WIll I ever run again? Advice on where I can go..

I really can't stress enough how easily you need to transition back into running.

Once the inflammation dies down, and you feel like you can run again, start with absurdly slow and short runs. Anything that result in pain is too much. Your achilles needs to continue getting better (even just a little bit at a time) rather than staying the same or getting worse.

Use heat before and ice after.

Calf strength and flexibility is key. Instead of doing static stretching, do calf raises/drops and use the foam roller after running.

You can also try putting lifts in the heels of your shoes.

This isn't something that is going to magically go away one day. I had achilles tendonitis in my HS sophomore track season. I lost the rest of my season, and spent all summer getting to a point where I could manage it and run successfully.

I'm 23 now, and I STILL have to manage it. My right achilles is noticeably less flexible than my left, presumably from scar tissue. I don't have to wear heel lifts any more, but I have to be careful of running hills too much, and I have to stay on top of ANY inflammation that pops up.

The most important thing for me is keeping my calves strong and loose, with strengthening exercises and foam rolling.

You could be doing all the right things, but if you don't do them in a smartly structured way and you don't listen to your body, you won't get better.

You are on the right track in trying different things. Try everything, something may eventually click. When I had PF, I found that masso-fascial release, massage by a good masseuse, self massage, rotating shoes, and Pinnacle Powerstep insoles helped the most. Also, running itself and walking (with insoles in) helped even as I had to run through some pain initially.

The problem is probably in your hip flexors or above and has nothing to do with the strength of your calf muscles. Get the september issue of Running Times and read the article about the psoas muscle and the article about massage therapy.

I had an accident and couldn't run for 3.5 years. It took about the 6th person I saw who finally figured out the major problem was in my neck causing my lower back to go into spasms when I tried to do anything. I have been going to her for about 3 years now. During that time, I have had a calf issue as well as hamstring tightness that went away after she got my hips back in alignment. Most of these injuries are simple overuse injuries but until you can find the cause and not just the symptom, they will keep reoccurring regardless of how much time you take off.

It rather looks like you never made it to a D1 training/sports medicine facility and wasted a bunch of time on people who don't know what they're doing (except extracting currency from your wallet).

You tried everything EXCEPT the one thing that actually works for AT---eccentric strength training. Here's one link, but there are some old threads on the subject if you do some targeted searches:

http://www.carletonsportsmed.com/chronic_achilles_tendinitis.htm

I would strongly suggest graston, but make sure you find someone who really knows what they're doing and can perform some form of functional movement test (FMS).

...suggestions are good but it's funny how people can tell you some things so concretely without even meeting you.

Not sure if this will help for the calf problems, but I'm surprised none of your doctors prescribed an eccentric calf strengthening program. You might find some answers here:

http://runningwritings.blogspot.com/2011/08/injury-series-eccentric-exercise-and.html

I'm in a similar boat and now on my fourth ortho in three years. My symptoms are also similar. I don't have an entire diagnosis, but it looks like I have chronic extensional compartment syndrome along with some chronic nerve damage. Look up the CECS and see if that's in line with the feeling you're having.

coach d wrote:

It rather looks like you never made it to a D1 training/sports medicine facility and wasted a bunch of time on people who don't know what they're doing (except extracting currency from your wallet).

You tried everything EXCEPT the one thing that actually works for AT---eccentric strength training. Here's one link, but there are some old threads on the subject if you do some targeted searches:

http://www.carletonsportsmed.com/chronic_achilles_tendinitis.htm

This is spot on. I've had ankle/achilles problems for years, tried to doing all the different stuff you did, and in the end it was as simple as getting the muscles around my ankles and calves stronger. If your achilles was moving correctly (biomechanically), you wouldn't have these problems - you need to get to the root of it by getting everything moving properly again. It doch scar tissue you break up or inflammation you take down with pills, it will always come back until you fix the ultimate cause.

Try Graston. In fact, Graston should have probably been your first treatment. It got me through an achilles injury without losing too much fitness. Took about 6 weeks.

Calf raises are also something you should have done from day one. I like doing them on a leg press, starting with body weight and moving up from there.

Stay away from orthos unless you can find a real sports med guy who specializes in foot and ankle. Most orthos are surgeons who just look for something to cut. If you don't need surgery, they really aren't interested in helping you. Dr. Tom Clanton is one of the few in the US who really understands achilles injuries. He is practicing in Vail, CO. Otherwise, a really good chiro who handles pro athletes will be more help than an MD.

Lastly, take a look at what is on your feet. Experiment with the height of the heel on your shoe. Some people do better with a very low heel and others benefit from a heel lift.

What you describe sounds remarkably similar to chronic compartment syndrome. Find a doctor who's dealt with this before or go see Phil Wharton.

