Recovering from achilles injury. When to return?!

If you want to heal, you better start doing eccentric heel drops.

Physio advised me not to do eccentric heel drops as I had insertional achilles tendinitis and was told not to stretch the achilles at this meant more tiny tears.

I've had insertional achilles tendonitis for almost 2 years now. It hurt pretty bad when it first happened but I was able to run through it. If I would have stopped running for 2 weeks and did eccentric heel drops during that time I would probably be fine.

I think you should probably do the heel drops, but on flat ground and not on a step or something. They seemed to really help. I also found that running doesn't really make it worse unless it's very hard running. And over time, it's actually gotten much better even though I have taken literally no time off for it. Currently the pain is a 1-2 out of 10 at the worst moments, and I often don't notice it.

You'll have a choice to make about whether you should continue to sacrifice fitness or run though it. Generally speaking, activity and movement is good for tendon injuries as long as you're not really stressing it. Tendons are made to move, glide, etc. They get stiff when they are not used.

I also think calf strengthening and rolling helped me, but it's so hard to say because it's been 18 months since I initially hurt it.

Lower drop shoes seemed to hurt it, so I just went back to using boston boosts for speed instead of lower drop kinvaras. Rest usually isn't the best protocol for tendon injuries. Be proactive. Heal that sucker your self.

Thanks for the advice. I normally where very flat shoes but if I try them now, they just seem to hurt so will keep the heel lifts in. There is no pain walking about but it is about 1-2 out of 10 when I do the heel lifts. I'm still icing and rolling every day. I feel like I could try some easy running but the creaking is now getting worse as the injury has went on (not sure if this might be a sign of it healing?) but it definitely doesn't sound natural.

Dealing with this problem now, though mine isn't insertional. I can't offer advice because I don't know how you feel and I certainly am not an expert. But my experience has been that I felt the symptoms come on gradually over a week, starting the day after a 3k indoors. I had run three weeks at 60 mpw following a week off at the end of Xc season, day after the race the tendon felt rubbery. It's hard to describe. It got worse over the course of a week, even though I took days off here and there. When I felt discomfort in the mornings, mild pain when I balanced on the injured foot, pain when I got on my tiptoes, I knew I needed real time off. I took two weeks complete rest, then a week running every other day, starting at 15 minutes, working up to 30, then a week where I ran five days, longest run was 30 min. I started doing heel drops immediately, and there was a small amount of pain when I first started them. My first runs were not pain free, but they got better. I also ran them very slowly. I bought a night splint and started wearing one to sleep, and also iced a lot, contrasting ice and heat, etc. Eccentric exercises, morning and night, helped most I think. The past week was the first week of training for me, but no workouts in spikes yet. I did one run of an hour slow, 12 x 400 Tuesday, 30 min Wednesday, 2 miles with strides Thursday, 5k race at tempo effort Friday. Weekend off. So it's been a month and I'm back to training, but at less than 50% of my old volume. I still have occasional twinges, but I think it's getting better and I can run hard on it with no pain. Also still doing eccentrics, still sleeping with a night splint, and I probably will do both all track season. Hope that helps

I spent most of 2017 wrestling with achilles issues. I'm coming back now and am up to 40+ mpw with no pain. Nothing fancy, I know, but I'm rather gun shy about coming back too fast (cuz I already reinjured it once last year when I thought I was healed).

I second what the other poster said, heel drops. Do them to flat ground (I never did mine off stairs or anything like that). Do them daily. Do them in high reps. Do them for low reps where you take 10+ seconds for each rep. They are key.

The other key is trying to figure out how you got this. If it was a traumatic injury, that was some kind of bad luck. But if it was overuse, you might have some weakness or imbalances in your hips or lower leg strength. The drops will help the tendon heal and help strengthen your foot and calves. But I would also add some single leg strength and stability exercises.

And the lifts in the shoes were key for me, too. When I injured it I was running in zero to low drop shoe models. I switched to a more standard 8 mm drop and that has helped. I occasionally try out my old shoes and I'm still not ready for them. Maybe I won't ever be. It doesn't really matter so long as I have comfy shoes that I can actually train in.

Good luck, take it slow.

Thanks for the advice. I did the flat heel drops for about 4 weeks but I felt like this was doing it more harm than good so I've stopped and the pain has went down since, the physio was fine with this. I don't have any pain now but I do have the creaking still badly? Was this something you still had when returning to running?

Maybe. That area around my ankle does pop and crack occasionally. Usually after I've done some stretching/exercises on it. It does not pop all the time. And pretty much never on my runs. My pop also feels good. Like scar tissue is being released or something like that.

As for the drops, they did hurt a little from time to time. I certainly can't say from here whether or not you're experience too much pain or what have you. But from what I've read, lots of people need to keep doing them and push through the discomfort of the drops. That ouchiness is usually increased blood flow going to the damaged tendon.

Get prolotherapy, the heel lift will stuff your knee.

Bump!

So I started running again a few weeks ago after about 9 weeks off with my Achilles issue. First week I only done about 10 miles, 2nd week up to 20 and last week I was up to around 30. I was quite happy with how the return was/is going however I am still slightly aware but not sure if it's more of a mental thing. There isn't any pain whilst running but I have a slight burning/tingling sensation in the heel and achilles still when I'm sitting around which isn't shifting. (Pain only around 1/2 out of 10 but just annoying) Does this eventually go? Should I ease back a bit? I'm able to still do heel lifts with no pain either and no pain when I'm walking, just when I'm at my desk really...