Yes it is fixable.

I am going to say sorry in advance for all the questions.

Do you stretch your caff and your solues? Are they tight? Solues can causes alot of problems and no one checks that. To check it have your legs 90 degrees bent then see have someone lift your foot up like a caff stretch.

If you are dropping your heel I would say lower your seat alittle. When was the last time you went for a bike fit? Are you pushing with your foot on the down stroke? I feel your seat might be to high.

Are you doing any treatments for it yet? Ice...ect?

What is your day job? Are you on your feet alot? what shoes do you wear?
Ill ask about heel cups later..

How long has this been hurting you? Do you remember doing anything to it?

Where is the pain located at?

Are you limping? Is your hip, quads or hamstrings tight?

Did you change anything on the bike?

Rest is useful but if we dont find the cause then it wont help much..

You can PM back if you want. I do have a background in sports med but its always hard to figure out a problem without being there hahaha

Thanks for taking the time to write all of that!

No - not doing any stretching. In my physio sessions sometimes the PT does some calf work.

No - no limp at all.. The annoying this is that its 99.9% fine, but not quite there.Just enough to notice. I'm not doing any ice, but i did when i first did the injury. It was caused from a turbo session(indoor), and it was painful after the session, so not incurred gradually. This wasn't my bike, but on mine the setup is pretty dialed.

It's worth noting that i notice it more on long rides (3+hrs), shorter ones are generally ok. In fact i notice it more off the bike than on it. The pain was initally on the insertion, but it seems to have largely moved to slightly further up. This is the reason heel drops were not advisable (apparently).

n=1, I had some success with lingering achilles tendon issues from ART (active release therapy) / Graston technique.

In college I partially tore (or badly strained? idk, I could barely walk) my achilles while running. Took months to heal. Couple years later I had started racing triathlons and occasionally that achilles would flare up; more of a sustained ache than the immediate debilitating pain. Each time I'd stop running for awhile and ease back into it. Found out about ART randomly (here, I think) and decided to try it. It seemed to help.

~4 years later I went in for another couple treatments (at that point I was running a *lot*). Overall, for a relatively small time / money investment I was happy with the results. Also got in the habit of doing calf raises after running.

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All we have to decide is what to do with the time that is given to us. ~Gandalf

Good news there is alot of things we can do to help it. So no giving up right now. The best thing you told me is that it doesnt hurt all the time so this is mild.

We need to start with some modalities. Ice massage and Icing. I want you to get a dixxie cup ( Idk how to spell that) fill it 3/4 with water and throw it in the freezer. Do a few cups. Peel back the paper and For 10min rub the ice like a massage on your cafe and the area that hurts. Make sure you push hard enough. Do it 2-3 times a day even if it doesnt hurt. We are just trying to get ahead of the problem. Best to do it after each ride also.

We need to get you stretching also. I want you to do wall stenches with a straight leg then with a good amount of bend in your knee. hold it for 45 sec each and do it 2 times. I want you to do it 3 times a day. If you have a better way to stretch your caff im good with that.

Keep up with your exercise the PT gave you.

Lets turn down your millages/time and lower your power some till we fix this.

Your heel dropping is the biggest problems. It makes scenes you hurt it not on your bike. For a temporary time try to lower your seat alittle. Just alittle amount. ( Your caff could be tighter for some reason now and the bike fit that onces worked for you might not work right now)

Lets try this and then if this doesnt work look into getting you a heel cups and use them for a week or so.

If this doesnt make scenes let me know and I can explain it better.

Have you looked at your cleat position on your cycling shoes?

I have achilles issues but running is the big factor and I've only occasionally had problems when cycling. The last was years ago and I moved the cleats to underneath the balls of the feet and, if anything, slightly back from that. My idea was that the further forward the cleats are the more leverage the down stroke has to apply force to the tendon. Running wise I am improving but I have had times (since moving the cleats) when running was out of the question but cycling was not a problem at all. Just because it worked for me doesn't mean it will for you but might be worth trying.

Yeah i've done that. It's not a bike fit problem. This was caused from a specific event, and i wasn't on my bike. The fit on my own bike is dialed.