I had chronic compartment syndrome, it's a brutal condition but one year after surgery I've been back to running and have set several personal bests. So glad I didn't back down from surgery.

suggestions

google and talk directly to physicians showing promise.

call david moorcroft, in person. he had this problem. or tell his representative exactly what you want and leave your email address. people want to help.

have an operation, like john walker of new zealand, to expand the sheeth around the muscle.

yoga, ham strings and quads. calves too. research this, use trial and error.

put a cold bottle between the hamstring and calf directly behind the knee and kneeel down in this position.

http://www.exrx.net/StretchImages/WristFlexors/Kneeling.jpg

apply pressure as you can stand it. then roll the bottle down an inch and repeat. do this 20 minutes am, and 20 minutes pm. 3 days on one day off.

if you cant understand what i mean let me know.

I had the same issue but also had aching knees as well- 5 years off an on. I am a 1:48; 3:43, 14:20 30:30 pr's. I would have soleus, calf, achilles soreness constantly. I went to everyone, anyone I could think of - no-one helped. Here is what I suggest and how I finally got over it. I work out about 60-70mi per week plus bike 5-7 hrs a week.

1. You need to let your achilles, legs heal. You can still walk/jog but no fast running or else you will. When you go out an jog - focus on relaxing your legs ... just let them move on their own (see #3). If your legs are sore, don't run and do something else.

2. Drink plenty of water, ice/heat the area 5 min alternating, eccentric stretching to build strength and flexibility. Eat well - veggies, protein. Check out eat right for your blood type.

3. When you are running - really focus on relaxing; don't drive with your legs; forcefully push off of the ground. Really let your lower legs really relax when you are running; don't push. Read Chi running for some pointers about relaxation in running. I am not sure about the whole "leaning to faster" thing in Chi Running but he has some good info on relaxation.

4. Make cross training a part of your routine on your easy days, even on your occasional hard day.

5. Once you are recovered - go fast (but relaxed) on your hard days. On your easy days - go easy and relaxed... when you race - run fast but relaxed... relaxation is the key.

Good luck.

The body has an amazing capacity to heal. You will be able to run again.

I would recommend the book Pain Free by Peter Escogue to start because it does not look like you have seen an OMM. Because this problem has gone on so long you need to retrain the proper mechanical functions of your foot/leg.

This book is easy to read. At first, I thought it was too crazy, too simple...might be worth a try.

bob d. wrote:

I would strongly suggest graston, but make sure you find someone who really knows what they're doing and can perform some form of functional movement test (FMS).

...suggestions are good but it's funny how people can tell you some things so concretely without even meeting you.

This. And the eccentric exercises. Both helped my hamstring tons. In 1 month I had more improvement than 2 months completely off, and 5 months easy with 3 months of PT.

I ruptured my left achilles playing racquetball some years back. Had surgery which grafted a part of my plantaris onto the site. Anyway, a few things I learned in therapy were the achilles stretches (prior and after exercising). The most effective way I've found is to stand on one leg, off the edge of a bench or curb and let that foot support my entire body weight. Bend knee slightly then ease heel down. Repeat for the foot. Have two slushy ice bags under your ankles for around ten minutes when you get home. Really helps to cut down on inflammation and promote fast healing of the miniscule tears that develop as you work out.

Finally, avoid uphill running until things get better, that really aggravates your achilles.

"Repeat for the other foot"

...and to clarify the stretch, you should be standing on your toes or ball of foot with the rest of your feet hanging off the edge.

"coach d wrote:

You tried everything EXCEPT the one thing that actually works for AT---eccentric strength training. Here's one link, but there are some old threads on the subject if you do some targeted searches:

http://www.carletonsportsmed.com/chronic_achilles_tendinitis.htm

"

+1

Same thing for me. As long as I do eccentric strength training consistently, I have no issues. If I ramp up my mileage or intensity without maintaining the eccentric calf strengthening exercises, I get a quick reminder in the form of sore achilles.

This sounds like something I used to have. Had Achilles tendonitis out of High School which hindered my first year of college. I would take 4-6 weeks off then run for a few weeks before feeling the same injury. Pretty soon I would take off 6 weeks to return for only a couple days before feeling that injury. I finally saw PT for 9 months. The PT suggested the injury gave me so much anxiety it was psychosomatic (aka in my head), he told me I appeared to be fine. Nothing was ruptured and there was no reason a young healthy male should be going through this.

So he told me to run on it, every other day, then every day. So I did what he told me to, I felt the same Achilles pain, maybe even worse. But I kept running through it... as the days went by the pain lessened and lessened. My pain ended up really being psychosomatic, even though it felt so real. a year later I was in my 4th year of school and finally joined the D1 program.

If you were to try to run through that I would suggest you do so while performing those exercises your PT has given you, especially the eccentric heel raise exercise, daily. gl