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Old 01-15-2006, 07:03 PM   #1
Russ Greene
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I have a pain in my achilles that from reading a lot about achilles injuries online I have decided is probably achilles tendonitis. It is definitely not a ruptured achilles. I got it from running 9 miles as fast as I could. Thanks to crossfit my aerobic capacity was more than sufficient and I maintained a 7:30 minute/mile pace the whole time. However, my calves and ankles were not ready for that kind of impact. It's been 9 days, and now I can't walk up or downhill, or for more than half a mile on flat ground, without pain in my achilles. The pain is really nothing significant, but I'm very concerned about how long it will take me to recover to full functioning. From what I've read, since very little blood flows into the area, healing takes a very long time, though obviously it varies significantly person to person. Has anyone had this injury before, or know anyone with it? My plan is to do no running and jumping until the problem's gone, and squatting as long as it doesn't hurt the area. I guess this means it's a good time to focus on ring and handstand work.
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Old 01-15-2006, 11:07 PM   #2
Mark Brinton
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Russ,
I'm no expert but I did have a mild to moderate case that took me about a year to fully recover from (jump shots with my son and nephew). Immediately after the injury, get plenty of rest, ice, etc. After that, I don't necessarily think you should quit running or other activities. Rather, I think you need to be moderate and careful. I would run on flat surfaces and after each run I would do post-run stretching, icing, and some ipubrofen. What really helped me, though, was eccentric calf lowers. Use both heels to raise and then balance and lower on one foot. Perform for each foot because you don't want to create a strength imbalance.
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Old 01-16-2006, 02:10 AM   #3
Christian Lemburg
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Russ,

massage your soleus and gastrocemius (read: your calves) *deeply* with the knee of the other side leg when sitting, several times a day. It will probably hurt like hell, but it really gives relief to those cramped muscles pulling on your achilles tendon. You need to massage very strongly to resolve trigger points here. If you are successful, you will feel super-sore, like mega-DOMS, in the muscles, as compared to a cramped feeling before.

Look here for likely points to massage: http://www.triggerpoints.net/userfil...trocnemius.jpg and http://www.triggerpoints.net/userfiles/Soleus.jpg.

Good luck, and fast recovery,

Christian
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Old 01-16-2006, 06:01 AM   #4
James Falkner
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Russ,

I did the same thing as you, and now that I think about it, I think it was the 9 miler that did it, in addition to upping my weekly mileage too much. I am 31 yrs. old and 200 lbs and run about 20-25 mi/week. My post in this thread has a description of what I am currently doing to recover from my achilles pain (I think it's tendinosis but honestly I am not sure). I am almost back to pre-9-miler intensity and distance so I am quite happy I didn't just sit around waiting for it to heal, because it definitely was NOT going away by itself.

Yours sounds more acute than mine was, so I would definitely recommend first taking a couple of weeks off of running (depending on how your pain level is "graded") and definitely read achillestendon.com if you haven't already.

-- (edit) Just noticed Mark's thread re: eccentric calf lowers. I wholeheartedly agree. Start with bodyweight. later, hold BBs/DBs/weighted vests or use one of those calf loading machines at the gym to progressively load the calf (I currently hold a 50lb DB in my opposite hands when doing them)

(Message edited by schtool on January 16, 2006)
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Old 01-16-2006, 09:23 AM   #5
Christopher Sommer
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About 7 years ago, my own son had achilles tendonitis that we treated relatively unsuccessfully for over a year with the traditional regime of ice, rest then reduced training and rehab exercises. Despite consistent treatment there was no long term improvement whatsoever, a very frustrating situation.

While perusing an Ultra Marathoning site (people who race 50-100 miles); I came across their treatment for achilles tendonitis; HEAT. I implemented their treatment program and a problem that had dragged on for over a year was resolved in about a week.

The treatment is simplicity itself. Take a hot/cold pack that is capable of being boiled. Heat a pan of water to boiling and then carefully drop the hot/cold pack in. Heat the pack to as high as you can reasonably tolerate; this will take anywhere from 30 seconds to a couple of minutes depending on your individual hot/cold pack. You will need to experiment; if the temperature is too low it will be ineffective, if too high you will be burned. Start low and gradually, in 30 second blocks, build the amount of time the pack is boiled. Once the pack is at the correct temperature, place it directly on the achilles tendon and let it remain there until the pack has cooled completely. Repeat 2-4 times a day.

