Besides some rest, I feel that what helped me was calf raises and heel drops.
Also, shoes (but I guess depends from person to person). I've started using stable cushioned shoes with "high" heel drop (Brooks Adrenaline GTS, 12mm heel drop if I recall correctly) and I think it helped as well. After few months I've started using the Saucony Guide with lower heel drop, 8mm AFAIK, to try to increase the ankle strength and range.

PS: not a doctor, just my personal observations.

Yes, eccentric heel drops did wonders for me. Google it. I had regular bouts of Achilles trouble until I started doing this exercise in my mid-40's, and it's been much better since then. I did 3 sets of 15, 1x or 2x almost every day, for about two years. In the past few years, I do it about 3x/week for maintenance. A young PT I know does them as part of his warmup before running, then does them again afterwards.

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<The Dew Abides>

I have also had Achilles tendinitis issues and there is unfortunately no quick easy fix but what helped for me was the following:
1) Rest, take at least a week or two completely off running. You can still cycle, this didn't affect my Achilles at all. When getting back to running, slowly increase volume.
2) Rolling calves with foam or hand roller. I do this every night.
3) Rolling feet with a massage ball or golf ball. I do this before and after each run.
4) Try out different shoes, I switched From Nike Pegasus to Hoka Rincon but shoe choice and comfort is personal.
5) Heel raises and stretching also seemed to help.

Also not a doctor but this is my experience with it.

The thing to be careful about with eccentric stuff for Achilles is there is a different recommendation for mid tendon or insertional injuries. On a phone so won’t try and get it right here but make sure the advice you are following has that difference and you know which you are.

Sounds like you've not been to a physio, and whilst it may appear easy to get diagnosis here, and copy others rehab, that may prove costly in time and even money down the line.

I started with Achilles tendonitis issues aged 10, had surgery aged 11 and 35 years later am having issues with my left at the moment. But the current bout is more to do with my calf than my Achilles. So no amount of achilles treatment would sort my current pain in the achilles, it's the calf that's pulling on the tendon and causing the pain, as opposed to the sheath itself being inflamed (tendonitis).

I'll also add that the heel raises have previously been both totally ineffective, and amazing silver bullets - very subtle differences in the protocol I was using about how often and how many reps to do made night /day difference.

I know everyone here says heel drops/raises, and so did my doctor or PT - however they didn't do jack for me. My miracle cure was foam roll the bejesus out of it twice a day - problem was solved in 10 days. This was after nagging for probably 6 months.

I have been dealing with something similar. What has worked for me is regular calf stretching (I do 2x30sec each time I go to the bathroom as an easy way to ensure I get several stretches in a day). Using a theragun on my lower calf has also helped tremendously to loosen things up. I was initially unsure if beating on it with a percussive massager would help or hurt, but it helped a lot!

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ECMGN Therapy Silicon Valley:
Depression, Neurocognitive problems, Dementias (Testing and Evaluation), Trauma and PTSD, Traumatic Brain Injury (TBI)

Oh the can of worms. Almost as big of a can as Plantar Fasciitis.

There are lots of things you can try and do. The best thing would be to see a PT/Physio who knows the sport of triathlon and understands the demands of the sport.

Foam rolling, eccentric calf raises and rest are all good places to start but they are also very different starting points. Going to a physical therapists will show you the starting point and how to best progress.

Laying off running would be a good place to start for a week and then going from there. Sometimes just taking away a consistent stressor can give you and your body time to heal up.

Where are you located? I know some good PTs that understand and do Triathlons around the USA.

note: Despite being a PT, this is NOT medical advice. Seek a local PT for an in-depth evaluation.

You have to begin to think about how much you are loading your Achilles and the different states of the Achilles according to blood flow and temperature.

If you’re above your optimum weight, it might be a good idea to take rest days and intermittent fast. Give the Achilles a break but also utilize upper body activities to encourage blood flow and provide dynamic rest.

Get some gel packs (velcro wrap) to put in the freezer and put them on your Achilles after an activity. Seek out anti inflammatory foods and take anti inflammatory medicine as well if needed.

Increase Bromelain intake through a supplement or eating pineapple.


