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Achilles Tendonitis

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#1 Toolish

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Posted 10 January 2017 - 07:29 AM

Mr google tells me I have Achilles tendonitis.  There is a lump at the base of my Achilles, very stiff and sore in the morning.  Ice helps. etc, etc.

 

It hurts to walk or run, riding is ok pain wise, but I am not sure if I should stop that too.

 

Does anyone have any experience with it?



#2 Notsofast

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Posted 10 January 2017 - 07:51 AM

If it is AT, rest, rest and more rest unfortunately. It is a PIA.

 

Good luck

 

Cheers

 

NSF



#3 ozzybuds

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Posted 10 January 2017 - 07:59 AM

Injured achilles' are a bitch and notoriously slow healing. Would still be worth getting a diagnosis and treatment plan from a good physio though.

If you need one recommended..... an old friend of mine, multiple IM finisher, physio and ex-Mildura resident (until she married a rockstar and moved to QLD) would likely know who is best to see in your area. I can ask her if you like.
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#4 Katz

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Posted 10 January 2017 - 08:20 AM

We can't attach documents in this forum, can we?



#5 nuth75

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Posted 10 January 2017 - 10:48 AM

Hi I've struggled with Achilles tendonitis for years and it is a right bind. The way i got over it was to go and have dry needling in my calves and start doing exercises to strengthen calf muscles. I went to Physio One in Taringa who I go recommended by a mate. They were v good. 

 

it did take a while to fix. Lots of slow build up with endless heel drop and calf raises with added weight.

 

i'd say if you have a lump go and see a doc as this could mean you have torn or ruptured Achilles?

 

Ice and compression helps too and very very slow build up of impact stuff. swimming I found was ok but stiff in mornings.

 

Hopefully some of my ramblings is of some use.

 

Cheers,

 

Kenny



#6 TenPints

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Posted 10 January 2017 - 11:03 AM

I've had it, and it lasted for about 8 months. I saw a sports doctor, and there were a few steps we went through to sort it. Firstly, there were scans to confirm the lack of blood flow to the tendon. Good tendon: thin and white, bad tendon: thick and black. Secondly, ten minutes of massaging the area every day to help stimulate the blood flow. Thirdly, I went for an ultrasound treatment.

 

This treatment involved the firing of a precisely aimed "sound" into the Achilles. The doctor used a scan to ensure the aim was accurate - he explained that if he hit the bone, it would break. It really, really hurts! It felt like there was someone inside smashing my ankle with a hammer, I was sweating in pain and gripping the bed as if my life depended on it. Good news is, is that it doesn't last very long, and it really worked for me.

 

One thing I was advised, was to stay away from dry-needling into the Achilles itself. Around the area, OK, but not directly into it as this could result in a tear.

 

I believe the cause of my injury was switching to Newtons and more fore-foot running prior to the calf muscles being sufficiently strengthened and thus the Achilles was carrying the load (back then I was over 100Kg, so it was quite a load).



#7 The Turtle

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Posted 10 January 2017 - 11:10 AM

Mr google tells me I have Achilles tendonitis.  There is a lump at the base of my Achilles, very stiff and sore in the morning.  Ice helps. etc, etc.
 
It hurts to walk or run, riding is ok pain wise, but I am not sure if I should stop that too.
 
Does anyone have any experience with it?


If u want a good physio recommendation, I'll PM you. You likely know who im talking about tho

#8 Rog

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Posted 10 January 2017 - 11:51 AM

Sounds like insertional tendonitis, which is very different to your typical Achilles injury. The bursa underneath the tendon might be inflamed which is possibly the cause of the lump.

Careful with internet advice not all Achilles injuries are equal and if yours is the same as the one I had your typical Achilles treatment is unlikely to be optimal.

Also anyone that tells you to rest is way off the mark. Tendons need load to regenerate / improve so you ought to stay active (but be reasonable) and complete rest is likely to actually slow down your recovery.

I've spent a good part of 12 months trying to find a cure for my Achilles injury. Many years later and it still bothers me sometimes but I got better at recognising the signs and taking the precautions to keep it under control.

#9 Toolish

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Posted 10 January 2017 - 12:00 PM

Booked in to see the physio first thing tomorrow.  Thanks all for the advice.

