Achilles pain for years - How do I fix it!?

Try prolotherapy. Deep tissue massage.

I currently have left achilles pain since I started running in the NB Vongos, it goes away when I run in my old Supernova Sequence shoes, but my right ankle starts to hurt in them. The Vongos are 1/2 too big for my left foot, so don't go larger.

stop wearing built up heels, wear a Salming or an Altra

achillespainistheworst wrote:

-weighted standing heel raises on flat ground (religiously, no effect)

Are you doing these eccentrically? How many per day?

SoCal Pete several months back recommended doing them on a step, even for what appears to be insertional Achilles pain.

For my insertional Achilles pain, I did heel drops to flat for months with little benefit. I figured I probably wouldn't make things worse, so I started doing them on a step, trying SoCal Pete's advice. Immediately, I could tell that my Achilles was reasonably strong down to flat, and then got really weak once the heel got lower than that. You're probably at that point now. So I started working the full range of motion of the Achilles, from as high up as I can tippy toe, to full heel down. That definitely helped me. You experience may vary.

A bit later I came an article on Competitor.com that I hadn't seen before:

The main thing new I got from that article was that I wasn't doing enough heel drops. It's noted in that article that high mileage runners (over 50 mpw) need to do a lot more than the 3 sets of 15 they recommend for hobby joggers. I had been doing 3x15 most days, with a lot of rest days, but it was recommending 4x80. It took several weeks, but I finally got up to 4x80, and now I'm doing 4x125+. This is with a backpack full of heavy stuff (as much as my bad left shoulder can handle), plus a really heavy tool box in one hand. I switch the tool box from one hand to the other between sets.

My Achillles started showing signs of improvement after I started working the fully range of motion. It showed more improvement when I boosted the number of drops from 45 most days to 500+ every day. I'm making progress on recovery and able to run, though it will take more time before full recovery.

achillespainistheworst wrote:

It's such a depressing injury... If anyone can help me start running again, I would be extremely happy.

Yes, very frustrating problem, a lot of us have been there.

I think it's time to stop randomly trying solutions (sometimes this works, sometimes not) and seek a root cause. The podiatrist seems to have failed to diagnose, otherwise it probably would've been fixed. The eccentric heel drops are a favorite of runners, but they don't work for everyone, the science behind them is considered sketchy in some circles, and in my opinion they are not the one size fits all achilles treatment.

Just curious about the shoe change in 2013. How many miles did you run in neutral shoes after making the change, before the achilles issues started? Did you ever think about switching back? Shoe changes have definitely been known to cause/fix some runners' achilles problems and those changes are not always intuitive or obvious.

But mainly, I think it would be worth scheduling a consultation with both a physical therapist and a massage therapist. But with one very important caveat:

Be very specific on your initial visit that you are NOT asking for recommendations for more exercises or treatments to "try". You are asking them to help you determine the ROOT CAUSE of your problem. This will help them to focus their examination.

My experience is that for achilles issues, medical professionals often don't find it necessary to really have an accurate diagnosis because the treatment will basically be the same across a wide range of diagnoses. This works fine in a lot of cases, but in your case it is NOT working. You need to get them to make every effort to search for and find a root problem.

And don't agree to try any remedies until or unless they have provided you with a DEFINITE--or at least likely--specific root cause of your problem.

This is an approach that worked well for me in fixing a recent persistent peroneal tendon (similar to achilles) problem. I went to a very good podiatrist for a couple months and he did his best to help, with limited success. But what he did NOT do was really go through an extensive full lower body examination. Because that's not really what he does. A massage therapist, on the other hand, was able to really dig in and go through every muscle, every tendon, etc. One visit was able to identifiy the likely root cause and basically fix it.

I would also focus on the shoes. Anecdotally, I have a friend who changed to a lower drop shoe, which is basically the opposite of what you would normally do, and it really helped a persistent achilles problem. Sometimes it's just trial and error with the shoes, you never really know.

I'm 35 and had over a year off of running from this injury. I went to PT, accupuncture, tried supplements, changed my diet, tons of eccentric heal raises, and much more. I am back to running 50 miles a week, and just did a 14 mile progression run yesterday and felt awesome. These are the things that worked for me:

1. Standing desk - the best invention ever. Will prevent your hamstrings from shortening while you sit all day, and yanking on your calf/ achilles.

2. Strength training - I do a modified version of this, and it has been fantastic. I feel like you need to strengthen the entire body to help your form, and reduce strain on certain areas. I realize this does not seem conducive to running, but I started this months before I slowly eased back in. It started with trying to help get a friend back in shape and I always wanted abs. Now I live by this as it works every muscle group in the body. Modify the weight and reps as you please, but I stick to the 8 sets of calf raises.

3. I found a really good bio-mechanics expert to help me improve my form. My stride has gotten longer out the back, which seems to help put less strain on my calves.

4. I used to eat a ton of spicy food (I'd put hot sauce on everything), but was told by a Chinese Herb doctor to cut it out.