I started having Achilles issues in the summer of 2016. Once I realized that I could not train through it, I researched the hell out of it-- I read all of the academic papers that I could find on PubMed, articles written by (orthopedist doctors, podiatrists, chiropractors, and physical therapists), used the search function here on slowtwitch and read TONS of threads, and I read all sorts blogs where people documented their personal history. Some conflicting advice, but more similarities than differences in rehab protocols. The main thing that I gained was a sense of the various timelines others have suffered through while overcoming this issue. I saw that the *BEST CASE SCENARIO* for those who catch the injury early enough and use a sensible recovery plan is 12 weeks. Many through trial and error end up taking more like a year to get back to normal. Some never seem to recover, possibly due to constantly "testing" it too soon and basically experiencing a lot of error in the trial and error process.

For me with 23 years of multisport and 25 full Ironman distance races under my belt, I decided to pace my recovery over a year. I figure that with all of the wear and tear that this cautious approach would benefit my whole body not just the Achilles.

I did 6 months of swim only in addition to the classic heel drop protocol. After 6 months I moved my cycling cleats back to place less force onto the Achilles and began using TrainerRoad. Surprisingly, 6 months of swim only training (VERY LARGE VOLUME) allowed me to start back bike training at a lifetime best watts/kg fitness level! I have since improved it even more. I have only recently begun running in the last couple of months using a very cautious run/walk protocol and so far so good.

I have probably gone overboard with my approach, but I plan to be physically active the rest of my life and hope to do some more racing too. Based on that, I figured that I should "nip it in the bud" to better be able to enjoy the multisport for years to come.

Has anyone successfully 'beated' tendonpathy?

I have. I had been dealing with achilles tendonitis for about a year. I finally went to my PT who put me through a series of 5 treatments. Each treatment consisted of 1) tx with a TENS unit followed by 2) Cupping on my calf muscle followed by, 3) Dry needling followed by 4) the Graston technique (scraping of the calf muscle with a dull metal blade. Man, it hurt).
I've been putting in some long runs preparing for an ultra in several months. This past weekend I did a 17 mile (fairly hilly) trail race without any issues. And I won, crushing my nearest competitor by 20 minutes!!! Ok, I'm lying about that last part. But I was pain free for the race and after.

May not be the tendon itself, it may be a bone spur or Haglunds' bump. Or the bursae are being inflamed.
If you have a high arch, check that the footbeds in the shoe are supporting the arch. although no complaint about plantar fasciitis, that band also pulls on the heel.
also ask PT if they have worked on the plantaris muscle.

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Anne Barnes
ABBikefit, Ltd
FIST/SICI/FIST DOWN DEEP
X/Y Coordinator
abbikefit@gmail.com

it's been nearly 2 years and not only have I not beaten it, it has gotten a friend and recruited the other leg to join in the fun.
I admit I've not been very dilligent in taking care of them.

I rest (completely) for 3 months and then resume acticvities (low impact. low mileage) but it still comes back. I've done heel drops. accupunture. PT. Ultrasound. Icing etc but it still rears its ugly head.

It's not so bad that I can't run or walk properly but its a niggling feeling that _just_ stays there and tells you that it's still alive.

On some days its OK, on some days it aches quite a bit.

I found that sitting on my lacrosse ball (piriformis?) helps.. so does pulling my toes up and then rolling it on a "hard" roller I got from decatlhon / PVC pipe. In addition to that, rolling on the top of the calf helps as well (the shins I believe)

My Cycling / running activites has grinded to a near halt. (as I read that I cannot completely rest as exercise is what will deliver more blood to the achilees)

That's my story. It's an ongoing saga.

Yes you can overcome this with patience. I had this issue and took 1 year before I could run again. Mine started after doing NYCM in 2014. Started back running after about 4 weeks. Had major Achilles pain. Sought out PT..all those exercises, graston etc. Nothing worked.

Sought out ortho Dr...put me in a boot for 4 weeks. Did nothing.

Tried acupuncture, saw a different PT..did graston exercises..etc. Nothing worked.

Now 9 months has past and no running, cycling hurt..etc..you get the idea.

Finally sought out another sports Dr. and he said.."let's shut it down"..do nothing..no PT, no exercises, no graston..nothing. Well by the end of October the following year after doing NYCM, I was slowly..very slowly getting back into a walk run routine. I used my orthotics religiously!

So all of 2015 was a write off. Gradually started back doing tris and cycling in 2016 and a ton of strength training that winter. Then by this year..completely back to normal even did my 11th Ironman with zero issues, zero pain. Just take some time to rest and heal and do things that won't ever aggravate that area. Good luck!