Fastest way to heal achilles tendonitis

I recently saw a good sports med doc who prescribed SLOW eccentric achilles stretches.

Basically you stand on a step supported only on the ball of your foot.

Start up high on the ball, then slowly lower the heel below the level of the step. Repeat 15 times. Do this 3 times/day for 12 weeks (at least that's what I've been told to do.)

I've tried these eccentric exercises before with mixed results. But when I did them then, I was letting the heel drop very quickly. Doing it slowly seems much more effective.

According to the doc, putting a slow stretch on the tendon somehow cuts off blood flow through the small vessels that form in the tendon in response to injury.

Apparently, there's some good scientific evidence that it's these blood vessels that cause the pain.

The injections described in the Medline article linked to above apparently do the same thing as slowly stretching the tendon. Both the injections and the slow stretching seem to devascularize the tendon.

I have less pain in both tendons after doing the slow eccentrics for less than 2 weeks. So I'm hopeful.

Good luck with your rehab.

Postscript:

The idea that vascularization of the tendon causes the pain seems consistent with something I've observed over the years: if I do any upper body exercises after I run (e.g., pullups), the pain in my achilles is immediately relieved. Maybe others have had the same experience.

On the other hand, if I've been in a position that causes blood to pool in the lower legs for a long time, such as sitting at a desk, the pain in the achilles increases.

That's always puzzled me. It could be, though, that the upper body stuff shunts the blood away from the lower legs, flushing it out of the blood vessels in the achilles. I'm probably wrong, but the doc's explanation got me thinking.

By the way, it seems to be OK to do these eccentrics even if they're painful. Mine sure as hell were, but they're getting better already.

The PT who the doc referred me to said they're painful because you're breaking up the existing tissue matrix and laying down a new one (or something like that -- didn't take notes).

bump

The Sports Bulletin exercises and Swedish exercises listed above are great. Would also suggestsingle leg bent knee calf raises, with dumbell on knee, toes on block of wood. Walking in sandles during the day is helpfull for flexibility and calf strength.

Try some barefoot jogging on grass. You'd be surprised how your body compensates for not wearing shoes, and fuctions more effeiciently.

Anabolic steroids+HGH. And rest.

RTC wrote:

AT can be tough to get rid of. You really need to rest it, take NSAIDS, and ice it until the pain and swelling are gone. Putting a heel lift in your shoes can help, but you don't want to become reliant on it. Once you are to a pain free point, work on strengthening and stretching your calves. I actually did some strengthening before I was completely pain free and it paid off. Do a search for eccentric calf raises.

I did a search for it and found this.

Rest doesn't matter. You should run at recovery pace to promote healing.

Don't use NSAIDs.

Don't do calf raises. Do calf drops.

This sounds like a problem no one knows the solution for since opposite advice is being given everywhere.

almost opposite advice out the wrote:

RTC wrote:

AT can be tough to get rid of. You really need to rest it, take NSAIDS, and ice it until the pain and swelling are gone. Putting a heel lift in your shoes can help, but you don't want to become reliant on it. Once you are to a pain free point, work on strengthening and stretching your calves. I actually did some strengthening before I was completely pain free and it paid off. Do a search for eccentric calf raises.

I did a search for it and found this.

Rest doesn't matter. You should run at recovery pace to promote healing.

Don't use NSAIDs.

Don't do calf raises. Do calf drops.

This sounds like a problem no one knows the solution for since opposite advice is being given everywhere.

No. What you are saying is known. This is a 10 year old thread.

Fat Boy wrote:

There is a 99.999% chance that it was caused by your shoes. You can cut out the backs of them, that is remove the achilles rippers from each or do what I found to work the best, run in Huarches and gradually phase in minimalistic shoes with no (or soft) heel counter. Press on the back of your shoe and try to make it fold into the shoe. If it won't go, your shoes suck. Most racing shoes pass this test. Most trainers do not.

lololololol the Adidas Adios "fails" your "test."

When was that last time a marathon WR was set NOT in that shoe?

I had it for a few months. Took an entire month off then tried to run a bit while doing eccentric calf raises after runs. I kept adding volume and intensity too fast so kept having to back off again to let swelling go back down. There was a 5k road race I had planned on running and felt good enough to do a 3.1 easy run without much pain. Last minute I decided to race it all out in flats. My calves were a good sore after the race Achilles tendinitis got completely better.