I’ve been suffering with Achilles Tendonitis since about June. I tried to run through it for about two weeks before it got worse and called it quits. I’ve tried just about everything I can think of to fix it. I did about 6-7 weeks of eccentric heel drops off the stairs but that just seemed to make things worse. I have gone through PT but my PT didn’t seem to be much help and didn’t give me any exercises except balance on one foot with eyes closed and calf raises. I have gone through a running assessment which had me change to neutral shoes due to supination. I have gone to a chiropractor for adjustments and ART which seems to help for a little while. I took about 3 months of no running completely and just recently started using the elliptical. I get no pain while on the elliptical but when I finish and pinch achilles it gets pretty sore. I just picked up a strassburg sock and that seems to help a little. I haven’t had any soreness while waking up in the mornings for about two weeks even without the strassburg but if I try running I start to get sore about a mile in. I attempted to run two days ago and did a mile on the treadmill at an easy pace. I felt fine while running but the next morning my achilles was sore again.
I just accepted a game warden position in my state and start the academy portion in about 3 weeks. I’m afraid that my achilles won’t survive the physical portion and I will have to drop out of the academy. I’m starting to get pretty desperate.
Any thoughts on what to do next? I am seeing a sports medicine doctor next week as I just changed insurance. Has anyone else have bad results from the eccentric drops? Will custom orthotics help?
“I just accepted a game warden position in my state and start the academy portion in about 3 weeks. I’m afraid that my achilles won’t survive the physical portion and I will have to drop out of the academy. I’m starting to get pretty desperate.”
(pink font) Big deal. What if you had to drop out of Iron Man training?
Ha ha. That wasn’t nice. Man. Major bummer.
You’re case is almost exactly like mine, same timeframe, treatments, everything. If you feel good in the morning you are doing better than me (I feel OK after I am up for a while, just never first thing).
One more idea: I beleive I have gotten some good relief from my PT doing “needling.” (I forget the name). He inserts an accupuncture needle in 4 diff. spots in the achilles, then agitates the collagin. OUCH, but is seems to help and the little lump and general ache has decreased a lot. He also does Ultrasound combined with Graston. Been at it once a week, 1 hour, for six straight weeks. I also do the drops, up to 30+ per leg. No need to do them super slow or deep, just short drops (2-3 sec.), every day.
How bad is the soreness, really? I have done just about everything you described and it just aches (3 to 5 out of 10 pain scale after running, depending on the day), but I’m still trying to train through it as I am committed to Boston. I’m at 10 miles for a long run (8+ pace) & that’s not so bad. Its the speed (2-3 miles @ 6:30 pace, say) drills & some downhills that hit me the next day, but then I recover after a day or two.
Search the forum & the Net. There is a ton of info out there.
Do you have to run a lot for the academy? If its just a lot of hiking, you need to learn to tape & strap that mo fo! Trainers do it all the time for football, basketball & soccer players. Good luck!
Try kinesio tape. A little soreness might be okay. Sometimes doing absolutely nothing is not the right answer. I took 6 weeks off last time mine flared up. I did nothing until I could walk pain free the I started the heel drops. It came back again so I went to see a PT. My PT noticed a knot in my calf, he worked it out and I was running again in 2 weeks.
Question: is your tendonitis “standard” (pain in the achilles tendon itself) or “insertional” (pain in the posterior heel, right where the tendon attaches to the heel bone)?
The reason I ask is that the protocol for heel drops is different between the two: heel drops off a step for the former, flat ground heel drops for the later.
I went through a period with nasty (stage 3, it hurt to walk) insertional tendonitis. Following the protocol for standard tendonitis didn’t help one iota. However, a few weeks of following the protocol (along with some PT) for insertional tendonitis and I was back running.
Thanks. I hope this helps the OP.
It is definitely useful to me
I have struggled with achilles pain on and off for 2 years now. It was always about 6 inches higher than my heel on the back of the leg and heel drops always helped.
One week prior to Miami 70.3 in October I had burning pain on the inside of foot towards the back, let’s say between the ankle and heel. A google would almost point more to PF
Now recently it moves between there and behind the leg, centered, one inch up from the heel. This could be possibly insertional tendonitis.
I suspect there is more than one thing going on and it’s all interconnected and related to a tight chain.
But I will try the 2nd form of heel drops. That may help
One week prior to Miami 70.3 in October I had burning pain on the inside of foot towards the back, let’s say between the ankle and heel. A google would almost point more to PF
I’d be interested in this as well. I’ve experienced similar symptoms since April after running a 10k. For a while I thought it was peroneal tendonitis but after more research I tend to go with PF as well. Sometimes, the pain seems to migrate to to bottom of the foot and it’s always a burning / irritation sensation. For me it seems to go away and come back every few weeks, it’s always fine in the morning and gets worse as the day progresses and it’s seems to be better / worse depending on what shoes I wear. Anyway, it’s annoying but it hasn’t affected my running so far. Calf stretches seem make it better temporarily.
