how long before eccentric raises will clear up achilles problems?

I've heard mixed things about the effects of eccentric loading on insertional achilles tendonitis/osis. While it seems to be less effective than with the midpoint tendonitis, which is what I think I have, it sometimes still has a very good effect. Also, I have been wearing kinesio tape (sp.) on my achilles at the behest of a chiropractor friend of mine and it may be helping.

I believe the eccentric raises are not meant to be done while your achilles is inflamed. In other words, if your achilles is hurt do not do them. Rather, perform them when you are healthy to ward off a future injury. For me, aggressive massage therapy was the key to moving past a nasty achilles falre-up.

Look at the studies that soul_runner has posted. They are meant to be done while when the achilles fails to heal on its own. It doesn't make sense to me either, but again and again studies suggest that the program is very helpful. As I said before, this program is helping my achilles more than rest, ice, massage, and NSAID's ever did.

just run baby, nevermind the alternative exercises

Sorry to bump an old thread, but this might help someone with insertional achilles tendonitis. Eccentric strengthening has mainly been successful with mid-portion tendonitis only, but this is because loading at dorsiflexion is not so good for the insertional type of tendonitis. A new 2008 pilot study, briefly summarized here http://bjsm.bmj.com/cgi/content/abstract/42/9/746 (I had to purchase the full version on British Journal of Sports Medicine) shows that when doing eccentric exercises for insertional achilles tendonitis/bone spur/bursitis, you will have good results if you do not let your tendon load to full dorsiflexion. In other words you must not drop your heel below ground level (do not use stairs). Use your good foot to get to tip toe height and bring the bad heel to the ground. Repeat. 3 sets of 15, twice a day. I will try to up date you in 8-12 weeks. I have already been on the full dorsiflexion plan for 10 week without such great results so this has given me new hope. Anybody else have any luck with this?

Oh yeah, and of course you still have to add weight.

Thanks for the post regarding eccentric loading without dorsiflexion. I have had insertional achilles tendonitis for almost 1 1/2 years now, and nothing, including eccentric loading with dorsiflexion, has helped. In fact, dorsiflexion actually seemed to aggravate the problem. After seeing this post, I am going to give the excercises a go again, this time without full dorsiflexion. Would be interested to hear how this works for you!

I have insertional tendonosis on my left and the full length eccentric exercises flare up my condition, on my right achilles i have the mid point tendonosis and the exercises have helped.

Other than surgery does anyone know how to alleviate the insertional achilles tendonosis ? Ice and removing part of the heel only have a minimal effect.

so far so good for me. It feels a lot better stopping at ground level now. I don't think it is 100% but it feels so much better to how it usually feels--have had this since 2001. No more morning pain either. I'll let you know where I stand in 4-8 more weeks.

a key here is that you're doing the exercises correctly. I had marginal improvement allowing me to train pretty well with occasional need for rest as it worsened until I started doing the exercises correctly.

Many thanks for this. Please keep us posted on your progress.

So, when doing this exercise, you are NOT supposed to use your bad foot to do the rising? It's only in the descent that one fully uses the bad foot? Also, are you doing this with both feet -- to ward off misalignment issues -- or just the bad one?

up with both feet, down with the the bad one.

i did them for both feet, but i had AT on both sides.

Thanks. I'm interlibrary loaning a copy of the article. One last question: how slowly are you supposed to descend?

I only go down with the bad foot. I go down very slowly with the bad heel--counting to 10 on the way down. I do 2 or sets of regular calf raises with the good foot just so it feels like I get the same amount of workload with both sides.

don't forget to do the shin splint exercises as these exercises strengthen your calves. stand on a step, facing downward, with one foot half on the step, raise foot up and down to full extension while leaving heel on step. repeat hundreds of times.

I've been using the balance board for the eccentric stretches to good effect. It's easier to "reset" to flexed position when you're not on the stairs. It's not as much weight either, so it might be good to start out.

to the OP.

It worked for me, here are a couple of ideas for you to consider.

A) Really watch out about riding your bike too much. Esp. a mountain bike. The bike can actually (in my experience)prolong the injury. If you mountain bike a lot this means you are probably standing on the pedals which may put pressure on the achilles.

B) I added very gradually more weight. You said you are 15 lbs. I went gradually all the way to 30 lbs.

C) As recommended previously, I hired a massage person to work on the tendon and it seemed to help get the lump out.

Good luck and hang in there. Just be very patient and take you time coming back.

I have been trying the eccentric loading without dorsiflexion for almost a week. I've noticed I don't have much pain while doing the excercises, but right after, and throughout the day, the pain has definitely become worse in the mid portion of my achilles ( I've been suffering from the insertional problem, primarily). In fact, my "good" achilles (in my previously non symptomatic leg)is getting sore now as well. Is pain after initially starting this program normal and something one has to work through to get the benefits of the program? Does it take a few weeks of getting worse before getting better?

I didn't have any pain/discomfort doing exercise without dorsiflexion or really any discomfort afterwards. But I did go straight from 10 weeks with dorsiflexion (having pain) to a couple weeks without dorsiflexion--already up to 50 lbs with no real problems. I would stick with it if you're just starting out as you are going to have some pain if you hadn't been doing any achilles/calf exercises at all. I would say 3 weeks at least.