Post your Achilles Tendon injury and recovery experience story

I've had several such injuries. Lucky I found something like "Amazon ViveSole gel heel inserts" at my local running store (at triple the price). They felt strange when I first wore them, like I was getting more tendon packed in, so do experiment. I was able to jog the same day. After two weeks I was able to run without them.

Hey, sorry to hear your frustration.

Don't stretch it. If your PT and MD insist on it, they aren't up to date.

In the first few weeks of INSERTIONAL achilles issues, I would also recommend NOT doing eccentric heel lifts.

I would recommend working on a position slope (heels elevated above toes) and working on isometrics. Hold the top for 3-4 sets of 30 seconds with some form of resistance. Start with double, work towards singles.

I would also recommend working the soleus. Find some way to do seated calf raises with resistance (either with a machine or a weight on your knee).

I am currently in PT school, I have helped myself and others with insertional achilles injuries. If you need any advice, I'm here for ya.

Really good advice from this guy! I battled it for years and found active stretching and eccentric calf raises were never good during the acute injury phases. Oddly the thing that worked best was getting on a rowing machine. It’s a great workout but also a gentle Achilles stretch times hundreds of cycles in a 20 minute row.

Thanks for the info! So one question I have is how do I know when I’m passed the accrue phase? It’s been 9 weeks. Should I be pain free walking around or will I still have some level of pain and stiffness?

I would remove any time table/expectations like that for now. Take it day by day.

What resistance/weight equipment do you have available?

You're currently in a "chronic" phase, which isn't a bad thing. I'd do double leg isometrics for the 3-4 sets twice a day, everyday for 3-4 days. If that exasperates your symptoms, decrease the sets and the time and build up the sets and the time over the span of a week or two. If it DOESN'T irritate it, progress to single leg isometrics after the 3-4 days. 3-4 sets, 30 second holds.

I would try the rowing machine! Or cycle. Or go for a walk! Get some heel lifts like Road Gymnastics suggested and walk it out.

I struggled with insertional achilles tendinopathy for ~6 months, only took a month off (the fifth month). When I started running again I started with really slow jogging mixed with walking. I felt the heel lifts helped with taking stress off my achilles.

Your PTs are not current. I am in the (un)enviable position of having both types of achilles tendinitis at the same time: insertional on the right, and "normal" (non-insertional) on the left. I do NOT stretch the insertional side. And, my PTs have allowed heel drops, but I wouldn't call them eccentric on the right hand side (at least how I understand those): the right-side drop ends at the horizontal position, and my heel never goes below that, so I often don't do those on a step. For the left (non-insertional) side, I do go below the horizontal on my drops, so those I think of as the more typically eccentric.

And to answer your question about stiffness and pain, I have it pretty much every day, but it's SLOWLY getting better (my PT said that if I didn't mind the discomfort, I could run through the pain if it was 4 to 5 (out of 10) at worst, but it was going to slow ultimate recovery). When my pain gets very out of control, I just take the day off and work only on exercises that day (but moderately). This schedule has me at about 35 miles per week, with 2 days off (roughly one every three to four days).

Hang in there.

Also, my PT used to be a sole practitioner, but is now a local outlet of Fyzical; this article/video has their typical guidance on insertional issues:

fyzical.com

Achilles Tendinitis - When stretching will make you worse

When people get Achilles tendinitis one of the go-to exercises they do is the Achilles tendon stretch. But you have to be sure you're doing it for the right type of Achilles Tendinitis because there is one type you absolutely...

Link:www.fyzical.com/hazleton/blog/Achilles...

I’ve actually got a rowing machine. Have not used it at all since the injury as I thought it would aggravate the Achilles. I’ll give it a try. I’ve also got some free weights and a lot of therapy bands from rotator cuff tear PT in the past.

This article seems to be the best guide on IAT that I’ve been able to find. https://www.running-physio.com/insertional-achilles-tendinopathy/#:~:text=Activities%20that%20combine%20compressive%20and,it's%20likely%20to%20aggravate%20symptoms!

Just need to find a PT that is up to date on these methods as I know I’ll need to be working with one weekly to fully recover from this.

I’ll give the isometrics a try this week and see how it goes!

So I’d like your take on this. Discussed all this with my PT today. He said the IAT is not the primary problem right now. He says ankle mobility is my biggest issue. I only have 4 degrees of dorsiflexion in both feet and extremely limited side to side movement. He said the stretching of the calf and Achilles are necessary before isometrics or eccentrics. Pain level is currently low and he said to only lightly stretch just to the point of feeling some tension. Does this sound correct or is stretching still the wrong way to approach this given the limited Ankle mobility?

I'm feeling incredibly low with my achilles challenges at the moment.

Having had a great first half of the year, running 2:26 for the marathon, the classic limp every morning on both sides started and I found myself limping for a little while every time I got out of a seated position. 5 months on, there's been a lot of false starts with running and I have tried more or less every resource available: rest, shockwave therapy, gtn patches, in-soles, compression etc, lots of rehab (eccentric drops, soleus work, gastro work, etc), an injection to separate the plantaris from the achilles which is the challenge on the left hand side.

I can now walk day to day without limping which is a big achievement, but it's a huge climbdown from 6 days a week running a relatively modest 100km per week which feels huge compared to the fat zero these days. An attempted run earlier has left both sides tender and dreading the morning stiffness.

To anyone struggling - it will take a long time. Come to terms with the timeframe and if it feels good, rest it anyway. 4-5 times I've thought "I'm back" and started planning races in the future, only to relapse after a couple of runs.

The next step might be tendon scraping or it might just be accepting the situation and jacking it in/finding a new sport. Either way, try to accept the time and let them heal - you want to be able to run with your kids in 10 years time, the 6x 1k session isn't always worth the damage!

