too hard too soon to stop all running (well, as much as possible) and to bite the bullet and get back on the bike and the ski. Need to keep some fitness up / get some back.
Will not commit to any racing in the short term, but am already thinking about possibilities for the second half of next year.