When to come back from Achilles Tendinitis

Triathlon Forum
1

My Achilles’ tendon started acting up a little while back. It was sore and stiff in the morning and at the start of runs. It would get better throughout a run but the stiffness and pain wouldn’t quite go away. The tendon itself was also tender to the touch when I pinched it or pressed against it.

After putting up with it for 3-4 runs I decided it was probably a good idea not to try and just push through it anymore. Stopped running (and biking) and started aqua jogging. Also started doing eccentric heel drops multiple times a day and got a night splint to wear when I sleep. Foam rolling the calf muscles but haven’t been doing calf stretches or icing the tendon as I’ve read it can actually delay recovery.

Anyway, looking for thoughts and advice as to when I can start slowly adding land running back (or even biking). When morning stuffiness is gone? When I can do single leg calf raises with the bad leg with no pain? When tendon is no longer tender when I press against it? When I am able to run a few steps with zero discomfort?

From what I am reading, the quoted recovery can be 4 weeks to 4 months. Just wondering how I can use my body as a guide to get back into it

2

Tendons don’t get a whole lot of bloodflow, so injuries there tend to take long to heal. It’s also the reason why it gets a bit better after running a bit.
I had it two years ago and took a month off doing nothing and it got only marginally better. What did work was doing stretches. The ones on where you put your toes on the stairs and slowly lower your heel, hold for a second, then slowly go back up again. 20 times per foot, sometimes several times a day.
Sleeping with a Strassbourg sock can also help, but I have no experience with that.

In the end I just ran and monitored the achilles with the idea that if it would get worse I would take a break from running. For me it started in May/June, I exercised through to the end of September, then in October I took a break. It was pretty bad by then, such that I would walk like a cripple for the first 15-30 min each morning and it was painful to touch and a swelling was noticeable.
In November I started the BarryP running program, with 30k per week and build that up to 70k per week in January. During this the achilles got better and better, but slowly. I think that in January I stopped doing the stretch exercises as the pain was only minor, so I started forgetting to do them. Somewhere in February I realized the pain had been gone for some time.

3

I tore both of my achilles in 2016 and would still do workouts then. But, on the days I could not, I would focus on other activities like core or upper body strength. On days that I engaged the achilles and they hurt, I’d have gel wraps in the freezer post activity. I gradually went to having 2 rounds of gel chill sessions after an activity if it was hard. Then, when it wasn’t healing that fast (for months), I had to accommodate more upper body type activities and a significant amount of core. Also, I took Bromelain and ate more pineapple in general as well.

I did a few ice bucket sessions that were great for hot days, but the freezer gel wraps are so convenient.

Also, tendons need lots of water for healing and recovery. I was chugging water day and night to expedite.

4

Tendons don’t get a whole lot of bloodflow, so injuries there tend to take long to heal.

This is an important statement. You should look out for activities you can do to burn calories without aggravating the tendon. This will increase blood flow and promote healing. Swimming might be great.

5

I had bilateral Achilles tendinosis last year and it was brutal. Budget 3 months for recovery. It got better around month 3 for me. I wasnt running and I had to be religious about doing eccentric heel drops.

6

I tore both of my achilles in 2016 and would still do workouts then. But, on the days I could not, I would focus on other activities like core or upper body strength. On days that I engaged the achilles and they hurt, I’d have gel wraps in the freezer post activity. I gradually went to having 2 rounds of gel chill sessions after an activity if it was hard. Then, when it wasn’t healing that fast (for months), I had to accommodate more upper body type activities and a significant amount of core. Also, I took Bromelain and ate more pineapple in general as well.

I did a few ice bucket sessions that were great for hot days, but the freezer gel wraps are so convenient.

Also, tendons need lots of water for healing and recovery. I was chugging water day and night to expedite.

Care to elaborate why you ate more pineapple? And drank more water?

7

Not sure if mine was tendonsosis or tendonitis, all I can tell you is that the heel drop didn’t do squat for me, PT was marginally better (felt great but didn’t really resole things), and foam rolling the bejesus out of my leg resolved it 100% in 10 days or less. YMMV based on when the injury was, etc.

I will say that I went the heel drop/PT route for months before my wife encouraged me to roll it. I knew there was a reason I married her.

8

I tore both of my achilles in 2016 and would still do workouts then. But, on the days I could not, I would focus on other activities like core or upper body strength. On days that I engaged the achilles and they hurt, I’d have gel wraps in the freezer post activity. I gradually went to having 2 rounds of gel chill sessions after an activity if it was hard. Then, when it wasn’t healing that fast (for months), I had to accommodate more upper body type activities and a significant amount of core. Also, I took Bromelain and ate more pineapple in general as well.

I did a few ice bucket sessions that were great for hot days, but the freezer gel wraps are so convenient.

Also, tendons need lots of water for healing and recovery. I was chugging water day and night to expedite.

Care to elaborate why you ate more pineapple? And drank more water?

I wanted more natural Bromelain from the pineapple. I also supplemented Bromelain.

Bromelain in the early phase of healing in acute crush Achilles tendon injury
https://www.ncbi.nlm.nih.gov/m/pubmed/20623610/

You can also add Tumeric to make the effects of Bromelain stronger.

http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000163

Nutrition and Supplements

Bromelain. This enzyme that comes from pineapples reduces inflammation. Bromelain may increase the risk of bleeding, so people who take anticoagulants (blood thinners), such as warfarin (Coumadin), clopidogrel (Plavix), and aspirin should not take bromelain without first talking to their doctors. People with stomach ulcers should avoid bromelain. If taken with antibiotics, bromelain may increase the levels of antibiotic in the body, which could be dangerous. Turmeric is sometimes combined with bromelain because it makes the effects of bromelain stronger.

Vitamin C. To aid in healing, increase immune function, and reduce inflammation. Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others.
Calcium and magnesium. To aid healing of connective tissues and muscles. If you have any underlying medical conditions, especially heart conditions, such as high or low blood pressure, COPD, or others, you should not take calcium or magnesium supplements without your doctor’s supervision.

Vitamin A. For immune function and healing. DO NOT use if you are or may become pregnant. Vitamin A interacts with a number of medications, including some that are available over the counter. Some of these interactions can be dangerous. Ask your doctor before taking vitamin A.

Vitamin E and essential fatty acids, such as fish oil or evening primrose oil to reduce inflammation. Vitamin E may interact with a number of medications. Vitamin E, fish oil, and evening primrose oil may increase the risk of bleeding. If you take blood thinners, ask your doctor before taking any of these supplements.