Injury of the Week: Achilles Tendonitis

Ice is paramount. Tendonitis is inflamation and inflamation is combated best with rest, ice and advil. I like 2 forms of icing for my achilies or peronius when they get sore or inflamed.

A. I use an ice bath for the. Get a bucket or big pot and fill it with cold water and ice. Soak your legs for 15 minutes. It sucks, its cold, it hurts but it feels great afterwards.

B. Ice massage. Take some dixie cups and fill them 3/4 the way with water and stick it in the freezer. Once its frozen pull one out and tear off some of the paper to expose some ice (you should still have some paper to hold on to so your fingers don't freeze) and start to massage the inflamed area. This serves 2 purposes: first it ices the area, second it works as a light cross friction massage for the area. I've also used a liquid muscle balm, like biofreeze in the ice cups but it makes your freezer stink like the AT room at school.

Good luck and let me know how that works out for you.

how long really depends on how bad. the answer is probably "longer than you will" and certainly "longer than you want to".

i was thinking i'd be fine in 2 weeks so went for a 3 miler and it came right back. now it's 5 weeks and it feels like it's all gone. i'll try a few miles probably next week.

meanwhile it's time for some pool running :(

Mine started out like that and then I raced on it and it got really, really bad. I've been out for going on four months, so my advice is to be very conservative right now and take a week or so of down time. It may save you months down the road. Instead of NSAIDs, which some people argue may actually hamper recovery you might try eating a lot of fresh fruit, and particularly pineapple. Of course as others have pointed out ice is also key. You might also want to contrast that with heat baths as well. Good luck. I've heard it can be basically nothing if you catch it early.

back to work wrote:

Ice is paramount. Tendonitis is inflamation and inflamation is combated best with rest, ice and advil. I like 2 forms of icing for my achilies or peronius when they get sore or inflamed.

.

Hold it a second. Yes Tendinitis is inflammation tendinosis is not. Too often what people call tendinitis is tendinosis.

This could damage to the tendon well beyond simple inflammation. In that case, ice is not the answer. Rest and healing are (or at least part of it)

Really, it depends how bad it is.

You may try the elliptical and see if it bothers it or not (or a stationary bike, as well). If you can just feel it coming on now for the first time, chances are it isn't bad enough that those activities will hinder the healing much.

I agree with previous posts - I like the ice bath, and the ice massage is also highly recommended. Just be sure not to overdo it and damage the skin. If the skin gets somewhat damaged, you'll have to lay off the cold therapy for a while, and that also means stopping the Achilles therapy.

The very best therapy, in general, seems to be eccentric calf raises to strengthen the tendon and related muscles. These should be performed seated and standing, since each exercise works the legs in different ways. Let me know if you need more info on those. These have been scientifically demonstrated to be highly effective, and I have personally seen good results with these through many experiences.

I would say try to do 2 weeks of rest, if you can. It is better to have 2 weeks of rest and be done with it, than have a week of rest, have it almost go away, then miss a day or two of training here or there, and then maybe another week, etc. wind up with a persistent injury. I would also recommend easing back into running - don't do 30 minutes back on your first day, just go for 5-10 minutes and make sure things feel okay. Take a few days to get back to the duration of your normal training run and make sure it does not hurt after that... if it does, back off. I know this sounds very conservative, but I really think it is worth it in the long term.

The other thing is to find out the true cause of the injury. Try to determine if you have a strength imbalance, flexibility imbalance, etc. (If you need more info on that, let me know.) Many people get caught up thinking about the Achilles itself, but there may be a problem elsewhere in your legs/feet causing you to slightly change your mechanics and place greater stress on your Achilles and injure it.

I think we should just shoot you preemptively and put you out of our misery.

I think that the reason that you hear from people on this website who have had this injury for years is that they never really took serious stints of time off to let it heal. Mine is finally getting better with weeks of no running. If you have access to a pool I would use it to stay in shape.

I am on week 4 of total rest for my achilles and it is feeling great. I am so glad I took all this time off rather than trying to run through it. But then, I have learned the hard way that that is the only way.

