Sore achilles -- cure?

Slaying Patroclus usually gets Achilles back into the line.
But he's awfully ornery when that happens.

-Luigi couldn't resist.

Matt: FYI from a recent Rec.Running thread:

Quoted message said:

Basic questions: (*) What was the injury ?

Achilles tendonitis.

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(*) When did you first notice the symptoms ?

First logged in about Nov 02.

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(*) When did you realise you actually had an injury ?

Didn't really think of it as an "injury" until some time
in January.

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Questions that are important IMO: (*) When did you begin
treatment ?

Didn't substantially reduce milage until March, but I was
icing it using a gel pack before then, in Feb or so, I
think. I don't think I took any layoff until March.

Taking a one week layoff much earlier would have probably
saved me a lot of trouble. As it was, I spent a good 6
months with fairly erratic training, because I wasn't able
to train properly. It took a solid 6 week layoff to really
make inroads into the injury.

Achilles tendonitis does not hurt in proportion to the
damage, so even though the pain is very soft and dull, the
healing time for the injury can be quite long and the damage
can be reasonably severe.

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(*) What sort of treatment did you use ?

Ice, reduced training load, and rest in that order. The two
things that aggravated the injury most were long runs and
speed work. A long run at a brisk pace would cause the most
severe flare-ups of the injury.

I also used a heel-lift when I returned to training.

I cannot say with a great deal of confidence that any of the
treatments I used with the exception of hard downtime had
much effect. However, it is possible that a modest amount of
milage with no speed work would not have been much different
from rest.

Given the success I had in treating another soft-tissue
injury (with a short but immediate rest), I think I would
have done much better if I'd got on top of it earlier.

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(*) How did you approach rehab ?

Periodically attempted to return to running, and took
downtime if it hadn't recovered. Started by doing a weekly
run until it felt OK. Then jumped right back into hard
training, then came to my senses and set appropriate
milage goals.

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(*) How long was it before symptoms completely
disappeared ?

The injury originally came in late 2002, and the sensation
of the achilles tendon being sore when I got out of bed -- I
still have it from time to time. But it doesn't interfere
with my training any more. In total, it took about 9 months,
though it could have been much faster had I been more
willing to accept downtime.

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(*) Given 20/20 hindsight, would you approach treatment
and rehab differently ? If so, how ?

Rest for a week. Immediately.

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Moderately interesting questions (but less important
because causes of injury have already been discussed to
death here): (*) Was it preceeded by any warning signs ?

Not really.

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(*) Was it preceeded by ill-advised training ? Or any
training that was " ill-advised" given 20/20 hindsight ?

Running 5k at top speed for a week and doing intervals
regularly .... probably ill-advised for a beginner.

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(*) Was footwear a contributing factor ?

My shoes were not a very good choice for me (NB 806), but
they're what the local FootLocker had, and I doubt they had
much to do with my AT problems.

Matt-- I just posted that rec.running item regarding AT, and I want to stress 3
things from my own experience as a cyclist and a runner:

(1) It's normally due to either overuse or a change-of-use
(different equipment, riding/running differently,
different terrain; (2) The Icy gel-pack thing wrapped
around the area for a good hour after workout is
critical to reduce swelling and allow the tendon to move
more freely during the rest of the day without
aggravating it further, and putting heel lifts in your
walking/running shoes helps too; and (3) the
recommendation about taking a week off right away is
very smart. This is an injury which nags, and doesn't
heal quickly, unless some real rest is applied, despite
your strong resistance to sitting out. Best of luck.

Sorry to keep multiple-posting here, but after all,
what's the purpose of these groups if not to reach
someone who might have info for you, right? This website
has useful AT material.

sportsinjurybulletin.com0031a achillesOpen ↗
tendonitis.htm

"Matt O'Toole" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I've had a sore achilles tendon for the last week or so,
after a ride that

was

Quoted message said:

quite a bit longer/harder than planned. I went on a
moderate ride two

days ago,

Quoted message said:

and it was worse afterward. How can I speed up recovery,
without giving

up

Quoted message said:

riding completely? Should I just cut the mileage, avoid
climbing out of

the

Quoted message said:

saddle (hard to do around here), or what? How about
medication?

