Achilles Tendonitis Question for the Experts

10-15 minutes a day, that is.

Bump

I've had a few achilles issues in the last couple of years. For me, they take a while to fully heal. Sounds like you are on the right path.

As for mine, a 50 meter jog would not really have been enough to tell me if I was ready. Sometimes it would be extremely painful in the beginning, sometimes later in the run, and sometimes not until I was done running.

The trick will be for you to learn what the pain means. I would experience two kinds of pain. One pain was the kind where it was being injured or reinjured. I don't really know how to describe that too much. It was acute and felt, well, bad. Like I should stop. So I would.

The second kind of pain was a healing kind of pain. I believe this would come from stretching and working the scar tissue that had built up in the healing process. I learned this pain and was able to just run through it. In fact, it seemed to help it heal faster when I'd feel this kind of discomfort and work on it.

Massaging the tendon is good. I did a lot of that. Mostly after runs. And that would hurt, too. But it was more like the second kind of hurt.

And do eccentric heal drops. At a minimum do 3 sets of 15 drops (both legs) early in the day and again later in the day. You might notice the second kind of pain while doing these, and again, that is OK.

Heel drops, massage, calf stretching daily. 10-15 minute runs every other day and then daily when you can handle them. Slowly, very, very slowly, increase the minutes on some runs. A lot of people will say to run on soft surfaces, and I agree. But for me they needed to be stable soft surfaces. So lumpy grass or a bike path with ruts/footprints in it would be too much and aggravate my tendon.

Good luck.

Great advice here. I would add making sure you aren't running in 0 drop shoes. I've been struggling for almost 12 months with my right Achilles in pain. It is very slow to heal. My PT indicated 12-18 months. On month 11 now. The eccentric heel drops are essential to promote healing.

I had a lot of achilles issues

Massage will definitely help. In addition

1) check your shoe toe to heal ratio. I always put heal lifts in running shoes on easier days.

2) Ice after running. I had a deep pan that I would put water and some ice cubes in that worked great

Most important, gradually increase workload and I mean gradual. I bumped my runs 2 minutes per week when I started back.

My problem is not the Achilles but the bursa. It is the same problem that Rupp had surgery on. A cortisone shot helped but the problem returned a few years later and hasn't gone away.

Alan Scharsu wrote:

Most important, gradually increase workload and I mean gradual. I bumped my runs 2 minutes per week when I started back.

Totally agree! When I was coming back I strictly limited myself to the silly feeling %10 mileage increase rule. So early on I was doing about 8 miles in a week. That mean the next week was limited to 8.8 miles. Then 9.6. Painfully slow increases, but it totally worked. I got up to the mid 30s and then was pretty much in the clear to pile on more miles and intensities after that.

I had a terrible bout of Achilles tendonosis after I ran a marathon in 2016. I attribute it to running in racing flats and starting my training back up too aggressively after the marathon. I have run one marathon since (in May) in which I PRd and also have had zero issues since. Before I give my opinion on the answer to your question, these are my keys to success:

1. Strength train if you don't already. As the other guy mentioned make sure to do eccentric heel drops (make sure not to overstretch). Don't forget to also incorporate glute and hamstring exercises (squats, leg press, hamstring curls, etc.). Weak glutes can cause you to overuse your calves and give you achilles issues. Once you are fully comfortable with eccentric heel drops start slowly incorporating weighted calf extensions (both standing and seated). The standing will get more of the gastronemius, etc. and the seated will work more on the soleus. I worked up to eight sets of six with heavier weights.

2. Foam roll like a MF. If your glutes and hamstrings are tight or knotted up, they will yank on your calf/ Achilles. Your recovery will take much longer if the muscles and tendons are not strong, loose and flexible.

3. If you work a desk job, get a standing desk. The more you sit, the more your hamstrings will tighten up and pull on other muscles. Its important to extend the muscles regularly.

4. Incorporate dynamic stretching (leg swings front to back, side to side). Do these several times a day. I do sets of twenty each.

5. Wear comfortable shoes as often as you can, when not running (wear comfortable shoes while running as well). My shoe of choice is the Adidas Ultra Boost when not running - this is the most comfortable shoe I've ever worn. I also wear recovery sandals in my house rather than walking barefoot -this is also key in my opinion.

6. Eat quality foods and try to avoid processed as much as possible. Any foods that are processed or have chemicals will only slow the healing in my opinion.

Now, to answer your question. My experience was that I still have a little soreness from time to time in the Achilles after tough runs (but only when I squeeze it). It never hurts during the run, and it seems to always go away by the next day. I'd say if you are still tight when you wake up in the morning, you have more work to do before you are ready to start running again. The last thing you want to do is to jump back in too soon. I recommend following the steps I layed out above (maybe get in the gym more, swim, etc.), until you are no longer sore in the mornings. Then slowly start getting back into running.

I hope that helps.