You now have Achilles tendonosis, not tendonitis. The treatment is well described here and elsewhere and it includes massive amounts of eccentric calf exercises and also physio to loosen up chronically tight calf muscles. It is best to use a foam roller or a wobbly roller. Art and dry needling may help as well as a possible injection of PRP plasma. You may continue to have pain for months as the rehab goes on. I have personally gone through it for several years and now I am “cured”. You also must be cognizant of why the acute inflammation started, which is usually from poor run mechanics and weak hips. Best of luck!
I am very familiar with this injury as I suffered for two years with it. Here is a brief rundown of what I did along with some thoughts.
For the first year and a half I fluctuated between complete rest and short runs. The rest would help with the pain then it would come right back when I tried running. Rest was not the answer for me. Then I saw a sports and exercise trainer who was recommended to me. He was able to diagnose where MY issue was. I have high arches but they were collapsing. Anyway, I bought some Superfeet orthotics, stretched, iced after every workout, then (I know I may get flamed for this one) I would rub castor oil into the tendon and cover with Seran wrap and an ace bandage. The combination of these has been a complete game changer for me. I have been pain free for 6 months and running around 25 miles a week and increasing. There is no reason why the Castor oil should work, but I was desperate, and read about it on a weight lifting forum for tendonosis.
Since then, I have removed the orthotics and have been working on exercises to strengthen my arches. I developed some knee pain with the orthotic use and have since removed them and the knee pain has subsided. It is really important to diagnose why you have pain. Achilles tendonosis/tendonitis can be caused by many things. The treatment strategy will change. Try the ice/castor oil to help with the symptoms. As far as the strengthening exercises, I would try to get a diagnosis as to why you are having problems before you do any of those.
(I know I may get flamed for this one) I would rub castor oil into the tendon and cover with Seran wrap and an ace bandage. The combination of these has been a complete game changer for me. I have been pain free for 6 months and running around 25 miles a week and increasing. There is no reason why the Castor oil should work, but I was desperate, and read about it on a weight lifting forum for tendonosis.
I use DMSO. It penetrates the skin and relaxes the muscles and tendons.
I periodically use Absorbine which is 4% menthol and increases the blood flow to the area.
I just tried starting up doing the eccentric calf raises about 2 days ago. I am noticeably more sore/stiff in the mornings than before I restarted them. Also right after completing them (I only did 3x10 each side straight leg and 1x10 bent leg each side) the pain is more noticeable than before. It also seems to be moving slightly down towards my ankle. Here is where the pain is when I pinch before I started the eccentric raises. This second picture is where the pain is on my left ankle
I feel your pain. I’ve been struggling with achilles issues (both legs) for the past 18 months, with various periods of downtime in there. Right now things are going better than they have in a long, long while, which I’m quite happy about. I never got a professional diagnosis of the problem, but think that it has been ‘standard’ variety. I’ve had the usual complaints - very stiff when getting up in the morning, though it quickly improves. Feeling mostly fine when running, but extremely tender afterwards. Currently I feel pretty much fine when waking up, and I have essentially no pain during or after running. I’m up to 50 mpw now.
Here are things that I’m doing now. They seem to be working. Impossible to tell which of them is most important.
I’ve been running in Hokas for the past 8 months. That has reduced the wear and tear on my legs.
But I worried that the heel-to-toe drop was too little, so in the most recent and most successful build I’ve put small heel pads into the shoes.
Now I’m doing daily eccentric heel drops and calf raises on the stairs (25x on each leg is my current limit). But before that I spent quite a while of doing lots of flat floor heel drops. I would do them throughout the day, e.g., when waiting in line for lunch. That seemed to provide a good start.
Perhaps it goes without saying, but I’ve been quite cautious about building the mileage, and even more cautious about running fast.
I’m wondering if it is possible that I my issue could be located in the glutes and hips. After my first marathon I had a meniscal cyst that had to be surgically removed and since then I have had issues with ITBS and now achilles. I never had any real injuries before the cyst.
What is the collective wisdom regarding cycling through this type of injury?
I am pretty sure I have battling the insertional version for the past couple of months. I have pretty much cut out running, but have upped my bike volume to keep my sanity. I have no pain biking and based on what I have read it sounds like the additional blood flow and post ride stretching is probably a good thing.
