So after my tri season ended at IMLP, I qualified for Boston in early November and had been training pretty intensively up until late January when I started to have some chronic achilles tendon pain. Since then I’ve backed off the mileage. Reduced my weekly mileage from 50-60 miles to appx 8-12 miles. At the same time, I’ve tried to do steady work in the pool and some sessions on the bike trainer.
I’ve seen a physical therapist for some electrical stim, etc., and gotten some strong anti-inflammatories from my podiatrist. In short, the pain/irritation continues every time I run even with some treatment and greatly reduced mileage.
Short of ceasing running altogether (which may be what I should do at this point), what have people found that works with this type of persistent achilles tendonitis.
Its roughly about 2 months until Boston and another few weeks after that until St Croix. Getting very concerned about my spring race schedule. Any ideas how to get the run training back on track and save my schedule?
Get someone to massage your calf really well. I’m talking a painful, deep tissue massage. Then stretch and ice both the calf and achilles for a few days while not running on it. Make sure if you start running again to continue stretching often (both calf and achilles, there is a difference) and icing the painful area after running.
i had the same problem during marathon trainning last year, i switched shoes to asics kayano, and i get a new pair every two months or so and have never had the problem since. expensive, but worked for me.
I had some Achilles tendonitis popping up a few weeks ago with PF in the same foot a few weeks ago. I went to PT after it hurt for about a week and I’m fine now. The PF is 98% gone, but the AT keeps flaring up a little. I stretch out my lower calves/soleus at least 3 times a day for 60 seconds each. That’s what I did and it cleared up pretty quickly.
There is another one, but this has the same info about eccentric exercise and achilles injury. It has helped me trememdously. Thierry has the other referrence.
When I get AT or PF I find it’s usually due to a tight soleus. Lots of calf/soleus stretching, calf raises (while standing on the edge of a stair step), ice, and going to town on my soleus and calf with the TP massage ball kit seems to help me a lot. Good luck.
Yes, yes, YES on the soleus. I had a friend tell me her Achilles was giving her trouble, I told her to check for trigger points in the soleus, and BANG, fixed her up in a few days.
You can work the soleus over really well with “The Stick” or a massage ball or your thumbs yourself. Sit on the floor, put the foot of the affected leg flat on floor (knee bent), which will relax the soleus and gastroc. Start poking around 6" up from your ankle in the center with your thumbs. You will find messed up ouchy spots. That’s what you want to work on. You can stay in that position and use your thumbs or The Stick. Or you can straighten that leg out and put that ball under your soleus and roll around on it. Do this with the unaffected leg, too, so you have an idea of what “normal” should feel like.
Whether or not you have actual tendinitis, I can’t say. But chances are you have messed up soleus/gastroc, which need to be tended to anyway before the Achilles will be able to do it’s thing.
As part of my daily stretching and weekly massage I/my massage therapist hunt down trigger points and address them before they turn into problems. I stretch my calves/soleus daily, yet they still develop trigger points. The moral of this story is that your muscles can get messed up even though you are flexible, and I am almost hyperflexible. But the muscles at the back of the leg are particularly ornery and despite my best stretching attempts, retain focused tight spots (those trigger points) that I need to work on periodically.
My achilles problem didn’t go away until I changed my work shoes. I had a pair of expensive Rockport loafers that I changed out for a cheap pair of Skechers. Noticable improvement within a week, problem gone (90%) within a month. I guess I needed the extra arch support!
Bummer - I’d much rather break my ankle and need surgery than have chronic achilles tendon issues. At least I’d know when I’m healed and it would mostly likely be faster.