I had some tendonitis in my achilies at one point. I pretty much did what that first guy was saying but ofcourse i wasn't running either. I took 3 weeks off and hit the pool. I tried to bike but it still put pressure on my achilies. Hasn't bothered me sense.

1. Don't run on it while it is hurting.

2. When you do run, 1st time run 5' walk 1', run 5' walk 1' and see how that goes.

3. (a) massage the tendon 3x a day. (b) Use deep tissue massage to help lenthen soleus/gastroc. (c) squeeze tendon sheath between fingers and dorsiflex-plantar flex foot.

4. Eccentric calf raises.

The second way of icing was a miracle cure for me.

Are there any suppliments that significantly help or are they just a waste of money? I have been taking fish oil pills and MSM, but I'm not sure if they are doing anything.

to quote Dr. S:

The very best therapy, in general, seems to be eccentric calf raises to strengthen the tendon and related muscles. These should be performed seated and standing, since each exercise works the legs in different ways. Let me know if you need more info on those. These have been scientifically demonstrated to be highly effective, and I have personally seen good results with these through many experiences.

I CANT SAY ENOUGH about how effective this is: Eccentric calf raises have been a miracle cure for me. In the 3 years that I've been doing them 3x weekly, my achilles have never bothered me--except when I'm lax with the exercises for a few weeks.

Now for the pseudo-scientific bit of wisdom:

When I haven't been doing the eccentric calf raises, and I develop tendonitis, the only thing that EVER works for me is running THROUGH it. I'll resume the exercises and build back to full mileage. Honestly, the tendon 'heals', maybe scars over, well enough to permit full training again!

i gotta agree with the eccentric calf raises...time off is important but if you don't correct the problem that caused the injury to begin with then when you start running again, you're just going to get injured again.

Anat&Phys wrote:

3. (b) Use deep tissue massage to help lenthen soleus/gastroc.

For a poor-man's version of this, I roll my calf on a tennis ball. Sit on the floor and rest your leg on the ball just above your Achilles tendon. Then lift your butt off the ground with your hands, put some weight on the ball, and roll forward until the ball is just under your knee. Repeat several times to cover the inner and outer regions of your calf muscles. Hurts like hell the first few times you do it, but if you do it regularly, it's not bad at all. Helped with my Achilles problem, as did many of the other suggestions here.

In several bouts of achilles pain over some 50 years, I have found that cross training on elliptical machines is the best way to maintain condition during the healing process of roughly six weeks.

this injury used to be the bane of my running career...i've made some other switches that had basically cleared the sucker up. I'd definently advise:

1. the massage thing that the above poster advised with the tennis ball...you could also go like lacross ball or golf ball to get more specific.

2. light light stretching if its ok, but not if you think you're doing damage...I know some people say you gotta get flexibility, but at this stage you are dealing with micro-tears in the tendon and its trying to put itself back together...so stretch, but there should be NO PAIN. If there is don't do it.

3. active release therapy (www.activerelease.com)...I swear by this now. You can put in your zip-code and check for someone nearby. I've had some muscle issues before and I go in for this and its gone. You got to find the right person for you though. For me it works well, but there's always going to be someone who says its a crackpot and blah blah so spend some time and find a reputable provider. Everyone off that site is trained properly.

As the saying goes sometimes the hardest thing to do is rest for an athlete. If you need it take it now before it gets worse and please don't be the moron that lets it get so bad that you get the bump going on the tendon and it explodes and your really f'd.

Thanks for the advice everyone. I know I have some sort of muscle imbalance in that leg because it always feels tighter than my left leg. It's also the same leg I've had the tibial stress fracture and stress reactions in. Like I said, I've never had achilles problems before. I did switch to racing flats at the beginning of the summer, but I don't know if that caused it. I like the flats because they've helped with my stress reaction. I'm a forefoot striker, so I didn't think I would get achilles tendinitis. I think the main cause has been running too many hills on concrete and roads.

i had achilles tendonitis for the past 5 weeks. first run back was today. did 15 mins real slow. there was some light pain (niggle) for the first half of the run but it was fine for the second half. am i ready to continue training? my doctor told me it was normal to feel some pain on the first run back.