Let me preface by saying I have never had any achilles problems or shin splints before…ever. Over the summer I started wearing flip flops after riding or swimming…this caused the first signs of achilles tendonitis. It passed as I stopped wearing the shoes. I continued to train for my half iron and had no issues.
Now…during the off season I have been running about 1 to 3 times per week…12-15 miles total. Last week my right leg said no more…i finished a little 6 miler and the tendonitis flared up BAD. Over the past week I iced, wrapped and stretched…by late week it was gone. I decided to try another 6 miler today…made it 3 with no pain and then all of a sudden I was done. It hurt so bad I thought my achilles tendon was going to rupture. So I limped in the last 3 miles. WTF???
Why is this happening and most important…what should I do to get rid of this issue? Anybody had the same problem? Do I need to see an orthopedic or a PT? Or just lay off for several weeks?
LOADS of info here on Achilles tendonitis/tendinosis - search.
But, #1 is rest and I mean REST. No trying it out in a few days, cycling is OK as it doesn’t hurt for the first 10 mins, etc. Wear a CAM boot even if you have one - easy going up stairs, etc. If it truly is tendonitis (need a clear diagnosis first), you will probably get more help via PT then a physician’s office.
ART, foam roller (outer front of lower leg), tennis ball (in the calf) and eccentric stretches (wearing shoes stand on stairs, use both feet to push up to toes, lower down slowly using only the leg with AT) x 15 three times a day is what finally fixed me. It still comes back from time to time if I’m not consistent with the foam roller/tennis ball. I start doing the eccentric stretches, schedule an ART appointment and 3-5 days later there’s no tenderness at all.
I had some achilles issues, and found it was due to knots in my calf muscle. I now roll out my calves with a MuscleTrac (similar to “The Stick”). As long as I regularly roll out those knots, the achilles issue doesn’t come back.
I’ve had issues with achilles tendonitis. 5 years ago I got it bad enough from running hard on a treadmill repeatedly, before I learned how to train appropriately. Could barely walk for almost a month. Over the years I’ve reaggravated it a few times. Now I’m really in tune with how it feels, and will stop running at the slightest sign.
Flared up in december and rested, iced, ibuprofen’d and I looked for past threads here. Heard of Active release technique and tried that out (thanks Pirategirl), first treatment the doctor said something to the effect of ‘wow you can run on this?’ Anyway, I also treat it w/ triggerpoint therapy/foam roller stuff, as other people have said.
Haven’t had any problems since, and I’ve been running almost every day.
I had some pretty vicious tendonitis in both ankles (caused at diff times) during a gonzo cross-country bicycle trip. Rest is key. Elevate your achilles above your heart if possible (I put my feet on my desk at work), regular icing, message, ibuprofen, etc. Then start strengthening with calf raises or whatever other exercises you can find. Then after a while gently start working out again. Rest alone is not enough, you really need to strengthen the muscles/tendons before you become active again (in my opinion + experience).
I second the active release therapy. I registered for Florida last year, and developed achilles tendonitis after that. I took 4 months off, then HAD to start training. The pain was still there though so I started getting Physio appointments for like 3 months. I ran once a week in pain, all the way up to the Ironman. I struggled through the run portion of IMF. Then I decided after a week off to try ART at the chiropractor. After just a couple treatments, I was running 3 times a week again. Now, after 6 treatments, I’m taking a 3 week break from treatment, but I’m running 5 times a week and cross country skiing. The only tenderness now is the first mile or so when I run at 6am.
That stuff works!
Alot of great advice. Rest is the most important as stated. Ice is recommended but when I had AT
ice didn’t work for me so out of desperation tried moist heat with some relief.
Another thing that has not been mentioned is heel lifts(like a 1/8" wedge) under both heels
to avoid inbalance. This rests the tendon. When you start back be sure to start slow not just
easy jog but short distance and build slowly. With mine I tested it in two wks and ended up totally off
for 8wks as a result.
The heel lifts go in your shoes all day not just when running.
Mike
I first had achilles tendonitis several years ago when I was in the process of switching from heel striking to midfoot striking. I was also training for my first marathon at the time. I just battled through it in lots of pain and did most of the marathon with screaming pain. Took several months off afterward and that cured it.
I just started having some achilles pain in my left foot/calf. I don’t know exactly how or why it happened now. I broke my left big toe in a trail race in November. I suspect that as I’ve come back from that injury I slightly altered my foot strike. For a couple weeks prior to the achilles problem I’m now having, I was having some plantar facsiatis in my right foot. I just ran through that. In fact I had a week of 81+ miles and it was just after that week that the achilles problem started. Last week I reduced the volume to about 43 miles and ran much slower for the most part. I started out by wrapping it with an Ace bandage, but that didn’t seem to provide enough support. I’ve now been using a more supportive ankle wrap and taking a couple ibuprofen before I run. That is helping allow me to keep running. After each run I stretch and use The Stick. Over the past several days the achilles is becoming much less painful. I did a decent 10 miler on Thursday and was going to race yesterday, but the race was cancelled. I had a faster paced run yesterday anyway. For the next several days I will go back to much slower paced runs and continue to work on the soreness with The Stick, and alternating icing and applying Biofreeze.
