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Thread: Achilles Tendon help !

  1. #11
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    Quote Originally Posted by Travs View Post
    I have had some low level Achilles pain (I wouldn't go as far as calling it a real problem yet), and since I stopped doing calf raises it's actually disappeared for now.

    I do a lot of strength work, squats, leg press, etc, and was really hammering the calf raises.

    Maybe I was just doing too much with all the running as well... in fact it was probably just coincidence, as I've recently changed my day-to-day trainers, and most of all I also started icing it quite regularly... but thought I'd share...

    I would however recommend skipping with a rope as a fantastic way to build your calves up. If you can work up to 5 x 3 minute rounds then your calves will certainly be in very good shape (and your shoulders!)
    .... or jumping just a few inches off the ground with the same timing as if you were skipping with a rope - I find the rope is just a distraction/time waster. Then you can do it as hops - 2 steps each side, 4, 8 ... all good plyometric stuff and great for the calfs/Achilles tendons.

  2. #12
    Senior Member zephr's Avatar
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    Quote Originally Posted by Mike T View Post
    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.
    I dont actually have one on me (as it were), but Im sure I can dig one out for you...
    Just in case youre wondering, it'll almost certainly come from Seth o'neill or Jill Cooke. I think it's Jills work...

  3. #13
    Senior Member zephr's Avatar
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    MikeT - Sorry about the wait...

    It's actually from a recent(ish) systematic review of tendon loading protocols by Malliaras et al.
    Malliaras P, Barton CJ, Reeves ND, Langberg H: Achilles and Patellar Tendinopathy Loading Programmes. Sports Medicine. 2013:1-20.

    publicly available pdf is here....
    http://physiovelo.com/wp-content/upl...mes.pdf?x12367

  4. #14
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    The clinic is based in Pride Park, Derby offers specific treatment options that are discussed with you and are tailored for your individual needs. Highly trained with over 20 years of experience, the physiotherapists use physical treatments to restore and maintain physical, psychological and social well being. Services are available for Physiotherapy and Sports Massage for sports Injuries. We provide assessment, treatment and advice to individuals, sports teams and local businesses in Derbyshire

  5. #15
    Senior Member DangerMouse's Avatar
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    Quote Originally Posted by Yaks View Post
    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.

  6. #16
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    Quote Originally Posted by zephr View Post
    MikeT - Sorry about the wait...

    It's actually from a recent(ish) systematic review of tendon loading protocols by Malliaras et al.
    Malliaras P, Barton CJ, Reeves ND, Langberg H: Achilles and Patellar Tendinopathy Loading Programmes. Sports Medicine. 2013:1-20.

    publicly available pdf is here....
    http://physiovelo.com/wp-content/upl...mes.pdf?x12367
    Thanks for that. It is my understanding that in general they feel that the outcome with eccentric exercise is no better than the outcome with combined exercises. In the summary they do say that loaded eccentrics are probably better in athletes with strong muscles/high loads, whereas the combined exercises are probably better in those with weak muscles.
    When I do calf drops (for prevention, despite the lack of evidence) I do them on the floor, not a step, so as not to stress the Achilles tendon insertion into the heel, and I go up on both feet and come down on one, so there is a concentric component in the exercise, albeit not a heavily loaded component.
    Of course the exercise that you don't do will not work - eccentrics are simple, but, compared to some other programs, do have the disadvantage of (supposedly) being done twice every day.

  7. #17
    Senior Member DangerMouse's Avatar
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    Just listening to this interview with Professor Håkan Alfredson, it's quite interesting and discusses the difference between midpoint and insertional tendinopathy:

    https://soundcloud.com/bmjpodcasts/t...dinopathy-with

    An important point to note is that if the tendinopathy is insertional that the heel drops should only be performed to the point where the foot is level and doesn't extend beyond the pinch point.

    I've been doing these exercises on the leg that is showing symptoms but you have me thinking that I should probably do them on my other leg too.

    For what it's worth I don't find the 2 x 90 repetitions each day to be a problem, it takes a little time and I am getting muscle soreness towards the end of the sets, which I take to be a good thing. I don't think it will be long before I start loading.

    I think you are probably very wise to do these as a preventative measure Mike T

  8. #18
    Senior Member DangerMouse's Avatar
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    I found these videos that should help eliminate the possibility of any misunderstanding on how to perform these exercises:

    https://youtu.be/M6EKuuZ7C2E

    https://youtu.be/XYl8pOkw-aE

  9. #19
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    Update: 4 days of doing these exercises and the difference is significant. The tenderness has diminished considerably and I have no pain in the tendon while running. I have been able to continue my training no problem, just making sure I take it a bit easier and don't push it. Which is probably sensible anyway.

    My calf muscles hurt from doing these exercises though, this is muscle pain, nothing else, and there seems to be bits of muscle at the bottom of my calf that are developing at an alarming rate, I mean I guess the muscle was always there, but I can see it and feel it whereas before they were kind of lost.

    I am also taking Vitamin C in the morning and MSM in the evening to help the production of collagen. This is info I know from elsewhere, not mentioned in any of the rehabilitation guides for achilles tendinopathy, but it can't hurt, it's just vit c and sulphur - both foods rather than medicines.

    I am also being careful not to over stress the tendon insertion point by not dropping too far below the step. One time I did it too far and it just felt a little bit wrong. Having heard that the way to strengthen the insertion point is to not descend below the step level, it seems sensible to build that up really slowly.

    I'll keep reporting back on my progress and hope my experience helps others

  10. #20
    Senior Member DangerMouse's Avatar
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    I am still doing these exercises, all pain and discomfort has all but gone. Some very slight tenderness, but almost nothing, certainly nothing to be worried about at this point.

    No interruption to my training at all.

    These exercises seem to be working

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