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Richard Self Offline
#1 Posted : 24 August 2013 09:11:23(UTC)
Richard Self

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For the last 6 months I have been plagued by Achilles tendon pain and running has become miserable. I have tried resting, stretching and NSAIDS. I am limited to about 10k on the flat and hills hurt.

I'm not ready to retire quite yet, so am at the point where I will give anything a go. Any recommendations for physio, sports medicine, witch doctors and purveyors of snake oil.

I would love to be fit for the cross country season.
Jerome Edwards Offline
#2 Posted : 24 August 2013 10:10:07(UTC)
Jerome Edwards

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Try acupuncture.....its a stab in the dark but it helped me a before London.

My sister in law claims to be good.....but she would, wouldn't she ;)

https://www.facebook.com...nctureAndTCM?ref=profile


Also Paul Harris does it

http://www.paulharrisspo...erapy.co.uk/contact.html

Edited by user 24 August 2013 10:23:20(UTC)  | Reason: Not specified

Mick McGeoch Offline
#3 Posted : 24 August 2013 11:44:41(UTC)
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Sorry to hear about your problems Richard.
I have been an Achilles tendon sufferer in the past.
In my case it was simply wear and tear after many years of pounding roads.
Achilles tendon shorten with age, and my solution was orthotics.
Would stretching help? Many would say yes, and I have become more convinced of the need for stretching later in life, but only because of my compromised running action caused, in no small part, by the lack of it.
amanda thompson Offline
#4 Posted : 24 August 2013 13:25:41(UTC)
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I had Achilles strain in the run up to Paris marathon last year. Like Mick says, Achilles' tendon shortens with age. I had physio treatment (Karen Fuller) and was advised then to get orthotics from Ace Feet in Motion. As well as correcting foot position, these inserts are very slightly raised at the heel to take pressure off Achilles' tendon.

I think I remember Julian sorted his Achilles problems out by switching to Vibrams. But that's not something to be done overnight.
Short Circuit (Howard Kent) Offline
#5 Posted : 25 August 2013 10:40:29(UTC)
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The bane of my life. I could go on about them more than John Plain.

I've tried just about everything except nitroglycerin patches.

A few comments I would make are:
Don't mix NASAIDS with training. An absolute no-no. It disguises the problem & makes it worse over time. If your not running, then a different matter they can help in the short term.
I personally found orthotics from ACE Feet in Motion a lifesaver. Didn't cure the problem but alleviated it sufficiently to allow me the interval train & race. I know of at least 5 people from the club who have had lower leg problems that have been helped by these orthotics.

This injury is a complex issue and deserves more detail than can be provided in this post. Perhaps I can do another post later or we can chat at the club.
Smoke me a kipper, I'll be back for breakfast!
Sean Smith
#6 Posted : 25 August 2013 11:55:34(UTC)
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A lot of the issues around Achilles/Calf problems are down to how tight your hip flexors are. Loosen your hip area and I am sure your lower leg problems will eventually go away. Also you will find that doing short but frequent stretches off the steps (say each time you climb the stairs in your house) will also help.

Huw Evans Offline
#7 Posted : 25 August 2013 21:17:42(UTC)
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I am with Sean on this. I thought that I had chronic Achilles problems when I was in my 20s and iced it religiously, etc. Rest never made any difference either. Finally, a few years later, after a visit to a very good sports physio it was eventually diagnosed as a back problem relayed to my Achilles and calf sometimes. Core strengthening exercises and a visit to a physio or chiropractor could help - it is worth a go.
Simon
#8 Posted : 27 August 2013 14:15:59(UTC)
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Richard, really sorry to hear this. As you know, Achilles tendinitis (and its evil ally - the calf tear) has pretty much put the keybosh on my running career. If there's any advice I'd offer, it's to give everything a fair go. I've tried:

1) orthotics
2) Shock wave therapy (Ouch and double ouch).
3) loads of physio.
4) Even more physio.
5) Stretching ad-infinitum.
6) Rest.
7) Suspending a crystal over the achilles and asking everyone to join hands and hum.

None of that lot worked for me, though there's no question that rest doesn't help much at all.

The best I've managed is through a combination of regular sports massage (Loretta - very good), stretching, training within the limits of your injury and lots of cross training (as you know, cyclo-cross in my case). One of the key things I've learned to do is to drop the ego before setting out for a run. I don't care if I jog-walk the first 2 miles now as long as I can go out. Recently I managed a 10 mile hill run after training like that (first time in about 3 years). If you do happen to hit the secret mix, drop me a note first. The beer will be on me.

