Achilles - Any experts?

Achilles - Any experts?

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HewManHeMan

Original Poster:

2,348 posts

121 months

Tuesday 26th May 2015
quotequote all
I've been having continued issues with my Achilles for what feels like an age.

As a keen runner, it's taken a little while to admit that my running days are pretty much done for now. It's not the end of the world, after all.

So, who knows anything about the healing / recovery process? What happens - if anything (is it ruined forever?) - how long does it take (I'm thinking a year or more?) and is there anything I can do (or even avoid) to help the process?

Any advice, or even just a push in the right direction (in terms of research) would be appreciated.

Cheers,

sawman

4,915 posts

229 months

Tuesday 26th May 2015
quotequote all
have you had a scan to find out what degree of a problem you have?


ewenm

28,506 posts

244 months

Tuesday 26th May 2015
quotequote all
I injured my Achilles in the 2009 London Marathon and didn't really run again for a couple of years mainly due to coming back too soon and not doing enough rehab. Key rehab exercises for me were:
  • Heel raises on a step; and
  • Single leg squats on a bosu ball/wobble board.
Now back running well but still get soreness sometimes, usually after too much road running. Most of my running is now offroad and I'm enjoying it far more.

HewManHeMan

Original Poster:

2,348 posts

121 months

Tuesday 26th May 2015
quotequote all
No. My only point of reference is the degree of 'oww' I say when moving any faster than walking pace...

ewenm

28,506 posts

244 months

Tuesday 26th May 2015
quotequote all
HewManHeMan said:
No. My only point of reference is the degree of 'oww' I say when moving any faster than walking pace...
I got a scan that resulted in a diagnosis of "nothing wrong" rolleyes

HewManHeMan

Original Poster:

2,348 posts

121 months

Tuesday 26th May 2015
quotequote all
I have to say, every heath care person I've spoken to so far (informally) kind of shrugged their shoulders. Just seems to be a bit of a black hole - hence the question here. I'd like to hear from people with experience.

sawman

4,915 posts

229 months

Tuesday 26th May 2015
quotequote all
try googling prof nicola maffulli, he has written extensively on the subject

ewenm

28,506 posts

244 months

Wednesday 27th May 2015
quotequote all
HewManHeMan said:
I have to say, every heath care person I've spoken to so far (informally) kind of shrugged their shoulders. Just seems to be a bit of a black hole - hence the question here. I'd like to hear from people with experience.
Are you doing any rehab exercises like those I've mentioned above?

I'd book an appointment with a decent sports physio who should be able to give an idea of what's causing the issue and suggest some exercises to help.

WestyCarl

3,217 posts

124 months

Wednesday 27th May 2015
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I've had similar issues, the problem is the achilles gets very little blood so it doesn't heal quickly.
It took 6 months but I went from sharps pains during walking to mainly ok by;

Stretching the calf (if tight, this constantly keeps the Achilles under stress)
Lots heal raises (high qty, low weight. I did both feet at same time)
Cross training that doesn't stress Achilles as much (cycling, etc)

I noticed improvements in 3-4 weeks

HewManHeMan

Original Poster:

2,348 posts

121 months

Wednesday 27th May 2015
quotequote all
Cheers all.

I'll give all of the above a look / go. Exercise is brilliant, isn't it ; )

Loopyleesa

2,894 posts

166 months

Sunday 31st May 2015
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I had an operation on both my Achilles' tendons last week, because of tendonitis!
I am lucky having private health care, but I know the NHS, is very limited on this!

If you need to know anything else, just ask!

It's probably the most painful thing I've had done to be honest, but if it fixes the pain I was in, it will be worth it!

dave_s13

13,813 posts

268 months

Monday 1st June 2015
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We recommend eccentric loading as a first line treatment. Not just heel raises.

Also depending on if the damage is insertional vs midportion depends on how you do them.

For midportion
Find a step.
  1. Stand with heels dangling off said step.
  2. Shift weight to good/better side
  3. Assume maximal tip toe position.
  4. Shift weight to didgy side.
  5. Lower heels very slowly.
  6. Assume bottom position with heel below step and hold it there for 10-20secs
  7. Repeat 5x (or more depending on how keen).
For insertional it's the same but only lower heel to same level as step.

Also ad in gentle calf stretches.

The Important bit is lowering the heel really slowly, this is the eccentric loading bit and is what stimulates repair.
You can also add a heel raise into your shoe to offload the tendon a little bit and daily icing may also help. Shoes with a slight wedge have a similar effect, no zero drop trainers.

Also foot position can effect it. If you have a lot of calcaneal eversion and/or foot pronation you can influence this with orthotics to a helpful degree.

If it doesn't get better then the next thing would be ultrasound and possible injection, or even surgery.

AlfaPapa

277 posts

159 months

Monday 1st June 2015
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WestyCarl said:
I've had similar issues, the problem is the achilles gets very little blood so it doesn't heal quickly.
It took 6 months but I went from sharps pains during walking to mainly ok by;

Stretching the calf (if tight, this constantly keeps the Achilles under stress)
Lots heal raises (high qty, low weight. I did both feet at same time)
Cross training that doesn't stress Achilles as much (cycling, etc)

I noticed improvements in 3-4 weeks
Exactly this. I'm recovering from a serious knee injury (have had my knee rebuilt with a donor Achilles tendon, a hamstring tendon and a jar of screws from the surgeon's wood shed). The one thing my physio has constantly stressed is how long it takes for tendons and ligaments to heal because of the lack of blood flow. The only way to help them to heal is to exercise them (and make them hurt). I keep hearing the same thing week after week "If it isn't hurting, you're not doing it right".

There's also some interesting information in Dave Macleod's book "Make or Break", he recommends the heal raises as a way of stressing the tissue to help it reform stronger.