I had overuse injuries in both my achilles almost 2 years ago. It started with stiff calf muscles and worked its way down. I finally went to a physical therapist and received electro-stimulation, massage, and learned that I have to stretch them slowly and gently as much as a possible, even during the day while at work. I also do a lot of (SLOW, GENTLE) toe raises on steps followed by holding the stretch for up to 1 minute 3 times for each leg. The pain is still there after brick days, but I'm able to run again (I just completed a half-marathon) and I can get up out of bed in the morning without limping! So I'd say P.T. and plenty of slow and gentle stretching. Good Luck!

I had a bad case of AT for a year and a half. The "normaL" prescribed treatments didn't work. After being told to take yet another two weeks off or face the possibility of developing bone spurs and possible surgery, I went looking for alternatives. First, I found a report on a study done that showed people who took a placebo recovered just as fast as people who did the RICE routine. Which wasn't encouraging.

Then I found the people who wrote "The Pain-Free Triathlete." Achilles Tendonitis is caused by spasms in your Gastroc or Soleus muscles (calf). When these muscles become shortened due to the spasms, the tendon is pulled and the damage is being done at the insertion point in your heel.

To treat this problem, Sit or lie down on your back. Place the knee of your (good) leg just behind your (bad) leg, as if you were crossing your legs. Line the kneecap on the calf muscle just below the knee joint. You want to press into your calf muscle with your knee, and slowly and firmly slide the knee down the calf towards your heel (the movement is actually lifting your bad leg up towards your chest). You might not want to do this on bare skin.
Go all the way down to about four inches above the back of your ankle. You are looking for small painful knots or "Spasms" They are quite painful and are causing stress to the Achilles tendon where it inserts into your heel. This will also cause heel spurs.
When you find these very painful little spots, keep as much pressure as you can tolerate on them for 60 seconds at a time. You will need to do this several times a day (including during my runs). You also need to stretch the calf AFTER every run, making sure you stretch the Soleus as well as the Gastroc.

I was at a point where I could barely run two miles before the pain in my heel would have me limping home. Within a week of doing the following treatment several times a day, I was back on track, training for an Ironman. When done correctly, this works.
You can find several posts on this subject at the julstro discussion forum. www.julstro.com/18.html
There is a section in the book that covers it as well.

If you want some intense soft tissue therapy, there's an extremely old technique with a new name called Graston technique. It came from Asian medicine and they called it "coining" or something like that but, like ART, now it has a new patented name so people can charge more money for it. Regardless, it is a very deep and intense friction technique performed with small steel tools that can work wonders for chronic soft tissue adhesions, scars, trigger points, etc. I'm coming from a chiropractic training background but I think some PT's are using this technique as well. I've heard that the technique is extremely valuable for athletes.

Like the other posters have stated, gastroc/soleus is probably the key. I'd also make sure that your footwear and stride mechanics are biomechanically acceptable. After all, there's a reason that you developed this injury in the first place. Also, as my chiropractic background would imply, postural alterations from a variety of causes along the lower extremity kinetic chain (foot, ankle, knee, hip, pelvis, lumbar spine, etc...) may offer valuable clues as to the most appropriate therapy. If you know of a chiropractor who focuses on sports injuries or one who regularly assesses and treats extremities, that might be an efficent way to go. Hope this helps.

Listen guys

A genine and really big thank you for taking the time to answer these questions and with such great, sensible advice.

I agree with the problems being based upon my calves (which are unfeasably thin) and I will putting the suggested exercises to work this week.

On Sunday I competed in an olympic distance race (although I am British, I live in Thailand and we have an all year round race season) and my AT is now sore. There is an American chiropractor here in Thailand and I went to see him yesterday - guess what? He carried out exactly the procedure recommend.

I now feel that with the exercises and the PT from my Chiro I can be cranking out the miles some time soon.

Thanks fellas, much appreciated.

Simon