 

I had planned to focus more on my golf game this year, seems now I might not have a choice  :smile1:



#10 Notsofast

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Posted 10 January 2017 - 12:03 PM


Also anyone that tells you to rest is way off the mark. Tendons need load to regenerate / improve so you ought to stay active (but be reasonable) and complete rest is likely to actually slow down your recovery.

 

 

Good point Rog, and I should have expanded. By rest I meant don't go running everyday. As others have suggested, calf raises and massage improved my experience with it (active recovery).

 

Cheers

 

NSF



#11 Aidan

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Posted 10 January 2017 - 12:06 PM

I'm a sports physio with an interest in tendons.

 

An individualised approach including some of the following normally gets these better.

 

 - heel insert

 - avoidance of stretching

 - specific strength program (calf but often also further up the leg)

 - close monitoring of run volume/speed/terrain (e.g. hills)

 - addressing of other 'lifestyle' factors e.g. poor insulin sensitivity/blood sugar control / increased weight

 

there are other options that can be used in specific situations but are more invasive

 

- shockwave therapy (as mentioned above, good as an adjunct but not a sole treatment)

- high volume injections of saline +/- small amount of steroid into the tendon sheath (not the tendon itself)

- AVOID steroid and blood injections into the tendon. These are unhelpful at best and harmful at worst (and expensive)

 

If they are chronic, or there is severe limitation of function (e.g can't run at all), they can take several months (2-6) to get very good again.  There's no recipe (unfortunately!) and often no 'quick fix' solution. Bike/swim are completely safe and unlimited in the meantime.  Good luck!



#12 AA7

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Posted 10 January 2017 - 12:24 PM

Could be this maybe

 

https://www.footheal...d’s-deformity



#13 Aidan

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Posted 10 January 2017 - 12:38 PM

A Haglunds 'deformity' makes you much more likely to develop lower/insertional achilles pain, but the bone itself doesn't cause any pain.



#14 zed

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Posted 10 January 2017 - 01:06 PM

Sounds like insertional tendonitis, which is very different to your typical Achilles injury. The bursa underneath the tendon might be inflamed which is possibly the cause of the lump.

Careful with internet advice not all Achilles injuries are equal and if yours is the same as the one I had your typical Achilles treatment is unlikely to be optimal.

Also anyone that tells you to rest is way off the mark. Tendons need load to regenerate / improve so you ought to stay active (but be reasonable) and complete rest is likely to actually slow down your recovery.

I've spent a good part of 12 months trying to find a cure for my Achilles injury. Many years later and it still bothers me sometimes but I got better at recognising the signs and taking the precautions to keep it under control.

 

Yup this. I had AT for a 2 months and couldn't run more than 200m without it flaring up, phyios were treating the calf, but it didn't help. Rest did nothing. Eventually I went to a highly recommended sports physio and he immediately identified tight hip flexors as the problem. 3 days later, after some treatment and stretching I ran a few kms pain free and 10 days later was running 10km+. It's OK to ask others and Dr google to get an idea, but with tricky injuries like this  you really need to go to an experienced, reputable professional not just your local physio. You may have to pay double and wait a few weeks to get in to see them, but it will be worth it.


Edited by zed, 10 January 2017 - 01:07 PM.

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#15 Nath.

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Posted 10 January 2017 - 05:52 PM

I feel your pain.....most of 2016 was a write off for me due to Achilles issue!

#16 zed

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Posted 10 January 2017 - 09:12 PM

We can't attach documents in this forum, can we?


How have u been Katz? Doing any tris this season?

#17 longshot

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Posted 10 January 2017 - 09:35 PM

Been past threads about AT.

 

My experience was 2 years rest fixed it. That was the best medical advice at the time - "the only high probability cure known to sports science is for you to rest it for 2 years, i.e. no running, and go cross training".  About 15 years ago. Worked for me, and for a friend of mine who had similariy driven his AT into problem territory.  Had occasional issues since, but backed off when I've felt it.  Go swimming and/or cycling instead.

 

Plenty of others with contrary medical advice, including medicos themselves of course. I also did the medical rounds, like others. Spoken to plenty of former runners, for whom AT was the end of it.

 

Maybe medtech has moved on and now it's different. But my overall assessement is that it's something of a lottery. Pick your own numbers and take your chances :)



#18 Toolish

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Posted 11 January 2017 - 08:44 AM

Went to a physio.  Confirmed tendonitis but said it was not too bad.  Rest, stretching, tape and ice were recommended.