Bromelain in the Early Phase of Healing in Acute Crush Achilles Tendon Injury:

https://pubmed.ncbi.nlm.nih.gov/20623610/

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https://www.strava.com/...tes/zachary_mckinney

Everyone is different, but for me what worked was eccentric heel drops and pretty heavy localized pressure. By the localized pressure I mean forcing your thumbs into the area as hard as you can and then flexing your foot up and down. Hurts like a xxxxxx but effective. This is called tissue flossing. Give it a go.

I'm dealing with this now. The injury can vary a bit, but, my PT has me doing slow, HEAVY calf raises (60lbs in each hand plus 60lbs in a backpack), which has been helpful. He said not to foam roll.

I've been dealing with this on and off since November, including 4 weeks off running in Jan.

This is the first PT who has gone really in depth with me in the diagnosis and treatment.

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Long Chile was a silly place.

Currently at one week off of running. I can say after a day where I need to walk more than normal I even notice it too.

I am located in the Duluth MN area. So the odds of a good sport specific PT is limited.

I think I will give the basic exercises folks are recommending a try while I take another week off of running. Then give a short flat run a try and reevaluate.

Problem is that above there are several contradictory 'recommendations'. 1 - roll/needle on the calf. 2) avoid any rolling of the calf 3) slow heavily loaded raises 4) high reps going up on both feet and down on one. etc etc,

What's not been asked (surprising) is if it's worse in the AM straight from bed, or later in the day after use. That would be useful info for someone making a diagnosis as to if its muscular or the tendon sheath that's causing the issue. (Please don't tell me, I'm just a cripple that pays someone a fortune each year to fix me, clearly if I could diagnose and come up with a programme for you I'd be doing that for me).

Go see a physio. Use all that time you're not training this week to find one.

FWIW, this is my n=1 experience.
I had this pretty bad a few years ago. The started in July/August, trained and raced to finish the season in early September than took it easier. Didn't help, the took a full month off in October, didn't help. The achilles was still swollen, painful to touch and every morning the first half hour I was limping. During September and October I did do the calf raises and heel drop, but not very diligently.
In November I switched. I started the BarryP running program with 30k per week and monitored closely if things were getting better or worse. When it would get worse I would stop or take a step back. I was also doing the exercises more diligently.
Slowly it got better, and with an achilles it won't ever go fast, so I kept increasing the running. I kept up these exercises diligently through December, but got more sporadic in January. By the end of January/early February I was running 70k a week and somewhere in February I realized I had no more pain.

Funny, I had the same experience following BarryP. Had a big flare on my achilles (this time at the insertion) last year, couldn't barely walk. Took some months off running, was feeling good walking, and the doctor told me I could start running and monitor myself, and to not worry if I wasn't getting worse.

At the beginning I was still a bit tender after the run, but it wasn't aggravating, so I kept running slowly, and increasing volume. Today, I'm doing more volume than ever, before this my biggest week ever was 70km, and now I'm on week 12 with more than 60kpw (85kpw now), and I'm feeling great. Sometimes I can still feel something during run, but nothing major and at the end of the run I don't feel it at all (maybe it's psychological).

This has worked really well for me on 2 tendonosis and one plantar fasciitis incidents.

https://www.alimed.com/aircast-airheel.html

The idea is it stimulates the tendon, encouraging repair. I'd wear it all day, and during bike rides. If you're as crap at doing physio as me, it's perfect.

Some supporting research showing it working well as eccentric training.

https://pubmed.ncbi.nlm.nih.gov/16498185/

Am a Physio.
Looks like im the first to chime in.

Like others have said it can make a difference exactly where the pain is. If it is right on the bone or further up?
Or how reactive it is to activity, can make a difference to your rehab.

If you want some specifics, below is general guide for my patients especially if it is insertional achilles issue.
Also if you are really sore start with the isometrics ie if you can not do 10 single leg calf raises with out pain stopping you.

Try isometric exercises to start with (shown to build strength while also decrease pain).
seated calf raises with weight on your knee is best.
If have access to the gym can use a bar in the smith machine.
Use a relatively heavy load eg 20kg+ plus the bar.
Lift and hold 30 sec, rest 2 mins repeat 3-5 times. The rest between reps is really important.
If your pain is 1-2/10 that's ok, if your pain is 4-5+/10 stop.
Progress by increasing time to 45 sec (eg over a week or 2).
Then increase the weight, using the pain scale as your guide.
Try and do 2 times per day.

DON'T stretch - especially initially in the rehab. Especially for insertional tendinopthies.
Best way to describe it is you don't want the tendon to be 'pulling away' from the attachment site, early on in the rehab. Give it a chance to heal.