I treat this day in - some do very well at PT, ART, whatever, others don’t. It is OK to treat acute AT with anti-inflammatories, but chronic, probably not. Assuming true achilles tendon issues (i.e. not the paratenon or muscle, either soleus or gastroc), the best would be immobilization (of the tendon) if you are going to have any hope of running Boston. The body can heal about anything, but the largest tendon in the body (Achilles) just also happens to have one of the poorest blood supplies (bad engineering by our maker
I’d go to PT, ART, whatever, that is familiar with athletes that won’t stay off things (might as well be honest), then get into a CAM boot to immobilize throughout the day. Just walking around all day puts a lot of stress through the achilles. Do what they say (ice, massage, muscle exercises, etc.) and hope for the best. This can often be a long time to really get better as other posters have mentioned. You will also get the snake juice people who did XXX and theirs went away in 3 days. I hope you can find that juice.
No one will believe this but what works for me (serious/chronic AT sufferer) is to hit the shower or hot (not real hot) tub after a run and let the warm water beat on the backs of your legs. Everyone told me this was a “no, no” and I did it based on a recommendation from an Oly Marathon qualifier friend of mine.
It works for me. I also jump in the jetted tub (warm NOT hot) a few nights a week and let the water massage my legs.
From personal experience, you need to stop running until it gets better. You can limp along for months and end up way behind where you would be if you stopped, healed and resumed training. Once you resume training, ice after running. You may be able to feel scar tissue in your tendon if you rub it, gently massaging this area will help to reduce this. Use the down time to work on your swimming.
Try standing on a baseball - will all your weight. Shift around on the ball too. My Achilles problems have been related to my rear foot locking up. I usually get instant satisfaction.
In addition to ice and rest, I had good results by putting a small pad under the heel of my running (and other) shoes. It shortens the amount of stretch on each stride. It’s probably not a good permanent solution – you need to wean off of it or else risk permanently shortening your tendon, but it allowed me to keep training.
You can try all the massaging, orthotics, cutting the back of your running shoes, etc. but nothing heals the AT except NOT RUNNING. Google “Achilles Tendinosis” (not “Tendinitis”) and “Eccentric Calf Exercises” and you’ll come to realize that there are no shortcuts. You can rehab your AT by making it stronger but you will have to be patient for at least 12 weeks so forget about Boston and St. Croix. If you wind up in severe pain despite a conservative rehab program, you may wind up having to go under the knife.
There are docs over in the UK and Australia though who are researching sclerosing (shrinking) the “neovessels” of damaged AT cartilage with aprotonin and polidoconal. This kind of treatment, combined with eccentric calf exercises, supposedly allows athletes to perform at near-competitive levels 2 weeks after the initial 1-2 injections. Unfortunately, this treatment isn’t available in the U.S. since most orthos here are pretty wary about sticking needles near the AT. You can Google “John Orchard + Aprotonin injections” or “Hakan Alfredson + sclerosing neovessels” if you want to read more.
Good luck (since you’ll probably keep trying to run anyway).
Sorry to hear it. I went through (and am still going through) the exact same thing - in BOTH legs. It completely sucks.
Three recommendations:
Cushy shoes… I think part of my original flareup was due to my switching to some very light, perhaps undercushioned Mizunos. I switched to big cushy shoes and it helped somewhat.
Backing off doesn’t work. It never goes completely away and it comes back like a demon the moment you increase mileage. The only solution is to STOP RUNNING COMPLETELY for an extended period - yes about 3 months, and yes that totally SUCKS. Focus on swimming and cycling.
Startup again very slowly. I’m just in the process of starting up again myself at very low mileage and NO SPEEDWORK. So far, so good, but I don’t want a repeat so I’m being very very careful.
Thanks to all for the good advice about trigger points for massage, stretching and shoe choice. I do wear orthotics, but I’m wondering if the newish pair of Saucony grid triumph 3s I was wearing were too cushy for me. I haven’t had any problems though with earlier versions of the same shoe, but I also overpronate badly making me more prone to this type of injury. The orthotics can correct this to some degree, but less so when hills and speedwork are thrown in to the mix of high mileage weeks.
Anyway I’m swallowing the very bitter pill and stopping the running entirely for the time being. Focusing on icing, massage, and stretching along with twice weekly PT sessions.
Good luck to all. I’m hoping you won’t have to cope with the same or similar. Never ever take your good health/form for granted…every day you can get out there is a blessing.