 

Said the strength was there but I have shockingly tight calves which is probably the root cause.



#19 Parkside

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Posted 11 January 2017 - 08:05 PM

This area is evolving year on year. What was best practice when Rog's was at its worst is virtually malpractice now. Eccentric heel drops are out. As Rog mentioned rest is the enemy and a combination of isometric loading, heavy slow resistance training and activity modification with gradual return to aggravating activity gets good results.

#20 ScubaSteve

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Posted 12 January 2017 - 03:49 PM

Mrs Scubasteve developed chronic achilles after a half marathon in her 40's.  Looked like a lifetime of tri's, track cycling & lots of running had caught up.  Was in constant pain and could barely walk, let alone run.

Cortisone injection worked for a while ( excruciating by all accounts) but then it came back.

Saw multiple physios/chriro's/experts and a couple said it's weakness in the glutes, hips, calves etc.  We didn't necessarily agree but we didn't know how to fix it.  Go figure.

Eventually I dragged her to Crossfit as I wanted some cross training.

3 months of lifting weights, lunges, box step ups and general conditioning she was pain free but couldn't run.

6 months later she could run 2-3km before a flare up.

12 months can run 5km pain free but chooses never to run more than that.

 

So for her ( you could well be different) it really was weak muscles in spite of a very athletic background. 3 Crossfit sessions per week over 6-12 months fixed it.



#21 Nath.

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Posted 12 January 2017 - 05:09 PM

Mrs Scubasteve developed chronic achilles after a half marathon in her 40's.  Looked like a lifetime of tri's, track cycling & lots of running had caught up.  Was in constant pain and could barely walk, let alone run.

Cortisone injection worked for a while ( excruciating by all accounts) but then it came back.

Saw multiple physios/chriro's/experts and a couple said it's weakness in the glutes, hips, calves etc.  We didn't necessarily agree but we didn't know how to fix it.  Go figure.

Eventually I dragged her to Crossfit as I wanted some cross training.

3 months of lifting weights, lunges, box step ups and general conditioning she was pain free but couldn't run.

6 months later she could run 2-3km before a flare up.

12 months can run 5km pain free but chooses never to run more than that.

 

So for her ( you could well be different) it really was weak muscles in spite of a very athletic background. 3 Crossfit sessions per week over 6-12 months fixed it.

Whenever my achilles has flared up it has been preceded by a calf issue, even very minor which I haven't noticed until the achilles goes and I recall anything leading up to it.

 

The achilles will take an imbalance or weakness from elsewhere and absorb it for a period and then it will flare up due to the extra load.



#22 Ruley

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Posted 13 January 2017 - 10:39 AM

 
If they are chronic, or there is severe limitation of function (e.g can't run at all), they can take several months (2-6) to get very good again.  There's no recipe (unfortunately!) and often no 'quick fix' solution. Bike/swim are completely safe and unlimited in the meantime.  Good luck!

Take note of the time frames here. Largest problem I see with people with it is unrealistic expectation of time frames.
Unless it's pretty minor 2months is rare. Even those quite proactive as doing the right things I'd say 4-9months.

Many people who develop these problems are also a pain in the ass at slipping back into old behaviours and warped/desensitised about what short or easy is.. 'Felt good yesterday so went out for a short 10k.'

#23 northstar

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Posted 14 January 2017 - 07:13 PM

Are there any 'guru's' in Brisbane for sorting this?

#24 Toolish

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Posted 19 January 2017 - 09:07 AM

I'm a sports physio with an interest in tendons.

 

An individualised approach including some of the following normally gets these better.

 

 - heel insert

 - avoidance of stretching

 - specific strength program (calf but often also further up the leg)

 - close monitoring of run volume/speed/terrain (e.g. hills)

 - addressing of other 'lifestyle' factors e.g. poor insulin sensitivity/blood sugar control / increased weight

 

 

I have a heel insert from the phyio however she recommended stretching due to the tightness in my calves.  

 

The pain has mostly gone away now, so looking to start a strengthening program, not sure really what that would involve.  Physio recommended calf raises and that was about it.  I am wondering about straight leg or standard dead lifts, lunges, squats?

 

No running for a while yet!



#25 The Turtle

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Posted 19 January 2017 - 09:16 AM

If u want another opinion and good exercises, go see Steve Wilman. He's brilliant at that




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