I had an achilles problem as I increased my ride length and
solved it by lowering my saddle and adjusting the position
of my cleats.

My saddle was at a height were I couldn't maintain a good
pedaling technique and I lowered it by 1/4 inch. I also
ajusted my cleats so that the pedal spindles are positioned
exactly under the balls of my feet. Before, the balls of my
feet were in back of the spindle maybe 1/8 to 1/4 inch.

After I made the adjustments, the problem cleared up in less
than a week. Also, see Sheldon Brown's website on the topic:

sheldonbrown.compain.htmlOpen ↗

This what a podiatrist suggested for me after about 6
months of pain.
1. Heel lift till it's better. This is to change position of
injured tendons.
2. Stretch before and after rides. Very important
after. Stretch with knee slightly bent, hold for at
least 2 minutes.
3. Non steroidial anti-inflamatory. I used Aleve for about 2
weeks. This is to treat the inflamation not so much for
the pain so you will need to space out the doseage for 24
hour coverage. Pain gone after about 2 weeks. Chris

"Matt O'Toole" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I've had a sore achilles tendon for the last week or so,
after a ride that

was

Quoted message said:

quite a bit longer/harder than planned. I went on a
moderate ride two

days ago,

Quoted message said:

and it was worse afterward. How can I speed up recovery,
without giving

up

Quoted message said:

riding completely? Should I just cut the mileage, avoid
climbing out of

the

Quoted message said:

saddle (hard to do around here), or what? How about
medication?

Matt O.

TopCounsel said:

Sorry to keep multiple-posting here, but after all, what's
the purpose of these groups if not to reach someone who
might have info for you, right? This website has useful AT
material.

sportsinjurybulletin.com0031aOpen ↗
achilles-tendonitis.htm

Many years ago (before clipless pedals) I developed a
sore achilles tendon on longer rides. I realized that
shortly before I had switched to a different type of
toeclip and when I measured it found it to be slightly
shorter. Switching back to a longer toeclip seemed to
cure the problem.

The equivalent with clipless would be to move the cleat back
a bit on the shoe so your foot is slightly farther forward.

"Matt O'Toole" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I've had a sore achilles tendon for the last week or so,
after a ride that

was

Quoted message said:

quite a bit longer/harder than planned. I went on a
moderate ride two days

ago,

Quoted message said:

and it was worse afterward. How can I speed up recovery,
without giving up riding completely? Should I just cut the
mileage, avoid climbing out of the saddle (hard to do
around here), or what? How about medication?

I don't know how long you should rest it, but you should
definitely move you cleats back as far as you can until
things clear up (you'll have to drop your saddle height,
too). I get sore tendons sometimes from those sorts of
overachievements, but they clear up pretty fast (week or
so). I'm a believer in vitamin I (Ibuprofen).

"TopCounsel" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

off right away is very smart. This is an injury which
nags, and doesn't

heal

Quoted message said:

quickly, unless some real rest is applied, despite your
strong resistance

to

Quoted message said:

sitting out. Best of luck.

Indeed. I had some minor achilles pain and proceeded to go
on a gruelling death night of activity (motorcycle drag
racing..it's a long story..). The gist is, I ended up with a
small tear in my achilles and it took months to heal. It was
extremely painful at the time (and when I say extremely..)
and it's never been quite right since. I have to carefully
warm-up that side and I am concious of numerous small
twinges while I'm exercising, or even walking for that
matter. My advice is do NOT overstrain that side until your
pain subsides. Normal exercise is fine I think, but no big
strains. Perhaps avoid standing up on the pedals for a
while. The other advice here is good..ice etc. My broken
bones have healed better than my achilles.

Cheers,

Scott..

Quoted message said:

I get sore tendons sometimes from those sorts of
overachievements, but they

clear up pretty fast (week or so). I'm a believer

Quoted message said:

in vitamin I (Ibuprofen).

I too have run through Achilles Tendon pain with
Ibuprofen, even 6 days a week. However, it continued to
nag and never really disappear until I caught a
respiratory infection and had to sit down for a week. Then
-- voila! -- problem solved.