Achilles tendon pain - question

Ok, i’ve recently started to have some soreness in my lower left leg, the achilles tendon. i have never had this before, and used to run quite a few miles (50-70 a week). now i do far less mileage, but this has just started.

questions:

  1. should i stop running, or can i run while icing / advil and it will get better

  2. could this possibly be caused by my booties being too tight on over my cycling shoes? I use size L, probably should have XL’s. i noticed after my ride today that there were 2 big red marks right under the most painful part of my tendon. could the constant pressure cause the soreness in my achilles?

thanks in advance

mike

I have read/heard how tight boots, shoes, socks, etc can cause alittle irritation to the achilles.

As for training, just use your best judgement in continuing. If the pain is dull, just be careful and warm-up properly and check how it feels during your workout. However, if you are having increased pain… you should pobably stop training ASAP and RICE it.

Can you remind me what the RICE acronym stands for?

I’m an idiot, I know.

rest ice compression elevation

“Rice Rice Baby…Rice Rice Baby” :).

First of all NEVER use NSAIDs as a matter of daily or even weekly routine. If you need medication, you need to solve the problem or it will only get worse.

General Achilles pain is tough to diagnose. Could be a stride defect, tightness in calf (probably soleus, not gastroc) inflammation/scar tissue in the plantar fascia, tight peroneus, and many other possible causes.

Since it is one leg and not both, I’m inclined to suspect a stride discrepancy. Try running on a treadmill with mirrors nearby or have someone video tape you front on, side on and from behind. Look for any anomalous movement: pronation, left foot toeing in or out more than the right, lifting or rotating of one hip…

Also have a chiropractor check you for hip rotation.

Most of the time a problem like that in one leg only is a sign of spine/hip alignment problems that effectively make one leg longer than the other and result in a slightly different foot-strike.

Try these exercises:

http://www.sportsinjurybulletin.com/archive/achilles-tendinitis.html

Stick with them for ~1 month, even with a bit of discomfort. Works for me.

Check to see if it’s being caused by your shoes. I developed achilles tendonitis, which I swear is worse than breaking a bone, and the upper back portion of my shoes was keeping it aggrivated. I ended up cutting about a 1" slit down the back and then cut over on the sides so the pressure was relieved. Worked for me. I don’t envy your current situation.

Where, exactly, is the pain. If it is 3-6 cm above the heel bone, that is probably the achilles. Then you should rest it (you may be able to bike, if that doesn’t hurt), ice, stretch (gently) and do the exercises in Thierry’s post. You can also do some aquajogging.

If it is higher, it is likely the lower part of the soleus muscle, that begins on the upper back part of the tibia (shin bone) and attaches lower and on the front side of the achilles. (The gastrocnemeus starts above the knee.) Rest, cutting back your run mileage, decrease bounding and hopping as well as compression, etc. will usually help that.

Thanks everyone for the replies. It is 3-6 CM above the heel bone for sure. I’ll try out the exercises listed. I’ve always considered myself to have strong calf muscles, in fact i was awarded “best legs” by my tri club last year. I think the tight shoe really has something to do with it as well. hopefully a combination of looser shoe + exercises will help. it’s only been bothering me 3-4 days. in fact, it felt good when i woke up this morning but got aggravated after riding with those damn tight booties.

thanks again,

mike

I’d suggest RICE and religious adherance to the exercises/stretches outlines in the above link. During this time of the training year, better safe than sorry with a chronic issue…

I’m 50 and have recurring problems with my left achilles. Not as much problem with the right. Of course, I snapped that one about 15 years ago (not something I’d recommend), so it’s repaired and better than before. Of course, my right calf is the size of my forearm… which motivates me to take care of the good one!

I had a similar experience. The weather turned cold, I didn’t have my booties so I put on 2 pair of thick socks and jammed my feet into my cycling shoes. I went on a 50 mile ride and by the end of the ride my left achilles tendon was really sore from where the top of the back of the shoe was rubbing it. Because of the way the tendon is built, a cord inside a sheath, any pressure on it during the range of motion can cause problems.

I began icing and cut back on the running but the symptoms continued for about a month. The irritation grew worse until I could not run. I went to see a podiatrist and he showed me a very effective way to ice it that knocked it out.

Freeze an 8 or 12 ounce cup of water and take the block of ice and massage the entire length of the tendon. The end of the block will melt and become rounded. Rub both sides from top to bottom. Really work the ice into the depression between the achilles and the ankle bone. Work it on both sides and directly on the back of the AT.

Once the AT gets irritated it starts a cycle of inflammation that is hard to stop. Total rest will fix it but, according to my doctor, most cases can be knocked out by aggressive icing while continuing to train. That has worked so far in my case. I ice it 5 to 6 times a day for at least 20 minutes each time, even when I have no symptoms. I haven’t gotten rid of it completely but heavy icing has made it a lot better and I’ve been able to get back to normal levels of training. Good luck, this can be a bitch.

I totally concur with it being tough to get rid of. I injured mine on November 21st, did no running but continued to swim in December (thinking I was “resting” it but the flip turns weren’t helping matters). So…

Went to the Dr. a month ago…total rest! Now 4 weeks later it had begun to feel fine through the day and night (when things can tighten up) so I ran three yesterday am on a treadmill to see how we were doing…and it hurts this AM as if I hadn’t taken any time off. A frustrating and potentially chronic thing. No doc will shoot a steriod into that tendon (and rightfully so) to calm things down, so I guess patience and ice is the way to go…

Good Luck…it can literally be an “achilles heAl” for training intentions!

Get the book called “Pain Free” by Pete Egoscue - it will work wonders with Achilles and Plantar Fascitis problems.

Thank you everyone for the suggestions. i cut down my volume immediatly and now i’m having much less pain. I’d say it was originally a 8.5 on a “pain scale” of 1-10. now it’s more like a 2. here is something else i dug up that relates to achilles tendon pain and your cleats, worth taking a look if you have this problem

http://www.byrn.org/gtips/triAT.htm

As a doc who has had Achilles tendonitis, I definitely “feel your pain”!

If you aren’t seeing a sports or rehab doc at this time, I’d highly suggest you do that. One thing to discuss with him/her is eccentric exercise, which worked wonders for me and which I have used to good effect with my patients. There is a group in Europe (Sweden? Norway?) who have published remarkable results with an easy to use protocol. I can find you the reference to talk over with your doc, if you like.

The patients basically got on the stairs, placing the balls of their feet on the edge of a step with their heels hanging off. Then, they got up on tip toes, lifted one foot, and slowly lowered themselves down until their heel was about as far down as it could go. This was repeated on each side, 15 reps, several times a session, a few times a day, for many weeks. There was a good improvement in symptoms over a month or two. Like I said, something to talk over with your doc or PT, anyway.

Philbert