I have had a sore achilles for two seasons. I have changed shoes, take time off, built my distance slowly. None of these seem to work. Can anyone offer advice?
**Lots **of stretching and rolling the calves have helped with any problems that I have had.
Lots of excellent advice has been espoused here already. Grab a coffee, do a search. The short answer is that the only evidence-based treatment is eccentric heel exercises. Twice a day, progressing to a weighted backpack. And then just keep doing them, even after the pain/tenderness has subsided. I view my achilles as a perpetual work in progress. Sort of like addiction - you’re never recovered, always recovering.
eta like so: http://www.youtube.com/watch?v=M6EKuuZ7C2E&feature=relmfu
I’ve killed chronic sore achilles w/ calf raises, strecting, rolling, and KT tape.
As mentioned, regular stretching and rolling of the calves is great for it. That fixed my problem last year.
I had achilles issues last spring, and I tried those toe-raise rehab exercise mentioned. It seemed to make it worse. I did a bunch of swimming and then gradually worked in some easy cycling before I tried running again. I’ve had no real problems since. my N=1
I’ve killed chronic sore achilles w/ calf raises, strecting, rolling, and KT tape.
That and I also used a globus e-stim on my achilles…you can google “how to place electrodes for e-stim and Plantar Fascitis” and get a good idea of how it needs to be hooked up.
I’ve done everything over the years. Read every forum post, tried all the tricks (my latest has been ART and graston). I’m not sure anything really ‘works’, other than doing everything, feeling your way through and trying to keep the pain at bay.
It seems almost random for me. they didn’t hurt much last fall and I was able to get my running up to 60-75mpw and BQ in January, but that race pretty much killed them and they’ve never quite recovered. I wanted to do the Mt. Lemmon marathon this past weekend, but didn’t make the starting line due to achilles pain. AAARGH.
the latest thing an exercise physiologist told me to add (in addition to the calf massaging, rolling and eccentric leg stretches), is every hour or two during the day, do a set of 10 x 2 second stretches on your calf/achilles. Bending your knee during the stretch pulls on the soleus, so I’ve been trying to get that in.
right now, I"m just swimming and cycling. hurts a little on the bike, but I believe in ACTIVE recovery, and cycling seems to not make it worse.
I have an E-Stim I will try tonight. Thanks for all the advice from everyone.
I am 5months of achilles misery at the moment, with a few cancelled races so far this spring as a result.
Ditto on nothing works and do every known therapy anyway. Running clearly makes it worse. And running back to back days even worse. Makes my previous ITBS seem like a bubble bath
To you and all the others in this thread with chronic achilles issues…Are you sure it’s your achilles and not your bursa?
If the pain is isolated to just that spot at the back of the heel where the achilles attaches you may have retrocalcaneal bursitis.
http://www.heelpainhq.com/retrocalcaneal-bursitis/
This could explain why all of your rehab hasn’t worked…and it may just be that the primary contributing factor is footwear that places pressure on the bony hump at the back of the heel resulting in Haglund deformity which in turn causes the bursitis.
The solution could be as simple as changing your shoes. (or changing your dress shoes, work shoes…the way you drive your car…)
I had chronic achilles pain for years and years. I tried everything, including physical therapy, acupuncture, prolotherapy, and eccentric exercises until the cows came home. Nothing helped until this year when I got a PRP injection. From what I’ve learned, there are a lot of doctors offering PRP, many following different (and often ineffective) protocols. The University of Washington (http://depts.washington.edu/hhpccweb/article-detail.php?ArticleID=561&ClinicID=10) follows a strict protocol and supposedly has much better results than most. The tendons take forever to heal, however. I had my injection in December and it’s now (finally) at the point where I can squeeze the tendon without pain. I was told by other less-experienced doctors that my condition (a tear along the length of the tendon) wouldn’t respond to PRP but the Dr. Kimberly Harmon at UW was pretty confident I would respond well-- and I did! Personally, she is the only doctor I would trust and I would be willing to fly around the world and/or wait months to go in to see her.
A few caveats, however. First, PRP isn’t covered by any insurance plans and costs about $800 an injection (worth every penny). Second, a follow-up injection may be required months down the road. I may get one at the end of the season if I have even the slightest misgiving-- just because I don’t want my achilles to give me any trouble in 2013 or beyond. Third, do it at the end of the race season. Achilles Tendinosis (the chronic condition) usually doesn’t mean you’re any more likely to rupture the tendon-- it just hurts and feels like it’s going to rupture. So you can probably keep on racing this year. After a PRP injection, it will also be a good 6 weeks before you’re training full-bore again, so you don’t want to do it in the beginning or middle of the season if you can help it. Fourth, while you’re healing, the best possible running exercise is the Alter-G-- lots of PT’s rent time on them and you can find one in your area at http://www.alter-g.com/product/find-an-alterg.
Thanks for the PRP input. That’s the only thing I haven’t tried, and may resort to that at the end of the season
Have you tried A-stym? Cures most achilles injuries. It is performed by a PT and any good one can dial you in. I would avoid PRP. Too many complications.
Can’t emphasize enough the importance of the eccentric calf DROPS. Don’t do calf raises, do calf drops, working as FIFO noted up to using a weighted backpack.
I finally got so sick of my Achilles issues, that I decided active recovery was necessary. So I grabbed an old, first-gen pair of Nike Free shoes (used them as kicks rounds, not for running) and began running slow and short. 1/2 mile, 15 min / mile pace. Yup…4 mph.
Only added on 1/10 a mile a week. Once I got over 1 mile, I added 1/4 mile a week and that was it. Would occasionally up the “speed” and 3 months later I was up to 3 miles and then got to 8 eventually before ITBS kicked.
On that note, I would strongly recommend having your gluteus medius evaluated. The leg works as a system and although the pain may manifest in one area, the problem may be in another entirely. The gluteus medius is a critical stabilizing muscle when running and a weak medius can lead to ITBS and Achilles issues.
Have you tried A-stym? Cures most achilles injuries. It is performed by a PT and any good one can dial you in. I would avoid PRP. Too many complications.
What “complications” are there in your opinion to PRP injection(s)?
Rupturing your achilles and needing surgery.
Rupturing your achilles and needing surgery.
So, I assume you have seen this then? I highly suspect that you have not. In fact, PRP injections are often used in conjuction with an Achilles repair or in known longitudinal minor tears.
I have not - however I have repaired plenty of ruptured achilles. BTW, Graston, ASTYM, ART (pick your coined PT deep tissue massage acronym) can also increase the risk of rupture, although I am a proponent for most true achilles tendin*osis *sufferers.
Actually I have, in too many elite runners.
I have consulted with two different sports medicine physicians, both of whom said that achilles tendinosis doesn’t increase the likelihood of Achilles tendon ruptures. My first doctor cautioned me against continuing to train hard with an aching achilles tendon because of the pain and difficulty down the road with recovery. But, she said that the actual clinical data showed that full ruptures were no more prevalent with people with existing achilles pain than just for athletes exhibiting no signs of achilles pain. I was really skeptical, so when I went in for PRP, I asked another doctor (not affiliated with the first) and got exactly the same answer. Will continuing to train with achilles pain screw up your training? Absolutely. Will it make healing more difficult and perhaps necessitate surgery or some other drastic procedure? Probably. Will it lead to an actual rupture of the tendon? Apparently not. Actually, the answer of these doctors didn’t give me much comfort. Sure, I could continue to train within the limits of pain and common sense. But their answer also meant that I (or anyone else) could be perfectly fine and then get a full-blown rupture after some abrupt movement.