I ran a half marathon last Saturday (5/16). I PR’d, felt great, etc etc but in spite of this short-lived high, on the following Monday (5/18) I went for a recovery run and felt pain in my left Achilles and stopped after about 5 minutes. Took it easy on Tuesday and tried again on Wed - pain again, and stopped.
I have had Achilles tendinitis before in late 2013 - doc recommended 4 weeks off running and that cured it. Last fall I developed another foot injury - bursitis near my Achilles - another 4 weeks off. This time, the pain is not in the same spot. It is very high on my left ankle, only on the left side (I would almost call it my calf). Feels swollen and I can feel dense tissue in the affected area.
Since my last injury (November) I have completely redone my run training approach (from suggestions here). I started BarryP running 5-6 times/week, mostly easy. Only a 30 min tempo run once/week. After building through January I have been running a consistent 40 mpw with my runs being 35/70/105 minutes. I do eccentric heel drops at least 6 times/week. Calf stretches almost every day, and other ankle exercises prescribed by my last PT sessions.
I also feel a twinge of pain while biking. I took 3 days off this weekend and the pain disappeared. Got on the trainer this morning - and after riding for about 15 minutes pain is back, so stopped.
I may have to take a few weeks off of all activity except maybe swimming. If I have to do this - and my goal race is Aug 30th (70.3 worlds) how would you all approach this? I am in the middle of a trainerroad build program on the bike, and swimming 3 times/week as well for about 15 hours a week (which I have maintained for the past 4 months, at least since I did St George on 5/2). I also have “B” races on 6/14, 6/28, 7/19, and 8/12, all olympic except for Challenge AC on 6/28. Swimming, as far as I can tell, doesn’t hurt it.
I have dealt with Achilles issues for years too, starting way back in 2008. Derailed multiple seasons for me, and there was a time when I thought 10k was the max my body would allow for. Knock on all the wood but I’ve been drama free for two seasons of marathon and now Ironman training. Here’s how I roll: (btw, 41 years old, 6 feet, 185, MOP everything):
The thing I recommend right now is this portable ultrasound machine. I have something similar. I worked it into my RICE routine, especially when it was really bad. Ice 2-3x a day and Ultrasound 2-3x day for 10 minutes. In about 10 days I started to notice a change. It helps break up some of the scar tissue that can make achilles issues the plague they can be. Even now, if I feel a bit of ache or twinge after a workout I’ll sit with the machine for ten minutes while I watch TV or something and it helps. YMMV, but I can’t recommend this highly enough from my experience - I think it was the most significant thing I did to get on the path to wellness. And no, not affiliated with them or anything, probably there are other/cheaper, different/better models out there, this is an example. http://amzn.com/B00T8UH8EEI quit trying to be the fastest guy in the world. So many seasons I’d do one too many speed workouts and be out for 6 weeks, and I’d think - I don’t care how slow I’d go, I just wish I could be out there. So I limited speed work for several seasons. And I still don’t do it as often as most. I’m not out to win any reasons, just enjoy myself. That means intentionally slowing down, and only - diligently, patiently - paying back my training and never going beyond myself. It means I pace much more conservatively than maybe I need to, but I don’t care. FWIW, I’m almost as fast this season as I was 8 years ago, I think because I’m not wearing down so hard.More proactive rest. I take 2 days off a week. I don’t obsess about everything. I do yoga/stretching on one of my days off and treat it like a long run or ride - not negotiable.The minimalist shoe fad really did me in. I tweaked my Achilles the first time doing speed workouts on Newtons, and it was years before I felt like myself again. I train and race in Hoka’s now. I don’t love everything about them, but they’re cushy and forgiving and they help keep me out there instead of stuck inside.Crossing my legs or sitting for long periods with my elbows on my knees is a major aggravation for me, and can start issues happening if I’m not careful. I’m really mindful of anything limiting blood flow to my lower legs.
Good luck, keep your chin up. It really sucks, I know.