I’m in the process of training for a marathon and don’t plan on taking any down time unless it gets a whole lot worse. For the most part I just start out slowly then HTFU as I get into a run. If I let my mind focus on other things I can mentally block out the pain. However, if you can afford to take some time off, that is probably the best thing.
rest, rest, rest as tendons take more time to heal due to poor circulation and if you are not in the middle of training for a key event right now, 6+ weeks of no running (biking is fine if it doesn’t bother it, be careful pushing off the wall when swimming) with a gradual introduction back (6 miles on day one will likely just flare it right back up, something more like run 2 minutes, walk 3 min repeat for 15 minutes, if it holds then bump up to 20 minutes in a few days, then if it holds 20 minutes 3 min run 2 walk, and so on…), then for me; triggerpoint footballer 1x per day in addition to normal stretching/foamroller routine and ice for 5-10 minutes post all runs. You can also try some pool running (deep water) during your rest time if you get to antsy, good luck.
If you don’t have a ‘boot,’ try a heel lift to take the pressure off the achilles and calf.
Aquajog/run.
Eccentric achilles exercises when the pain is better.
We all post different questions about various aspects of this sport…but when it comes to something like this…something painful and personal…it is really nice to have people you do not even know to take the time to help. Again…thanks to all…i really appreciate the input.
I would add using a night splint to list offered up so far. From personal experience and in managing patients, I recommend it highly. Also learning to Kinesio tape for your return to activities could be helpful. Here is something that I have prepared for my patients: http://www.permanente.net/homepage/kaiser/pdf/33071.pdf
At least it is the off season. Think of it as a chance to work on your swimming. Unless it is a really severe case you can probably get over it with rest and self treatment. Good luck.
Let me preface by saying I have never had any achilles problems or shin splints before…ever. Over the summer I started wearing flip flops after riding or swimming…this caused the first signs of achilles tendonitis. It passed as I stopped wearing the shoes. I continued to train for my half iron and had no issues.
Now…during the off season I have been running about 1 to 3 times per week…12-15 miles total. Last week my right leg said no more…i finished a little 6 miler and the tendonitis flared up BAD. Over the past week I iced, wrapped and stretched…by late week it was gone. I decided to try another 6 miler today…made it 3 with no pain and then all of a sudden I was done. It hurt so bad I thought my achilles tendon was going to rupture. So I limped in the last 3 miles. WTF???
Why is this happening and most important…what should I do to get rid of this issue? Anybody had the same problem? Do I need to see an orthopedic or a PT? Or just lay off for several weeks?
Over the years I have had several bouts of Achilles tendinitis/tendinosis. I have also learned the cause (at least for me): Inflexibility in the lower leg.
About a year and a half ago during a really bad bout of AT, I finally broke down and went to a PT guy a friend recommended. I almost had to limp into his office. He gave me a really deep massage on my lower legs, really digging into those muscles. So much so that it hurt like hell. But when I got off the table, I didn’t just feel better, I was almost cured. I went from not being able to run at all to being back to a normal training schedule within the week.
Since then I have learned to be religious about really stretching and massaging those calves and lower legs myself. One would think I had learned my lesson about this when the same inflexibility turned out to be the cause of my plantar fasciitis 5 years ago. It seems that this inflexiblity is the root of most of my running injuries. I only run my best when I really take care of it.
If there is one thing I can suggest it is this;
GO TO A PHYSICIAN who is skilled and experienced with AT. After running on the beach barefoot last July, I wound up with micro tears of the AT. It progressed and eventually became chronic.
I saw an orthopedic surgeon who basically told me to wear a boot and rest it for 6 weeks. I did, and then as soon as the boot came off it was re-injured in October at a sprint triathlon.
My coach then recommended a physical therapist and a woman podiatrist who is a runner and takes care of the local University track team. She was amazing, told me that the boot and rest was treating the symptoms, but I needed PT to allow it to heal and orthotics to treat the problem. My arch was collapsing a bit with every setep thereby placing extreme stress on the tendon.
After 6 weeks of physical therapy using deep tissue massage, ultrasound, and application of a medicated pad with electrical connections (I think this was a steroid), the pain was eliminated and the AT healed.
The doctor cleared me to start training again and recommended the 2009 New Balance 1063 or Brooks Glycerine 7 shoes. It has been a long road, but this past weekend I ran the Disney Half Marathon with absolutely NO pain in my AT. Other parts of my body are pretty sore, but the AT is good.
Obviously I took it easy and didn’t break any records but had a great time running alongside my wife and finished injury free.
Now I do heel raises every morning in the shower and massage the tendons daily.
Good luck, AT is a really shitty injury but can be fully recovered if you treat the cause and not just the symptoms.
Go to the local feed store, buy the green poultice, wrap it in saran wrap each night, sleep in night boot, train as usual. This was one of the most valuable things Brett Sutton taught me last summer as I struggled with achilles tendonitis prior to Kona. Although it did not show on race day, I never missed a workout and was able to train at a level that would allow me to race at my best. It works.
Back in highschool I had a pair of soccer shoes that had a fairly hard plastic cup on the heel. This curved forwards to the top of the cup and after a few months of daily use I ended up with severe and chronic irritation of the achilles attachment point. Depending on the location of your issues this could be a contributing factor. I always make sure the heels of my shoes are relatively “vertical” and with smooth padding…no rough stitching or irregular changes in padding density around the heel cup. I can still (nearly 20 years later) tell when I put on a shoe if it’s going to cause problems.
Find a physical therapist who does ASTYM:
http://www.performancedynamics.com/
I, and others I know, swear by this. It hurts like hell, but it works fast and you may not have any downtime.
Have you changed run or bike shoes? How about bike pedals, which type do you use? Are you running more on ‘crowned’ roads than you have in the past? If you’ve changed bike pedals that might be one of the issues. It may not show up on the bike, but can end up showing up on your running.