Thank you so much for posting this! Not only is it great information regarding AT, it explains why I have received somewhat conflicting treatment advice from different medical professionals (stretch vs don’t stretch, wear a wedge heel vs wear a flat shoe). Eccentric heel drops have not worked for me at all and although resting is effective, the pain inevitably comes back. I’m going to try the isometric raises and see how that works out.
We tend to hang on to our biases as health professionals… If someone has high hopes in stretching, gives stretching to their patients and they improve, they attribute the improvement to their intervention. Most shit get better just by time and therapists can start believing they are wizards even though their interventions might be shit (cough chiros cough).
If your pain is mid-tendon, both stretching and wearing low drop shoes is not really contraindicated, just unecessary. Give my progression above an attempt and when you can do dynamic heel raises you can start experimenting with running again.
i started having AT pain 2 weeks ago. i took a week off and then stupidly raced a half marathon. (i’m kind of proud i can run a 1:30 even with achilles pain though!) anyways, for a few days afterward even cycling on the trainer hurt. i took another week off and the pain still comes back after 2 miles of running.
i’m considering taking a month off of running while doing the exercises you posted but i’m curious if i should stop riding too. i was able to ride on the trainer pretty hard the last two days without pain, but if it’ll hurt me instead of helping i’m willing to stop that too
Give the progression in my post a try. If it doesnt work, consider plantaris involvement. Surely you should ride during; if you can ride without pain it is not doing anything bad for your tendon. Cycling is very low load for the tendon, especially if you move your cleat back and pedal slower cadences.