Same as nitrox, Hokas did the trick for me. I’ve read born to run and research on minimalist running and always thought I would do myself a disservice by switching to maximalist shoes… Well, the truth is that the minimalist approach is not for everyone. We all have different anatomies and genetics and I have accepted that mine requires more cushion. I also worked on more non-pavement running (track, trails, grass etc.) and will take short breaks during long runs to stretch out my calves.
I’ve struggled with Achiles issues since I started tri’s / running (2009). Got through last year and IMMOO, but had a flare-up in the last week or so.
I dialed back my running, but kept at it. If your pain allows do shorter runs for a week or two (3 miles or so). You won’t lose much run fitness. After a week or so, see if you can do a day or 2 of 2x the runs.
Slowly rebuild from there. You have plenty of time to hit top form for August, but you gotta take the steps now to correct it.
Are you doing your heel drops with a weighted backpack? If not, start it now. Otherwise you are wasting your time with the exercise.
You mentioned pain while riding…are your cleats all the way back (towards the heel)? If not, do it now. Helps alleviate stress on the Achilles while riding.
Get a wobble board and do one-legged stands on it. Get a balance pad and do one-legged squats. Anything to help stabilize the kinetic chain of your leg.
Strongly suggest looking into run / walk as well. Start off at 3-4 min run / 1 min walk. Work your way up to 1 mile run / 1 min walk. This conveniently comes close to the aid station placement for a HIM. It will help alleviate the stress on your calf while running and give it a chance to relax.
I have found a heating pad to be therapeutic, as well as a night splint. Swimming was also massively therapeutic for me, so take this time to up your swimming.
Thanks all - sound advice. I ordered the compression sleeve, and I’ll start doing my eccentric heel drops with some weight and move my cleats around on my shoes. In terms of running volume, I’ll try to make my way back up to 40 mpw over the next month or two, and slowly… sitting here now, I still have some pain but it seems to be subsiding. Last thing I want to do is make this injury more serious than it already is.
Start with 5 lbs in the backpack and slowly add more as you can.
I think I was up to about 30 lbs during my original injury rehab.
The extra weight is a critical component in making eccentric heel drops beneficial. All the studies that indicate success with the exercise include added weight, but most people just use their body weight and have little success.
I have had Achilles’ tendinitis a few times over the past several years. Each time I have gone to this place called Pittsford Performance Care here in Rochester. They specialize in neurologically based treatments and modalities, partnered with chiropractic medicine. Depending on the severity of the tendinitis I have had to go for 2-3 treatments and it is completely back to normal. I’m back to normal training within a week of the onset of I get in right away. The first time I went I had been out of running and cycling for 2.5 weeks. They had me back up and training within a week.
It is a very unique form of treatment that I’m lucky to have available here. I would check out their website and read up on what they do and then see if there is anyone local to you who does treatment like that. If not, you could always visit Rochester and get treated.
I’m not an MD but I got injured really bad over the last 2 years, always on the left side (IT band, stress fracture, plantar fasciatis, achilles tendonisis). It was mostly due to overtraining/lack of stretching… the usual stuff. And eventually I got to see a chiropractor that showed me that my pelvis was very unbalanced and could partly explain these injuries always on the same side.
My achilles tendonis was due to the newtons. Bought them, went for a easy 1h run, and BOOM. Couldnt walk for a few days. Figured that minimalist / 0 drop heel-toe was not for me. Went back to 10 to 12mm drop and all good.
Might help to examine the shoe you are in. I had tendonitis and I made a minor change (Newton to Saucony) and that helped greatly. If the achilles is the only problem I wouldn’t run off to the other end of the spectrum, like going from Newton to Hoka, but maybe an ever so slight adjustments is all that is needed.
I had achilles tendonitis several years ago. I went to an orthopedist. He prescribed anti-inflammatories and had me put my feet in hot and cold water each evening. Feet in as cold water as I could stand for 5 minutes, then in as warm water as I could stand for 5 minutes. He said to do this for 30 minutes every night. No running until better. He did say I could swim.