That's also why you don't start with eccentric heel drops.
I see it a lot with my patients - wondering why they are not getting better with stretches and eccentric heel drops.

The most important thing to fix a tendon is build up strength. If you rest it's just getting weaker.
I say you need 'relative rest' for a few days at the start of the rehab, do the exercises, then slowly add low load activities eg swim and bike. Then progress to running.

Progression is isometric, then isotonic (eg calf raises 2-3x10 up and down on floor), then eccentric.

when you want to get back to running start with a jog/walk - start 1min jog : 1 min walk.
Progress run (jog) time using the same pain scale ie 1-2/10 = ok; 4-5+/10 stop.
If you are still getting pain 24 hours post run then you have done too much.

Hope that helps.

Seems like you're already getting a lot of good (if a bit disjointed advice) so I'll just chime in with the most important thing for me: patience.

A few years ago I started getting achilles pain in the middle of a relay race and I was on a 10k segment. My team was in the lead and I didn't want to let them down so I pushed through it and ended up with Achilles tendonosis in both legs. Back then I was still in the mindset that a few days off will cure anything. I would take 2-3 days off and try to go running and within 2 miles I was hobbling. In the end, it took me several months of almost no running to recover. For me, being religious about my eccentric heel drops with my knees slightly bent is what finally got me through. I wouldn't stretch and I would use my other foot to help me back up (so I wasn't doing calf raises). Every few days I'd add more reps or start holding slightly heavier dumb bells. I also did a fair amount of foam rolling. For me it was my soleus(es) that were tender/sore and not my gastrocnemius. I have to tell you, I felt like I was never going to get better.

There were many times that I thought that I'd never be a runner again. Just be patient. It took about 5-6 months before I was running 30-40 miles a week again and about a year later I was faster than I was pre-injury so there is definitely hope. I will warn you though, after this you will definitely be super paranoid anytime you feel anything in the ankle area. This is probably good as you'll be more careful. I still do heel drops occasionally whenever I'm feeling like things are going south and they still help.

Good luck!

had bad pain for a while - taking time off didnt do squat

I now do the 20-30x heel drops after EVERY run
+ calf stretches

Pain was manageable for 6 months while training for NYC marathon (60-80MPW)
Pain is now completely gone after doing these two simple things for 1 year

good luck to you

So just some clarification about my pain and its location:

The pain is localized to being on the back of my leg on the tendon, right above where the back of your shoe is.

Also, when I do single leg raises on my left leg, i do not feel any pain when I am lifting myself up, but I feel a bit of pain when I am lowering myself back down. I did ten reps and the pain level was not bad overall, I would say a 2-3 or so.

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Ryan

As for the timing of the pain, for me now that I have taken some time off the pain is really only noticeable when I am actually walking and then it is barely noticeable. If I walk a ton during the day, it is more noticeable. When I was still running, it would really be painful first thing in the morning if I had run the afternoon before. It seemed to loosen up a bit during the day but still hurt. It slowly went down as I took consecutive days off. Biking does not make it hurt at all in any way.

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Ryan

yes, the essence of the heel drop exercise - do NOT do calf raises during this time on a single leg - use both legs to lift UP and then lower on ONE leg - do 20x a side. Do that every day, 2x a day in the beginning and then after every run forever. You'll be fine.

You have good number of responses, but I thought it would be worth throwing in a basic exercise that may help - cross-footed push-ups.

I have typically try to work in some easy/fast upper body work after a trainer session - 35 push-ups, 60 crunches front, 35 push-ups, 60 crunches left, 35 push-ups, 60 crunches right, 35 push-ups, 60 crunches front, 35 push-ups. Several years ago I broke my foot and started doing them on one foot (the bad foot crossed on top of the good foot).

At some point I started having trouble with the Achilles in the same spot. I tried to run through it, and eventually backed-off until it felt better. Even so, I still had certain runs where it would flare up, so I reverted to shorter runs. Given that I was running less and had some extra time, I started working the push-up/sit-up thing into my post run routine. Out of habit, I would still do one foot push-ups and swap the right/left. As soon as I started doing this, the Achilles tightness vanished. I don't believe that it would have been good to do this at the onset of the pain, but once I was able to do short runs, it worked great. I believe that stretching after workouts is very productive.