Achilles Tendon help !

[Comfortably_Numb]

A friend of mine has been having trouble with her achilles tendon and not really got anywhere from her GP. I asked her to give me a script of what the problem is so that I could post it on here and see if anyone can help or point her in the direction of an expert in the Wigan area who is a runner themselves or who understands running injuries. This is what she sent me....

"Right here we go- hard lump on ankle tendon, which is aching and hot in the morning. If I am still for long periods it goes stiff and can be quite painful 😖.
I have iced it most nights, most days take ibruprofen and ibulieve gel alternately.
Went docs again on Tuesday after not running on it for about a month and I've got stronger anti inflammatory tablets, he's gonna send me for physio and ultrasound. He said its tendonitis and so far he doesn't think the lump has ruptured! Looking on tinernet and non impactive exercises are best -swimming n cycling. Also very flat shoes can be bad and it recommends gel heel inserts for running which I used to have up to the double marathon training so looking to use these again once I'm running again"

Any help or advice would be appreciated. She wants to get back running as soon as possible but doesn't want to start too soon to avoid serious injury to her Achilles.

[Eddie D]

Old recurring problem for me. Can be three forward then all of a sudden two back, if you over-do it. Physio didn't approve of breast-stroke because of 'flicking your feet'. Takes time, so you need handle the mental depression somehow. Physio said 3 weeks then confessed to more 'you wouldn't have behaved if I had said more than 3'. Informed me after 6 weeks that I could walk long distances in boots if I started slowly. Drove to Glen Etive: it worked. Depression cured. Best of luck.

[anthonykay]

The following is based entirely on my personal experience; I have no qualifications in physiotherapy etc.

If there is a hard lump, it sounds more like tendinopathy than tendonitis. The unwanted lump needs to be broken down, and it's a slow process, with most of the work being done by the runner herself, not the physio. It's a regime of "eccentric stretching" (heel drop) exercises; a Google search of terms like "eccentric stretching for Achilles tendon" will lead you to websites explaining this. My physio's prognosis was that it would take 6 to 9 months to get back to normal running mileage, which turned out right, although I was able to start the very gradual build-up within about 2 months of the diagnosis; but I am 58 years old, so it may be quicker for someone younger, depending on the severity of the problem. Last Saturday I ran my first race since the tendinopathy became apparent (Wardle Skyline): no problems with the Achilles, but the race did something horrible to my big toe!

Regarding alternative exercise while recovering: I don't swim, but I do enjoy cycling. My physio's advice was that cycling is OK as long as you maintain your feet in a "neutral" position, i.e. flat on the pedals.

I didn't take any anti-inflammatories, apart from a few applications of Ibulieve in the first days after the pain started (and it didn't seem to have much effect). The physio didn't use ultrasound, but he did some manual work on the tendons to help break up the lumps.

In conclusion, do see a physio, who will have the specialist knowledge that your GP may not have. And do be prepared for a rather long, slow recovery process.

[Yaks]

This link http://www.runningwritings.com/2013/...n-runners.html is by far the most comprehensive and well researched piece I have found on Achilles problems.

In summary, it's all about the eccentric heel drops, don't bother with anti-inflammatories as it is not inflammation, its a degeneration.

[DangerMouse]

This link http://www.runningwritings.com/2013/...n-runners.html is by far the most comprehensive and well researched piece I have found on Achilles problems.

In summary, it's all about the eccentric heel drops, don't bother with anti-inflammatories as it is not inflammation, its a degeneration.

This is excellent - thanks for posting

I have just started with this too, it is very mild, no pain after the initial onset yesterday evening while walking home up hill; just very slight discomfort today with no impact on walking or doing anything really, but slight swelling is definitely there.

I am not too upset, something going wrong somewhere, no matter how careful I am being, was kinda to be expected after such a long break from running, but yeah, I better get stuck into some heel drop exercises.

While I was searching on this topic, I found a physiotherapy service specifically targeted at achilles tendinopathy conducted over video call, they certainly seem to know what they are on about and focus on active recovery so you don't lose your fitness while healing your tendon.

https://www.treatmyachilles.com

Disclaimer: I haven't used their service so have no first hand experience. I will be monitoring my tendon closely and if I don't see an improvement this week with the heel drops, I will probably give them a call.

[Comfortably_Numb]

Thanks all for your posts so far. I'll pass them on to her.

[Fellrunner1975]

Hammer the calf raises. worked for me.

[BillrunsHills]

With these injuries it is very important to be careful with whatever kind of rehab you are doing. The Achilles rupturing can stop any kind of physical activity you if you are unlucky, and in some cases tendinitis in the Achilles can even lead to bursitis. Here is a good article that gives some advice on dealing with Achilles tendinitis https://runnersconnect.net/achilles-...hy-in-runners/

[zephr]

Just a slight continuation of this -
Generally speaking, yes, hammer the calf raises... but make them heavy rather than doing loads of them.... if you can physically do 10 calf raises then you're doing them too light. Load up.

Eccentric contractions have shown to be no more effective than concentric, so don't worry about doing it off a step, just calf raise from the floor.

Note that there are a couple of different types of tendonopathy - reactive and degenerative, and it will depend on which type you have, and what stage of tendonopathy you are in as to what might make it worse or better... so even though there are general guidelines, its probably best to see someone that can give you specific advice according to your circumstances.

[Mike T]

Just a slight continuation of this -
Generally speaking, yes, hammer the calf raises... but make them heavy rather than doing loads of them.... if you can physically do 10 calf raises then you're doing them too light. Load up.

Eccentric contractions have shown to be no more effective than concentric, so don't worry about doing it off a step, just calf raise from the floor.

Note that there are a couple of different types of tendonopathy - reactive and degenerative, and it will depend on which type you have, and what stage of tendonopathy you are in as to what might make it worse or better... so even though there are general guidelines, its probably best to see someone that can give you specific advice according to your circumstances.

Do you have a reference for that middle paragraph re eccentric vs concentric? - and you can of course do concentric on a step and eccentric on a floor.