AT/AS wrote:

So Ive had another bout of achilles tendonitis recently and im just not so sure what to do right now. The injury is def getting better as Ive taken some time off running. I dont feel pain while walking and Ive done a couple really short test runs (like 3x: 50 meters down, walk back) and there are no issues.

Every now and then I've had some stiffness in the morning when I wake. It always hurts when I grab/pinch it and that is what I'm worried about. Should I start running 10-15 a day and keep going even if it hurts to pinch, or should I keep going as long as it doesnt hurt to run/walk?

This past week has been my first experience with Achilles issues. Had a pinching sensation in my Achilles last weekend on an easy run. I finished the run just thinking it was my calf tightening up but realized after it wasn't. The next two days could feel it walking and on stairs. After that, I could feel it commuting to work on my bike but nothing painful.

At what point should I attempt another easy run? Should all sensations in that area be completely gone or is it ok to start again but be cautious?

I had actually just signed up for my first marathon in May the day before these symptoms started so a little frustrating but want to make sure I'm good before training again

I'd suspect it may also be related to Plantar Fasciitis, do you also get some heel pain ?

High dose Vitamin D for a couple of weeks. You will be surprised (Vit-k + magnesium is also good, but really it's mainly Vit-D).

Try running slow and slowly building up speed on your runs, so there's a steady progression throughout the run. That way you also can tell if you need to back off or call it a day until recovered further. If you feel fine after a few miles, keep pushing. But whatever make sure you are well warmed up for a few slow miles before anything else.

I injured (or at a minimum really bothered) my Achilles during a 3-day span of too much activity over New Year's. On the 3rd day I was 10 miles into a 13 mile run, and it started acting up. I should have stopped the run there but figured I'd finish it out. A little bump appeared on my left Achilles. Long story short I took 8 days off and have been easing back into it. So far what seems to be incredibly helpful is eccentric heel drops, 3x15 twice a day. I thought this article had a good description of it:

https://runnersconnect.net/achilles-tendonitis-and-insertional-achilles-tendinopathy-in-runners/

Shockwave therapy is spectacular

i run through excruciating pain for about 1 year, until it finally completely healed up without any treatment

So thing about an achilles injury, at least tendonitis, is that you can really over-treat it into some pretty bad pain. This is just what I have experienced.

I had an injury a while back. It flared up during a track workout in mid february, and it really wasnt that bad, but Id had this injury before and wanted to play it safe. I took 4 days off, then jogged a little bit, it felt fine. I was committed to a race and I felt fine jogging and doing strides so I continued with the race. Wore racing flats and felt ok. Ran the day after, could feel a little niggle but still felt fine. I got scared so I took another 4 days off. Came back and didnt feel much pain, but it didnt feel right.

This was the point where I kinda screwed myself. I should have stuck with easy jogging 10-15 min a day, eccentric heal drops, and some massage with foam roller. Instead I freaked out and really got intense with treatment. I THOUGHT I was in the right direction.

I came back to running about 24 days later and did not feel right. I was pissed because I knew I had taken some good time off and the original injury wasnt really that bad.

Everyday I was stretching, massaging, icing/heating, eccentric heal drops, and wearing a brace at night to keep the ligament from scrunching while asleep.

I basically started running 8-10 min a day easy and after a couple days the pain was so bad in the morning and I knew something was not right. When I had originally hurt the injury I was training hard and the pain was not this bad.

I basically read this really good, research based article below and it changed everything I though about achilles tendonitis.

http://www.runningwritings.com/2013/11/achilles-tendonitis-in-runners.html

Basically, it says that the only reliable methods to treating AT is rest, and eccentric heal exercises. Somethings may not help, but wont hurt. Other, will really make it worse. Ill just outline it briefly.

Do

Rest

Eccentric Heel Drops

massage

Sometimes helps, but wont hurt

Maybe ice after activity

Do not

Heat

Stretch

Sleep with a splint

Wont go into all the detail with the why not on those last 3 but I basically went from bad to good after following this plan. Ran 16 min one day.. Not really any pain at all. Started to feel some stiffness later into the evening (more than usual) Did all the treatment, woke up the next day and the AT was so tight. I usually had morning pain, but i was worse. Pain prob about a 6. It wore off as the day went on but still hurt.

It was that morning I came across the article above. I didnt stretch at all. I went to the stationary bike. I didnt heat or ice, I did eccentric heal drops in sets every 45 min till right before bed. Right before I went to sleep I massaged lightly with a foam roller and did NOT wear a brace or splint to sleep. I woke up the next morning and the pain was about 1, or less. That was my immediate first steps getting out of bed. After that I was sold on never doing any of things with an AT injury.

I feel like even though its a pretty strong tendon, the strongest in the body, its also a pretty sensitive tendon.

Good luck.

+1 for eccentric heel drops. Avoid hill workouts and running on overly softer surfaces like sand. Shoes with a larger heel-toe drop or heel pads can help, especially in the short term. In the long term excessive heel-toe drop can shorten your achilles so look to return to a moderate heel-toe drop when you can. Expect it to take a long time to completely resolve.