5. Eat lots of high quality foods. Try not to eat meat products, unless you know where it comes from.

6. Leg swings all day, every day. Front to back, and side to side. 20 at a time.

These all worked for me, and may or may not work for you. I tried a lot of different things until I found the formula that is best for me. The key is to continue to try new things and don't give up. Stay very in tune with your body, and create a log of what seems to work and not work. This will be a very long process so don't force it.

Thanks for the help.

I have not considered going back, and honestly haven't really thought about it since switching based on my own assessment. I'm thinking I'll go to a running store and try to get an assessment to see what they think. I did stay in those shoes for about two years before anything started though...

Would you recommend a PT first, or the massage therapist first? Thanks.

I have suffered frm achilles pain ever since I sprained my ankle really badly years ago.I now have to always wear an ankle support like this http://shoewawa.com/product/ankle-support-brace/ whenever I go running now. help a little bit but my ankles I have now accepted will never be like they used to be like. I think when there cellular degeneration of ligament and tendon tissue that it will always be weaker than it was before. Does anyone know how to reverse this thats what I wanna know

I think I'd probably go to a massage therapist. At least that's what I did.

Make sure and do some research and find someone that has a really strong reputation and is known to work with runners. That's very important.

I'm not saying this is the magic solution by any means. I'm just saying, having gone through similar experiences, at some point there just HAS to be a reason for what is happening with the achilles. And I feel like for me, I just started approaching the problem from that angle: looking for a cause instead of looking for a fix.

If you can actually find the cause, the fix then becomes pretty obvious.

Hill reps. Seriously. Nothing else will strengthen that area better.

You will laugh at me but cut off the back of your shoe where the pull band is for putting them on.

hey ho go wrote:

stop wearing built up heels, wear a Salming or an Altra

Shortest post yet most sound advice, I noticed improvement switching to Altra (75â„… of runs).Also, I foam roll my heel, lifting butt off ground so ibtry to hear a popping sound on each roll. Has really helped

Man, I'm in the same situation. Been this way for a little over a year. I can handle about 20 mpw with minimal pain, but if I go over 30 it starts to hurt. It's forced me to retire from competitive running and basically just become a hobby jogger. I've also tried virtually everything to fix it, including trying to find the root cause, and have come up short every time.

Do you have full power from your Achilles? If so then it's not the tendon, but the paratendon that tore. The pain feels the same. Surgery is a 6 month non-running commitment and I won't quit running. Ice to reduce the swelling after each runs really helps.

Sounds similar to what I have. I ran through high school and most of college before noticing any achilles pain. But once it happened, it basically sidelined me for good. I got the team physio to look at it, had X-rays taken and all that. No luck. Did excecises and took time off.

Eventually a couple years later I went to a pediatric doctor who said I had a flaired heel, or the haglunds deformity. I just had surgery on my foot to get it removed, but hopefully I think this is going to fix it.

I recommend doing the same. If it can be operated on without messing around with the tendon I say go for it.

Oh, I understand you so well because I had similiar problem several years ago. I got a trauma while running too and from that started all that problem with my Achilles too :(

I totally agree with one of the previous posters, the recommendations about standing desk and strength training really work. In my case also yoga was very helpful too but be very careful with it, without a qualified trainer this type of activity can cause even more harm! The same is about strength training, it's really better to start with it after a consultation with a professional.

My doc recommended me to use standing desks

https://www.primecables.com/p-355830-cab-et101-wh-primecables-electric-sit-standing-desk-height-adjustable-desk-frame-table-top-not-include-white

too, these items help to fasten the body recovery and keep your hamstrings in tone, which is especially important in such case. Besides these desks make exercise stress much less for the certain parts of the body.

And yeah, regular swings are a necessary thing for you too. However the process of making them can be a bit painful like it was in my postraumatic state but it's ok in the beginning.

Hey achillespainistheworst,

I wanted to ask what has been your progress since you posted this?

I have been struggling with the same issue for 4 years. When I read your post, you were describing my exact symptoms. I have basically followed all the things you have done + dry needling. I am still struggling. I was wondering if you are recovered now, and if so, what did you do?

Thank you!

Have you tried PRP (platelet rich plasma)? I had a similar problem (lump on Achilles, constant pain, stiff in the morning) for about 6 months. Got PRP, did a 6 week reco plan, and my Achilles has been back to normal ever since.

Mine was 6 years. Incredibly depressing to slowly get slower. I finally quit (well quit to 5 miles a week) running and just did weights and rowing, lots of squats. After 4 months I still have a little pain and tenderness, but nothing like what it was. The Achilles pain was terrible, but I think it was really the symptom of a weak/strained hamstring. Time off and weights was what I needed to get over it. I'm still nervous about aggravating it again, but starting to work on my vertical jump and speed again. Pretty excited about it.

Same symptoms as others on this thread: both Achilles injured since 2012, 6 years and counting.

Have tried eccentric heel drops, total rest, ice, cross-friction massage, ART, Graston, PRP (twice), dry needling. Only things I haven't tried are shockwave and surgery.

I'm interested to see any other replies/cures proposed here.

It's frustrating to be unable to do what you enjoy, and running was and has been a big part of life for a long time. I hope to be able to do it again at some point.