Achilles Tendonitis

  • Creator
    Topic
  • #33916
    austin.boese57
    Participant

    Hi all,

    A little background about me first. I’m currently 21, having been active in the mountains both running and ski touring for most years of my life, but particularly focusing on training for the last 3 or so. I didn’t do a great job of being consistent in my training this last cycle (roughly Nov 2018-Sept 2019). I had only about 12 weeks of running 20+ miles, and my top week was about 40 miles. Weekly elevation gain averaged about +5,000′, with my weekly max at +10,000′.

    Anyways, I was excited and had lots of stoke to start a new training season this Nov, with continuity and consistency as my focus.My first 3 weeks consisted of general strength, and 15-17 miles of trail running with about +3,500′ of gain. About half way through my third week, I did a quite steep hike uphill, and ran back down. It was a steeper grade than I had done in a few months, but still only a few thousand feet in gain. The next day I had some achilles pain where my heel meets my shoe.

    I ran the next day (probably shouldn’t have) and then realized this was actually a problem. I took a few days completely off, then ran the next few weeks at a reduced mileage, and with the heel cut out of my shoe, as there was no pain if nothing was contacting my achilles. I then did a run with regular shoes about 3 weeks after initial onset, and the pain had not improved.

    I then went into my GP, and was told I have achilles tendonitis, and that I should take a month off from running, and that I shouldn’t be doing any PT besides just normal walking to allow it time to heal. Makes sense to me.

    I have never been injured before, and I want to be conservative as I don’t want to have achilles problems long term. I’m just confused about what I did wrong to cause this injury. I have run in the same shoes (0 drop, Merrel Trail Glove) for the last 5 years, including off trail and have had no issues, so I don’t think the problem is that. I stretch regularly and do strength workouts in the gym, and don’t feel as though my calves were tight or weak. This leads me to believe that I started with too much mileage. It didn’t feel like it, but searching for reasons this is all I can come up with.

    Sorry for the long story. I would really appreciate any thoughts or advice you guys may have.

    Thanks!

Posted In: Injury & Rehab

  • Participant
    Pete Dickinson MS,PT on #33932

    You likely traumatized the back of your achilles from repeated heel cup overpressure into the achilles with the downhill running. Does your achilles ‘squeak’? Treatment would be to punch out the shoe contact area at the achilles, ice massage, and tendon strengthening. Avoiding activity does a good job of weakening the area. I like to try to find what is pain free, and progress from there. You might want to try 5x 30-45sec calf raise holds, if this isn’t too painful. This is a classic case of Early Season Over Enthusiasm Syndrome (ESOES)…..
    Cheers,
    Pete

    Participant
    austin.boese57 on #33933

    Pete,

    Thank you so much for your response. The traumatization to the back of my achilles from the steep downhill, makes a lot more sense than the classic case of tendonitis I thought I had. There is definitely a clicking noise as I lift up the injured side to take a step. I just tried the calf raise holds with zero pain, will continue to do these. Thankful I didn’t get a more serious reaction to my ESOES, will definitely start off training with a lower load when coming back from a break in the future.

    Thank you again so much for your feedback!

    Austin

    Participant
    aw11gwd on #34156

    I’ve dealt with achilles tendinopathy in the past and what worked for me (finally) was the following:

    – Research the very latest on achilles treatments. I found Dr Seth O’Neill’s papers, podcasts & articles very helpful
    – Don’t stop running completely (doctors like to say “complete rest” but I think that’s out of date for tendinopathy) tendons apparently need to keep moving to heal properly. Just reduce volume and back off even more any time you get increased pain the following morning. I wouldn’t do a lot of
    – Do lots of eccentric heel drops and gradually add weight. Loading the tendon apparently promotes proper healing.
    – Foam roll and theragun calves, lax/golf ball your feet. Tight calves and feet exacerbate achilles issues.
    – Back off training volume/exercises any time you get an increase in pain the next day.
    – Try indoor or outdoor cycling for maintaining your aerobic base.
    – I also found that pointing and flexing my feet helped. I would get cramps immediately when I pointed my feet like a ballet dancer and working through that by repeating until after a few days/weeks I could point without cramping seemed to help a lot.
    – Keep a log of your morning pain scale and training volume + reps so you can see progress. This really helps with morale and sticking with it.

    FYI I am not a doctor or physio so do your own due diligence.

    Good luck!

    Inactive
    Anonymous on #37707

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