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Achilles tendonitis

Andy Mink

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Getting old sucks! I wasn't even doing anything and my heel started to hurt a bit last Wednesday. By Thursday I was in full limp mode. Hiking boots helped but not much. I went in today to see my buddy the PT and he poked and prodded, mostly to confirm it's not a tear. That's the good news. Now I just have to wait, do a bit of therapy, and hope this clears up before the next big snowfall! Anyone else have this? Any hints?
 

scott43

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Perpetually.... I had a partial tear on mine from a motorcycle incident (don't ask..) and it still is tight and tingly all the time. The poking and prodding to determine it was a partial tear was extremely uncomfortable. I recall breaking into a sweat as he yanked on it. I try to do calf stretches regularly and do a warm-up before doing anything. Advil helps. Moderate exercise of it..don't over do it for a while. Fortunately it's a super strong tendon and will probably be fine.
 

Rod9301

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Achilles tendonitis takes about a year to heal with conventional pt.

I used shock wage therapy and it healed completely in 5 weeks.

It used mechanical vibration to irritate the tendon and bring blood supply to it.
 

bbinder

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I have done deep self massage and used a firm foam roller when I have had Achilles tendinitis. Worked for me.
 

Plai

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Stretching the foot helped me the most. Sit on the floor, leg straight out in front, pull back on the toes. I have low arches, and superfeet helps to support them. Haven't come back since. Other things said to help: anti-inflammatories (read ibuprofen/asprin/etc), ice/heat, and message. Oh also, my symptoms were partly caused by heel strikes during running. Had to change my running style to land mid-foot.

Good luck on finding what works for you.
 

neonorchid

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I had a bout with Achilles Insertional Tendonitis about a year ago, sounds like what you're dealing with that you said your heel hurt. I am back to trail running, have been for some time now. Haglund's deformity which typically goes along with it was not too bad but very much evident at the time. Initially didn't seem like much of anything and I underestimated what a PITA it would be. I could only tolerate my Birkenstock open back sandals and a ratty old pair of broken down minimalist trail-running shoes. Interfered with my ski season:(

IIRC, I did ~ 8 weeks of PT which consisted of deep tissue massage to break up scar tissue and aid in reforming the tendon along with an isometric exercise and simple stretches. Sports Med Doc Rx'd nitroglycerin patch to increase blood flow and promote healing. Don't take NSAID's as they are counterproductive to tendon healing. Best to use ice for inflammation.

Isometric exercise = standing up straight with both feet flat on the ground, lift up with the toes of both feet (standing on tippytoes), lift the good leg off the ground by bending the knee and SLOWLY lower yourself to the ground with the bad leg. Lifting yourself up doesn't matter, eventually you'll be able to do so with just the bad leg unassisted by the good leg, lowering the bad leg slowly is the key to the exercise. Physicial Therapist told me it would heal if that was the only exercise I did. I began by doing two sets of 3 reps twice a day (was all I could tollerate), and quickly progressed to doing many more.
 
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Jenny

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FWIW the surgeon for my peroneal tendon and other ankle stuff told me not to take ibuprofen but that other NSAIDS were OK. Mostly took acetaminophen and aspirin.
 

Kneale Brownson

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I have had both Achilles' tendons repaired after total tears from skiing incidents. One 30-odd years ago and the second three years ago.

After the first, PT guy suggested standing on a 30-degree ramp for at least five minutes daily. I did that for years, but started to stuff off several years before the second. I'm back at it now.
 
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Andy Mink

Andy Mink

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I have had both Achilles' tendons repaired after total tears from skiing incidents. One 30-odd years ago and the second three years ago.

After the first, PT guy suggested standing on a 30-degree ramp for at least five minutes daily. I did that for years, but started to stuff off several years before the second. I'm back at it now.
I'm doing way better. My PT messages it three times this week. WOW! OWYOWYOWY! But now it barely hurts. Obviously not a tear.
 

Jenny

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I love my slant board. It lives next to the sink in the bathroom and I stand on it while drying my hair and brushing my teeth.
 

Kneale Brownson

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The process 30-odd years ago involved six months of casts that got replaced every two weeks with the foot starting out pointing down as much as possible and then gradually being raised.

I had so many knots in the calf muscle that each visit to PT after the last cast was removed included my leaving a whole-body sweat stain on the table they put me on while the kneading went on for 30-40 minutes.

Last time, I was put in a splint like a half cast and then in a boot. I was allowed to gradually add weight to the injured leg and then to walk in the boot. No PT.
 

Started at 53

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You might want to look at PRP or more commonly known as “blood spinning” as a treatment. I am pretty sure this type of injuring might benefit, but then again it might only be a procedure for tears. But worth looking into.

When I had it done on my tendon (extensor in right forearm) it was not covered by insurance, and it was a PAINFUL F*@cking procedure, but it did repair my problem. There was a rehab involved, but without a tear it might be a quicker recovery.
 

