Treating achilles tendonitis on my own

May 21, 2008 1:03 PM

I seem to have classic achilles tendonitis and am trying to treat it myself. What treatments worked for you? At what point should I just give up and go to a doctor and get professional assessment and physiotherapy?

I've been doing a lot of hill walking without stretching adequately and am now paying the price. A couple of days ago, I found that both achilles tendons were very tight and sore when I got up in the morning, especially when I tried to walk down stairs. They hurt only slightly going upstairs and usually aren't sore at rest or when I do a little walking around the house. Starting yesterday, I've been doing the following.

Resting: no long walks, cycling, etc.
Icing: 3-4 times a day
(not Compressing yet. Should I?)
(not Elevating yet. There doesn't seem to be a need.)

I'm taking Tylenol to fight the inflammation and do gentle wall stretches when I get up in the morning. I've also started wearing good supportive shoes around the house instead of going barefoot.

Normally, I would already be at the sports medicine clinic instead of asking for advice here. But my new medical insurer is auditing my account after I submitted my first claim a month after signing up. They won't even pay for my prescriptions right now, and I have no idea how much longer it will take to resolve this. I'm trying to stay away from any medical consultation unless it's really needed.

Am I on the right track with self-therapy? Is there anything else I should consider?

posted by rosebuddy to health (15 comments total)

IANAD, but I had achilles tendonitis a few years ago and what you're doing sounds very much like I was recommended, and what seemed to work. Icing for 20 min a few times a day, supportive shoes, taking it easy with the walking/exercise. Using a resistance band for stretching was also helpful.
posted by supramarginal at 1:14 PM on May 21

If you can find a cheap immobilizing boot on craigslist or ebay that keeps your foot at a 90 degree angle I'd recommend you do so and sleep in it. It kind of sucks, but that was the part of my PT that had the most benefit aside from what you're already doing.
posted by true at 1:38 PM on May 21

I've seen a not-so-old study that concluded that ice was not helpful for achilles tendonitis.

The classic runners treatment is to do "negative calf raises" (calf lowers, really). Stand on a step with your toes, weight one foot and lower your heel several inches below the step, weight both feet and come back to a neutral position. Repeat with the other foot. This is a good treatment and a good preventive exercise.

Be very careful stretching. I've had stretching aggravate my achilles more often than not.
posted by OmieWise at 1:58 PM on May 21

Thanks, guys. One more question. How long did it take you to recover?
posted by rosebuddy at 2:08 PM on May 21

IANAD but have suffered many running injuries.

I'm taking Tylenol to fight the inflammation

Is there a reason you are taking acetaminophen and not an NSAID? Acetaminophen is not an anti-inflammatory. I don't know if you need an anti-inflammatory (OmieWise's study about ice sounds interesting) or whether the pain-relieving properties are what you are going for...

I did hear of a study that found that the effects of NSAIDS (aspirin, naproxen, ibuprofen) are similar to a straight analgesic (acetaminophen) for muscles. Now, whether this applies to tendons, I also don't know.
posted by Pax at 2:40 PM on May 21

I had a bad case in high school and asked a doctor about it. His response amounted to, "You can rest and it won't hurt as much, but it won't really speed up the healing process."

I'm not sure if that was true or not- being young and invincible, I didn't care. Regardless, I still ran with the injury (as much one could call it running) and it took me months to recover.
posted by jmd82 at 2:52 PM on May 21

Using the exercise I outlined, and staying off the hills, I find a slight case can go away in a week, even when I'm still running. But the truth is that some people suffer with chronic AT inflammation.
posted by OmieWise at 3:10 PM on May 21

I had this problem a few years ago - and successfully treated it myself with ice (despite the study - it DID help me), supportive shoes, and trying to stretch my tendons at night by sleeping with my feet against my bed's footboard. The stretching was very useful.

Also try to make sure that your weight is centered over your foot when climbing stairs. If it hurts, you are doing it wrong.
posted by The Light Fantastic at 3:30 PM on May 21

I managed to irritate one of my Achilles tendons to the point of shooting pains a few years ago and a single treatment of acupuncture did wonders.
posted by kbuxton at 3:58 PM on May 21

Acetaminophen is not an anti-inflammatory.

This needs to be emphasised. Not all analgesics fight inflammation.

I ruptured my left achilles when I was 27, playing softball. I had zero tendinitis before this happened, just so you know- and my orthopedist told me that ruptures are rarely preceded by what you're experiencing. I know that's not advice, it's just to make you less worried. And as I've gone, since then, to physio for both tendinitis and the much more painful inflammation of the tendon sheath, I'd say you're doing most things correctly now- just try a proper NSAID and not tylenol.
posted by ethnomethodologist at 5:03 PM on May 21

Thanks for all the good advice and recovery estimates, although I hope this won't take months to clear. Why didn't I remember that Tylenol isn't an anti-inflammatory? I'm icing and taking some Advil right now.
posted by rosebuddy at 7:39 PM on May 21

Seconding Omniwise's step exercise. This was the major part of the physio I did when I had Achilles tendinitis last fall.

It took me about two months to recover after putting off the physio for about 3 months.
posted by aclevername at 8:21 PM on May 21

I had it to such an extent that the nodes on my tendons and consequent pain and stiffness literally rendered me almost unable to walk for a good half hour after sitting at my desk for any length of time. It lasted for a decade or so, through all manner of treatments and doctory interventions.

I went to an acupuncturist here in Korea, finally, after suffering for years. Two months of 3-times-a-week treatment, and it was gone. That was 7 years ago, and it hasn't recurred. For what it's worth.
posted by stavrosthewonderchicken at 12:52 AM on May 22

I dealt with chronic achilles tendonitis for 3 years while I played lacrosse.

The treatment regiment I followed worked incredibly well: I ice bathed my feet/ankles after any ambulatory activity that was greater than or equal to the intensity of a jog.

Ice bathing your feet is incredibly difficult! If you can make it past the first 2 minutes, you are golden. My ice baths were 10 minutes long, and the bucket was about 80% ice - so much ice that it is hard to push your feet to the bottom of the trash can. Very cold - much more effective than packing or wrapping your feet in ice.

The cause of my tendonitis was short heel chords, and they would enflame and hurt very bad if I did not control the inflamation. Using this method I was able to get off the 12 ibuprofin I was taking per day.

Also, when I would go to lacrosse practice I put foam heel lifts (called quags, I think) into my cleats to lessen the impact on my AT. They lifted my heels about 1/4 inch -not recommended for casual use.

Hope this helps. Good luck - that is a difficult problem to cope with, but the good news is that it can be managed.
posted by yoyoceramic at 9:03 AM on May 22

Two weeks of stretching/ice/Advil and everything seems fine. The left leg was pretty good after a week, but the right took a few more days. I've been completely pain-free for a couple of days.

Thanks for all the help!
posted by rosebuddy at 3:25 PM on June 5