Hi all,
I’m seeking some non-reddit advice on my Achilles injury, before i completely toss the towel in the ring for all athletics. In sep 2024, I did my last long run before Chicago marathon, everything felt fine but next day I could barely walk. I managed to get somewhat ready for Chicago (14km long run 1 week out zero pain), then it came back 2 days before on a tune up run and i stumbled through Chicago barely using my right leg for the 2nd half of the race.
Took some time off to heal but things never got really better. Over the now last year i have gone regularly to PT, foam rolled, and done a million calf raises (different variants etc.). I have managed a maximum of 25km/week of running in spring 2025, before pain set back in. I have also managed to do 3 half marathons (all jogging tempo) from march-june 2025 and been surprisingly pain free after.
Then i got hit by a car and broke my hand in early july and took 10 weeks off running but did the calf raises for the last 8 weeks. I also did shockwave treatment 6x in august 2025.
However now here a year later it is “worse” than ever. I can not really run (did 2x3mins today which were fine), first run in a month with focus on exercises. However i never manage to load the exercises which are supposed to be heavy slow resistance.
I’m doing 2 feet up, 1 feet slow down on a step bench. Currently doing it with bodyweight + 5 kg (so nothing really). I can do the exercises without causing too much pain also with more weight but not 1 but 2 days later i get punished for going too hard and wake up with pain in Achilles again, pain walking down the stairs etc. Then i need to take a day off or 2 and start up slowly again. The pain is so late in onset it is hard to know if you are overdoing anything.
I have had it scanned twice by orthopedic surgeon, one says take it slow other same but also gave me 1 injection.
I don’t know what I’m looking for which is not just “be patient with exercises” but I’m completely lost on what the fuck to do to see some actual progress here. I feel like i must be doing something wrong, that others manage to bounce back from these injuries in a few month etc.
I guess any input is appreciated as to what worked for you, what I have overlooked etc.
I am not a medic but just sharing “what worked for me”.
My experience (at 46yo) was that, with no previous and no particular changes in training regime, I started getting pain. The physio decided that orthopeadic insoles were the solution and I/they got some made up and used daily in all footwear. Little running for several months but lots of moving around (job).
In that 6 months I went from the front of (vets) xc and road (year before 31 for 10km and 70 for HM) to 6 mins down when I returned (October) on no training to race xc (38 mins with winner = 32). Resumed solid training and four months later, back at the front in February. Stopped using ortho insoles in the April (still have them) with no adverse effects and many more years running/racing.
No Achilles issues until one month out from a marathon last spring. The last several years I have been focused on BQ’s and after the last marathon in May, I knew I’d done some damage.
Surgery on my Achilles in October(Tenex Procedure) after every other treatment I tried(rest/shockwave/lots of strength work/what am I forgetting?) didn’t get me any closer to even a moderate level of discomfort.
Surgery 90 days ago and the recovery process has been exactly what the orth said it would be: if you’re patient in the weeks after the procedure, you start to notice improvement about 6 weeks later and the biggest gains are around 12 weeks. Yesterday was my longest outdoor run in months(6mi) with no remarkable discomfort. I am registered for Boston; we’ll see.
One thing I can wholeheartedly endorse is the Lever System which is a treadmill attachment that takes as much as 50-60lbs of bodyweight off your knees/ankles/Achilles. A low-tech version of a Zero-Gravity treadmill. They make a portable one if you don’t own a treadmill but have access at a gym.
To the OP’s question, I read too many Achilles stories on the web that end with some running but more days in between and a lot of just getting used to it. That said, the remarkable capacity of the body’s ability to heal itself given rest/time is potent stuff. My $.02 is do the strengthening work, check the style of shoes you wear, recalibrate expectations for however long you need to, and unless there’s something really, really wrong with your run mechanics or physiology, you probably can truly get past it..good luck.
Without claiming to know the right sciencey words, distance running uses the Achilles and calf muscles passively as elastic recoil, motor units just provide resistance that reacts to load. Slow, active exercises after time off will have turned your calf into something more like a bicep and tendon will have less torsional springiness. Result is that now when you run, Achilles is taking damage each step instead of absorbing energy. I would take up skipping and slowly bring the running back in once the tendon is springy again
My Achilles issues may have been different from yours, but fwiw:
I was getting nowhere with light or bodyweight calf raises.
A new physio switched me to very heavy, raises with slow eccentrics and my issue resolved very quickly. He switched me to something like three sets of 6-10 reps with as heavy a weight as I could handle and increasing the weight higher as soon as I could do 10 reps of it.