Achilles tendinosis - how have you healed from it
May 8, 2024 9:28 PM   Subscribe

This is, I believe, my fourth round in a boot. I was ok until I forgot to get new runners, whomp whomp. Sick of it though. How has your AT healed?

It’s worse on the left, also have mild tendinosis on the right. Plus plantar fasciitis.

Previously: heel splints are actually what precipitated my PF graduating to Achilles problems. Eccentric loading and stretching made it worse. The only things that seem to work are the boot, orthotics and heel lifts (and fresh soles, not replacing them in time was a fatal error). I was fine for two years and now it’s come back. Super fed up. Anyone have success with shockwave? Surgery? Regarding healthcare access: I’m in Ontario, Canada. Were I to see an ortho I’d expect a 1-2 year wait.
posted by cotton dress sock to Health & Fitness (3 answers total) 3 users marked this as a favorite
I had Achilles tendinitis from like winter 2020 to summer 2023. It came and went in intensity. There were times when stretching did not help and times when it seemed to help a lot - my PT gave me a lot of tips on how to do a calf stretch and I can get more value out of it now that I used to. The things that seemed to help most were massage (both Graston massage with metal tools done by my PT and regular old massage from a massage therapist - I now also have a massage gun that I try to use regularly, though I'm not sure how much it helps) and, weirdly, a program of increasing calf raises (I thought my calves were already very tight and strong and it wouldn't help but I was getting desperate and it was on a worksheet my primary care doctor had printed out for me when I first saw her about it). Oh and on shoes, I go for shoes with a really wide toe box where I can spread out my toes, but YMMV on that.

Weirdly, the AT went away almost completely in summer 2023 when I spent six weeks away from home. I'm sure I was walking more than at home, but not wildly more and not on particularly different surfaces. I was probably spending less time at a desk. Since then I have occasional twinges which I take as reminders to slow down a bit and pay attention to my shoes, but nothing that's lasted for more than a day.

I don't know what your access to PT/physio is like but I'd recommend that if possible. A PT may notice imbalances and recommend places you can strengthen to avoid future injury. My hips are really weak compared to the rest of my legs and I have a tendency to injure myself as a result. I'm doing PT for a knee injury at the moment and it's mostly hip-strengthening exercises. The PT I saw for the Achilles stuff recommended a lot of the same exercises but I got lazy about them and I probably never got as strong as I need to be.
posted by mskyle at 5:06 AM on May 9 [2 favorites]

I've dealt with this on and off for several years, mostly in acute bouts during increases in running volume. My latest PT (keeping in mind his advice was specific to me, of course) was clear that stretching was not part of what would help and that strengthening and offloading the tendon was the only way to address it.

I use a 1/4" heel lift in all my shoes now, to reduce the "all the time" load, and most of my PT is progressive loading with calf raises, double leg hips, single leg hops, etc. Don't work through pain. Scale the difficulty to your tolerance, start short and build from there. 6 months in now and I'm pain free with a big increase in my running volume, so it seems to be helping. Good luck!
posted by Pantengliopoli at 6:35 AM on May 9 [4 favorites]

Eccentric loading and stretching made it worse.
Exercises for non insertional achilles tendonosis are not good for insertional achilles tendonosis.
They can make it worse.

I've had the insertional kind for most of my life. Since I was a teen anyways.
I've had cortisone injection back in the day.
That worked , but it's not a cure and has it's own risks like tearing the tendon.
It's not the first thing they will try , but as alternative to surgery

When i was young I was under a specialist care for several years
Surgery was considered but... decided against.
It's a major surgery, with a lengthy recovery.
Not days or weeks but months.
Plus potential drawbacks etc,

7 or 8 years later I saw another specialist. Different city. Very good reputation
I thought that perhaps there were advances in the surgery,
But going over it with him The same problems, same risks
I decided against it again.

The heel lifts were a part of my growing up, and replacing insoles or shoes quickly helps.
I avoid playing basketball as that always leads to trouble.
Other sports are ok. I avoid jogging or any distance running.
I can ride a bike if want or golf.

I accept that there are some things that may result in an acute flare and I avoid those activities.
If I feel that tell tale throb starting I 'll slow down . Take some ibuprofen and rest.

The acute phase when it's really inflamed is miserable , painful.
And can be crippling
Not something to go through, so avoiding activiies that can cause it to flare up is what I do.

Not a solution I guess but just a reminder that the surgery is/was a big deal.
At my age now I would not even consider it.
Younger I don't know .I had the chance then and the conclusion was not to have it.

Good luck with whatever you decide.
posted by yyz at 3:12 PM on May 9 [1 favorite]

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