I don’t know what level of tendonitis you have. My ankles were, as they say in the South, “all swolled up” and they were pretty much locked in place.
I’m currently dealing with some Achilles issues. I had a nasty injury four years ago that kept me from running for over two months. I’m currently using EPAT shockwave therapy. I had Graston in the past, but this is supposedly much quicker, and it seems to be working. I haven’t run for two weeks, but I have no pain after receiving two treatments and have my third one tomorrow. I’m hoping to begin running again this coming weekend.
I understand your pain, as I’m a “survivor” too. First thing; get a wooden rolling pin and roll your calves, in multiple directions. You’ll feel adhesions and work them out yourself, as your feeing is better than any therapist can do for you. Also, dump any shoes with a low ramp. This is what did me in, and I went to regular shoes, still lightweight, but no flat ramp, and id worked amazingly well. Then, the one thing that worked for me, in ONE session after I found which muscle group was the problem, acupuncture. I narrowed it down after 4 sessions and when I hit the right muscle, way under the soleus, one treatment of an hour plus and it was behind me. I have not been affect since, and it’s been months! (touch wood.)
Good luck, but get aggressive and get off any low shoes. Achilles issues are usually a high muscle group stretching to too far.
So, I have a mild case of this too. Do you all just stop running all together or do you go super easy and do the rehab at the same time? I haven’t ran in a week and it is feeling better. But I want to run if I can and do the rehab. Thoughts?
So, I have a mild case of this too. Do you all just stop running all together or do you go super easy and do the rehab at the same time? I haven’t ran in a week and it is feeling better. But I want to run if I can and do the rehab. Thoughts?.
You have to let pain be your guide. As I noted above, I had a mild flare-up a few weeks ago…dialed back my intensity and mileage, started some rehab exercises and was able to keep running. Was back up to 45 miles last week and heading towards 50 this week and everything feels OK.
If the pain inhibits your gait or hurts so bad that you can’t run the next day, you should probably take a more aggressive approach.
Another vote for the heel drops/raises! I struggled with chronic achilles tendinitis and crepitus after a stress fracture. I started doing a ton of heel drops/raises (like at least 2-300/day) and it went away.
As a tip, though - I also recommend supplementing the calf exercises with some shin strengthening, ie writing the alphabet by pointing your toes, etc. Too much calf strengthening without doing the same for the opposing muscle will create some bad shin issues.
Lastly, stretch your calves, roll them, anything to keep them loose, and ice the achilles. I like the method of freezing water in a paper cup peeling the top.
So, I have a mild case of this too. Do you all just stop running all together or do you go super easy and do the rehab at the same time? I haven’t ran in a week and it is feeling better. But I want to run if I can and do the rehab. Thoughts?.
You have to let pain be your guide. As I noted above, I had a mild flare-up a few weeks ago…dialed back my intensity and mileage, started some rehab exercises and was able to keep running. Was back up to 45 miles last week and heading towards 50 this week and everything feels OK.
If the pain inhibits your gait or hurts so bad that you can’t run the next day, you should probably take a more aggressive approach.
This is generally the approach I have taken, although I made the mistake of finishing my runs when I felt pain above an acceptable level, and it re-irritated the injury a bit last week (but not to the point where it did further damage, I think). Be careful.
As an update since my post 2 weeks ago - my achilles is feeling much better - it has now been more than 3 weeks since the actual injury and I feel like the rest has done its job. I am still hesitant about running however. I am completely pain free except for some minor twinges going up/down stairs, so I want to wait a few more days to make sure.
I also went to a different PT last week who said I had the least flexible hamstrings/calves she had ever seen, and I might have a hip imbalance (I broke my right tibia 4 years ago). I’ll continue to work on these; thank you for all of your advice.
The eccentric heal drops help but I had developed a bunch of scar tissue. My tendon feels like it’s made of Bamboo, complete with the little joint-thing. I’ve been rubbing at it with a piece of dowel-rod. That is really helping. If you have scar tissue, I think you are more susceptible to future problems.I wouldn’t try this until it’s healed though.