Hmm, ok. I had achilles tendonitis. It was my first truly 'bad' running injury I suppose.

How it happened:

I bought new spikes and stupidly bought some without a heel wedge. They were more like sprint spikes. They were gold and from Brooks. Anyway, they were sht. Not enough support. Remember doing 400m reps in them. Achilles started to hurt. At first it only hurt training in spikes and races, but then it started to hurt when running/training, and then any time when walking, then when I got up. It got pretty bad. Tried lots of things. It only went away when I left it alone. I couldn't walk properly for ages. Anyway, I rested it. I then used shoes with a higher heel, which was the opposite to what I was told, but it was the only way I could get it to settle down. I stopped doing the heel raises. I don't know why mine was different but it only responded to rest. For ages it still pulled going up hills and it still looks a weird shape. Once I managed to get it to stop hurting I went back to walking a bit and then light jogs. It wasn't career ending for me but a later injury was.

I think this is the key point. Even with PT, rest, exercise etc... it will take a long time to get back.

I have had tendinitis to both my Achilles and each time it has taken 6-12 months to get back to normal. My experience is that, for long distance runners, the injury often arises because of some other imbalance, so the time off should also be spent to understand and fix the root causes, other wise you'll get injured again.

I noticed that that there is a point, after a few weeks, depending on the severity of the injury, where it is possible to start running again, provided that all of the runs are slower than 10K pace. So, with some care, between running and cross training it is possible to maintain a decent level of fitness. Recently, I got injured in July, took a month off, and then trained for a marathon. Now, after ~5 months, the injury has healed; I have lost quite bit of speed, but I have built a pretty good base, so the overall fitness level is pretty good.

Hey aphil! Sorry that I did not see this message until now.

Feel free to Email me anytime at Mr.Andersonfeelro@gmail.com

My personal belief that the ankle mobility is a secondary concern/issue. Why do you only have 4 degrees of dorsiflexion? Is it painful to stretch passed that point? If so, there's a reason for it. Ask your pt if you have an "empty end feel" or "what kind of end feel do you have?"

There is no reason you cannot do isometrics right now. Physiologically stretching will do nothing for your achilles. Strength training will. There is absolutely no excuse not to.

That said, stretching isn't *bad* per say. It is my opinion (and I believe the research supports this) that stretching only makes you better at stretching. Tendons often get aggravated by overloading, not by "lack of stretching". Pain causes the tendon to not like stretching and gives us a *tight* feeling and so we falsely associate the two.

I am not a practicing PT at the time, if you want a real PT to do an online consult with, try this guy:

chrisjohnsonpt.com

Home - Chris Johnson PT

Nora Gray

Chris is a world-renowned physical therapist for runners & triathletes, endurance coach, & entrepreneurial advisor. He is based in Seattle, WA.

Link:chrisjohnsonpt.com/

But like I said earlier, feel free to email me! Anytime, any question. It's a throw away email I made 14 years ago, but I'll get notifications for it.

It sounds like you keep aggravating it. What kind of training program are you on?

Are you doing any sort of heavy calf raises and heavy seated calf raises? Does your rehab include any sort of hopping? If not, try adding these into your program. Body weight exercises isn't going to cut it for the Achilles. It absorbs 8-12x your body weight with each stride when you're striding/running fast. Your 130lb frame isn't enough resistance to stress it by itself, even eccentrically.

Next time you get healthy, try building up your program a little slower.

Thanks for the reply. I had been on a weighted programme with plenty of resistance - straight leg and bent leg, eccentrics on the leg press 3x per week - but I found that the soreness the next day was really rough. My calves could manage the weight no problem from a strength point of view, but my tendons were agony for 2-3 days and I'd limp consistently. That felt like a classic case of overloading so I've gone back to basics and just follow straight leg/bent leg, 3 or so sets to failure, with as much weight as I can safely put in my backpack (25kg, so not huge but ~40% of bodyweight). I started on bodyweight going to failure because I was sick of the reaction in the mornings. I can walk most days with no pain - good news - but any upping of force such as running and I'm back to square one.

Funnily enough I started hopping again yesterday - 3x 20 single leg, 3x 60 double leg - and I've woken up with a lot of soreness and stiffness this morning. The soreness feels very disproportionate to the level of activity.

So what I'm wondering is - do you just have to accept the soreness every day as part of the return process? If it felt like DOMS I could accept it, but this is just a limpy tendon pain. Or do I find a sweet spot in terms of weight where I can do 3x 15 reps straight leg/bent leg, and don't overload any more than that?

Cheers

My story:

1. April 2016: Experienced first symptoms of what I now realise was insertional achilles tendonitis caused by Haglund's deformity
2. Next four years: circled the toilet bowl of running with various half-comebacks and progressive worsening of the injury, endless stupid Alfredson exercises (dropped heel/non-dropped heel, weights, all of that crap - never did anything).

3. Eventually had surgery in January 2020: subcalcaneal osteotomy

4. Somewhat better now, still need to train very carefully as damage to the tendon is irrepreable, but it's no longer actively getting worse providing I'm careful. Ran 34m08s 10km last week which is within 20s of my PB (although this time I had supershoes to help).

No guarantees for outcomes but the rehab is 3mo to one year. Even a rupture can be rehabbed in 6mo! Its varies a lot. Ortho always gives you the worst case scenario. I think its fair to say that a lot of surgeries dont feel truly "normal" for a year. But you may be running fine in 6 mo.

Any experiences with PRP injection for insertional tendonopathy? I am considering it, but the evidence is not overly supportive. I do have a moderate bone spur/haglunds which makes me think it would be a waste of money.

After months and months of trying everything to fix my damaged achillies I changed shoe brand and style. Immediate relief was the result.

What were old/new brands? More drop? Thanks