Jenny

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The process 30-odd years ago involved six months of casts that got replaced every two weeks with the foot starting out pointing down as much as possible and then gradually being raised.

I had so many knots in the calf muscle that each visit to PT after the last cast was removed included my leaving a whole-body sweat stain on the table they put me on while the kneading went on for 30-40 minutes.

Last time, I was put in a splint like a half cast and then in a boot. I was allowed to gradually add weight to the injured leg and then to walk in the boot. No PT.
Isn’t it amazing how much it's changed? At one of the summer sports camps I went to back in high school there was a coach who was in the middle of the 6 month cast process. Not having injured anything until my ankle this year I was unaware how much that had changed until I was researching tendon repair and read up on it, even though mine didn’t involve the achilles.
 

Kneale Brownson

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World of difference, Jenny. Colleague here tore an Achilles while working on an addition to my house a couple years ago, went to my surgeon and had a whole new procedure. He was skiing four months or so post surgery. Instead of the zipperline scars I have on the backs of both legs, he has two tiny scars.
 

wyowindrunner

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Have a prominent knot on my left achilles. Running shoe switch ( from NB to Soconys- they fit like a glove but about crippled me) plus hill work was the culprit. Early 90's. In my case swelling comes and goes. At some points ceasing running for two weeks or more, and then easing into running again, taping the ankle to limit the lower heel to toe angle and flex, and heel lifts in the shoes all help to lessen the stretch on the tendons. In a bucket of icey water as soon as the shoes and socks are off. This has occurred to the right also but not to the same degree. ( And at this stage of the game I do no speed work and hill work is just on the treadmill.) Started one ski season with a very swollen tendon in Surefoot boots. The old hard foam. Heel firmly locked in. Fit like a second skin, but the tendon hurt like hell for awhile. The late George Sheehan( the Running Doctor), said something along the lines of you try all kinds of remedies to alleviate the condition in vain, and it will get tired of tormenting you and go away on it's own. Re-occurances seem to come with no reason. And you are correct- getting old sucks, but it sure beats the alternative.
 

wyowindrunner

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I have done deep self massage and used a firm foam roller when I have had Achilles tendinitis. Worked for me.
Did you shorten your stride length? Overstriding contributes to other problems- sore knees a leading one.
 

wyowindrunner

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sorry bbinder- was replying to
Stretching the foot helped me the most. Sit on the floor, leg straight out in front, pull back on the toes. I have low arches, and superfeet helps to support them. Haven't come back since. Other things said to help: anti-inflammatories (read ibuprofen/asprin/etc), ice/heat, and message. Oh also, my symptoms were partly caused by heel strikes during running. Had to change my running style to land mid-foot.

Good luck on finding what works for you.
 

Plai

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Did you shorten your stride length? Overstriding contributes to other problems- sore knees a leading one.

There might have been a shortening of stride. Most of my focus was in how/where to land on the foot. It's been close to a decade since my occurrence and it hasn't returned. No other body mechanical issues appeared. My last regular running program was 2-3 years ago. The last few years have been more focused on cycling. Throughout the whole time, I've played tennis, which I describe as a running/sprinting game with hitting a ball as a bonus.

Thanks for the check.
 

cosmoliu

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Isometric exercise = standing up straight with both feet flat on the ground, lift up with the toes of both feet (standing on tippytoes), lift the good leg off the ground by bending the knee and SLOWLY lower yourself to the ground with the bad leg. Lifting yourself up doesn't matter, eventually you'll be able to do so with just the bad leg unassisted by the good leg, lowering the bad leg slowly is the key to the exercise. Physicial Therapist told me it would heal if that was the only exercise I did. I began by doing two sets of 3 reps twice a day (was all I could tollerate), and quickly progressed to doing many more.

This exercise makes a whole lot of sense. It's using the eccentric contraction phase to treat tendonitis. This really excellent NY Times article describes the rationale as applied to tennis elbow, which I posted before on epicski in response to a tennis elbow thread. I have used a modification of the exercise to treat my own tendonitis on the opposite side of the elbow, "golfer's elbow". That it should work for Achilles tendonitis makes perfect sense. Actually- using neonorchid's description above, continue to use both legs to start the movement even when things get better. The idea is to pre-load the symptomatic side by contracting the calf muscles under minimal stress, then maximizing the stress in the negative phase of the movement.

https://well.blogs.nytimes.com/2009/08/25/phys-ed-an-easy-fix-for-tennis-elbow/

Maybe some coming to this thread who happen to have tennis elbow can benefit as well.

Edit: The article used to link to a YouTube video of the movement. That apparently has not survived the intervening years. Too bad. If a picture is worth a thousand words, that video was worth ten thousand.
 
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bbinder

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Did you shorten your stride length? Overstriding contributes to other problems- sore knees a leading one.
I did shorten my stride, but that was for my knees. I also went to a zero drop running shoe with cushioning (Altra Torin) for the knee pain. My Achilles pain was moderate, but not aggravated by running.
 

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