I just tried starting up doing the eccentric calf raises about 2 days ago. I am noticeably more sore/stiff in the mornings than before I restarted them. Also right after completing them (I only did 3x10 each side straight leg and 1x10 bent leg each side) the pain is more noticeable than before. It also seems to be moving slightly down towards my ankle. Here is where the pain is when I pinch before I started the eccentric raises. This second picture is where the pain is on my left ankle
To be safe, I would consider you as having insertional Achilles tendinitis (probably tendonosis now).
when you do the heel raises, do NOT go below the horizontal. Fast up and very slow down
always be massaging your calf muscles
get “The Stick” and keep it with you at all times. Use it before and after any walks/runs. Use it when you get up in the morning. Keep those calf muscles loose
NO running until pain free. Otherwise you will exacerbate it
PT was a waste for me. Not useful. I tried heel lifts and they made my Achilles hurt worse. Everybody is different so you got to see how your tendn responds
I did Graston technique with a local chiropractor after trying the other stuff for about a month. Graston HURTS but I feel like it made a huge difference
every night, I sleep with my left foot pressed up against the bedpost to keep my Achilles stretched out (same as what Strassburg sock would do for you but I did not like wearing the sock). No pain in the AM
Hope you can beat this. Very frustrating injury!!!
Having just gone through about 10 months of Achilles probs.
Eccentric stretches. Stick with them
Night splint or Straasburg sock. Even after it’s healed.
Massage the cheap out if the entire lower leg. Front shin and back. Use a tennis ball or baseball to really get into the calf muscle.
Also do stretches where you are almost in a plank and then drop the calf down for 2-3 seconds, release and do it again. 10-15 of these 3-4 times a day, especially before and after running.
Find something you can use to do graston technique on your calf and Achilles with. Google it I’d you aren’t familiar.
Ice after the graston and after running/stretched.
How long did you keep the Saran wrap on your achilles?I am very familiar with this injury as I suffered for two years with it. Here is a brief rundown of what I did along with some thoughts.
For the first year and a half I fluctuated between complete rest and short runs. The rest would help with the pain then it would come right back when I tried running. Rest was not the answer for me. Then I saw a sports and exercise trainer who was recommended to me. He was able to diagnose where MY issue was. I have high arches but they were collapsing. Anyway, I bought some Superfeet orthotics, stretched, iced after every workout, then (I know I may get flamed for this one) I would rub castor oil into the tendon and cover with Seran wrap and an ace bandage. The combination of these has been a complete game changer for me. I have been pain free for 6 months and running around 25 miles a week and increasing. There is no reason why the Castor oil should work, but I was desperate, and read about it on a weight lifting forum for tendonosis.
Since then, I have removed the orthotics and have been working on exercises to strengthen my arches. I developed some knee pain with the orthotic use and have since removed them and the knee pain has subsided. It is really important to diagnose why you have pain. Achilles tendonosis/tendonitis can be caused by many things. The treatment strategy will change. Try the ice/castor oil to help with the symptoms. As far as the strengthening exercises, I would try to get a diagnosis as to why you are having problems before you do any of those.
So what I did was immediately after icing I would massage the castor oil in (fairly vigorously), then Seran, then ace bandage and leave it all on over night. Take it off in the morning. I did not wrap it tightly, just tight enough to have it all hold together. Absolutely helped me. It took a few days so be patient with it if you try it.
What is the collective wisdom regarding cycling through this type of injury?
I am pretty sure I have battling the insertional version for the past couple of months. I have pretty much cut out running, but have upped my bike volume to keep my sanity. I have no pain biking and based on what I have read it sounds like the additional blood flow and post ride stretching is probably a good thing.
I can’t speak to your particular issues, but my PT recommended I cycle to keep my fitness when I was going through my own insertional tendonitis/tendonosis issues.
CAVEAT: If you feel any pain, either while cycling or in the few hours after cycling, then don’t do it. It took me a few weeks rehab to get to the point where I could walk comfortably, let alone cycle. Once I could bike without pain, the PT said I was good to go.
If you are noticeably more sore in the mornings after doing the eccentric calf exercises, you may not be ready for them. Also, please make sure you are doing calf drops, not calf raises (at least for regular Achilles issues, not insertional).
Cycling was great therapy for me, as was swimming.
When I started running again, I started slow and short. Like ridiculous slow & short…like 1/2 mile @ 4 mph (yes, that is a 15 min/mile pace). Never “ran” two days in a row and as long as it felt good, I ran again. Increased distance by 1/10th of a mile / week. Slowly increased pace…then increased distance by .25 miles, etc. Within 4 months I was running 8.5 miles @ 8:3-/mile pace.
Someone mentioned if glutes could be related…and the answer is absolutely. Part of the whole kinetic chain, and if you hips aren’t stable, it can cause problems further down the chain. Definitely work on your glutes, especialy the gluteus medius.
This second picture is where the pain is on my left ankle