Also make sure to increase your Vitamin C supplementation to at least 1-2g (1000-2000mg) per day to support the healing process. Fish oil is also quite helpful for accelerated healing and pain/inflammation reduction; I personally use 3600-4800mg twice a day.

Sometimes it can take quite awhile for information that was earned/learned in the trenches to make its way into the textbooks. Even today when PTs hear of my recommendation they continue to disagree despite the enormous success I have had using this technique while their preferred method has brought little or no relief to my gymnasts whatsoever.


Yours in Fitness,
Coach Sommer

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Old 01-16-2006, 06:14 PM   #6
Cole Hanley
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Here is a link to a page of advice from/by ultra runners: http://www.ultrunr.com/achilles.html. It includes the recommendation of applying heat and includes a description of the study that concluded that the eccentric calf lowers is an effective treatment. There are also a couple other recommendations that were helpful to me once after too many hill repeats which were lycene+glycene and no stretching of the achilles. "The first thing I'd do is stop stretching that area. The weakest link in the chain is trying to heal, but the fibers can't re-connect and knit together if you keep pulling at them." That was the advice I read at the time and it made sense to me and I think it worked. I'm not sure how to reconcile that with the eccentric calf lowers since that idea is supported by a study done in Finland that was successful for all the people that tried it. If I had that problem now I'd be tempted to try this.

Disclaimer: I work at a trucking company, though I have run a few 100 mile races.
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Old 01-16-2006, 06:43 PM   #7
Russ Greene
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Thanks a lot guys. This advice is very helpful.
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Old 01-16-2006, 06:55 PM   #8
James Falkner
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Russ,

One other thing on the eccentric calf lowers -- I came across a site that advocated them, but slightly different. Basically, they said that to really help runners out, it is important to use the same biomechanics of the foot strike to properly strengthen the right muscules (paraphrasing). Basically, "they" (and I can't remember who "they" was at the moment) say that doing calf lowers is good, but doing one-legged squats is even better, and the ultimate is doing one-legged squats and moving your raised leg to the left and to the right against a wall. Basically, stand 1-2 feet away from a wall. Start doing a one-legged squat ("pistol" to many) using the "bad" leg, but instead of sticking the "good" leg straight out, stick out across the body, and touch the wall (for support) while lowering into the squat. Repeat 15 times. then do it again pushing the "good" leg the other way.

Apparently this type of motion is more like what the achilles tendon feels during the foot strike, given that most people rotate from outside to inside, with the ankle, during running. Seems reasonable to me. I have not been doing this type but I thought I'd mention it. I might shift to it soon tho, and the HEAT therapy Coach Sommer recommends sounds like a winner too - will let you know how it goes. I'm also interested in how yours turns out.
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Old 01-19-2006, 06:21 AM   #9
Richard Paul Ham-Williams
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Injuries are pain:-)

HEAT therapy for an area that is past acute and in an area with poor blood supply (such as tendons)is the best idea - logically it makes more sense than cold - cold is used to slow down blood flow and swelling and enzymatic response in acute cases (it may have other uses too but from what i remember that is its primary use).

To try and reduce blood flow to and already deprived area to help it heal is silly! Go with coach sommers idea.

I would advise a lay off of running until it has healed (thats up to you and i say it because i think running that sort of distnace can be harsh on your knees!) and any exercises with legs should be performed slowly until you are better.

I would also go with cross stripping your achilless tendon insertion point into heal bone - use your thumb to rub across the direction of the tendon, use quite a fair amount of pressure for this

A question that may sound off key for you -

have you recently changed your shoes that you run in? or even walk around work in?
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Old 01-25-2006, 12:28 PM   #10
Matthias Neumann
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Is HEAT therapy useful for tendonitis that is *way* past acute, such as almost 20 years, but has never really gone? Wish this had been in use when my achilles tendon became inflamed the first time.
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