Simon

P.S. Try #7 on a club night. I'm sure everyone will help out :)

P.P.S. #7 is a fib.
Davey Proud Offline
#9 Posted : 27 August 2013 22:16:04(UTC)
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Hi Richard,

sorry to hear you've got achey achilles.

Seems like problematic achilles is the injury of choice recently!

I've struggled since Barry 40 2012 with initially a sore left achilles but now both. I managed to suck up the pain for several months but then it got worse so I went back to basics and reviewed my shoes as I'd been wearing the same brand/model for over a decade but in that time I reckon my achilles had possibly shortened (who knows for sure though!)?

A change of shoes helped a little. So then I reviewed my orthotics and went to ACE. They agreed that due to shortened achilles my orthotics needed raising up so a mere 3mm increase in the heel and things got a little better again.

For London I was doing more running than ever before often x2 a day and despite this pain didn't worsen, in fact if anything it got less??? Andrew at ACE suggested that this may due to micro tears initially in the achilles resulting in new capillaries forming into the tendon in order to try to provide blood flow and hence healing. However the additional capillaries running horizontally to the achilles only results in causing friction and poor tendon slide hence more pain. His advice based on the most recent research was if you can get through the pain then keep moving (I took that for, keep running in my head) as the moving/running motion helps to break up the unwanted capillaries and allows a smoother tendon slide (maybe thats why I found there was less discomfort when I run more frequently)??

I also use alot of omega 3 daily as an anti-inflamm rather than NSAID meds. I've read a few small RCT's suggesting that NSAID's used during/around training/racing may result in muscle deterioration so I'm always squeamish about popping them these days.

I'd love to say the above has cured me but alas it hasn't. I can say it's manageable and usually after the first 1-2 miles of a run the discomfort settles down and is much less of an issue (sometimes goes away completely), there was a 3 week stretch after London when I was pain free and that was just heaven, alas it didn't last.

I make sure I stretch every day and Martin Haley is working on the principal that the problem is stemming from somewhere else higher up in the body so as well as the work he does on me I do all the exercises he's advised on a daily basis.

Best of luck Richard.

Davey Proud
Short Circuit (Howard Kent) Offline
#10 Posted : 28 August 2013 10:12:09(UTC)
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Looks like Simon & Davey have gone thro' much the same process that I have.

I tried shockwave therapy (also referred to as lithotripsy). It was excruciating on both the ankle & bank balance. I found that it improved the Achilles attachment problem marginally. Slightly less painful & stronger, & recovered slightly quicker after a run. As I said to the practitioner at the time, I expected to assess it over a season. Some months later I sprained my back & could not do anything for 2 weeks. I was on naproxen, diclofenac & pain killers. After a gradual withdrawal my Achilles attachment was a lot improved! I'd tried (weaker) NASAIDs before but not with the same effect. Perhaps it was a combination of the two?

Also, raised the ACE orthotic prescription by 1mm. Surprising, even that made a difference.

Running in water exercises (like Mo & Galan do), also helped. Also, good for XC. Richard you've seen me do this so you know what's involved.

I think it's important to distinguish between an Achilles insertion problem, & one that affect the tendon itself (classic pinch position), & insertion into the muscle. Treatment modalities may be different.

Some informative links below (I've got dozens of these):-

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/

http://rheumatology.oxfordjournals.org/cgi/content/full/45/5/508

http://www.footankle.com/achilles-tendonitis.htm

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1570650

Hope this helps...

Smoke me a kipper, I'll be back for breakfast!
Richard Self Offline
#11 Posted : 29 August 2013 15:03:43(UTC)
Richard Self

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Thanks for all the advice. So far I'm cross training ( cycling ), going for adventures on my kayak, physio ( booked) and orthotics ( booked). I'm learning to enjoy life in the slow lane
Martin Haley
#12 Posted : 30 August 2013 15:09:34(UTC)
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Pain is almost never the source of the problem. If you have had direct impact or know the cause (twist ankle falling off curb, etc.) then yes, site of pain is where root is but otherwise, the cause will be further up or down the chain. If you have tried stretching, massage, rest, icing, etc. then that almost shows you it isn't an Achilles issue.

It was mentioned above, check out your Glutes around your pelvis. Glute Max is the main locomotor to push off when running followed by Hamstrings and then Calves. If the Glutes are not functioning properly then the calves will be asked to work harder to compensate. This is why stretching the calves sometimes eases the issue for a short time then it returns as the muscles become overworked again.

I have also seen many times that the muscles that work the toes (Flexor Hallucis Longus - big toe and Flexor Digitorum Longus - other 4 toes) can become so tense that they inhibit the Glutes so also make the calves work harder. Any discomfort on the sole of foot?

Stretching for maintenance is fine but never stretch a tight muscle just for the sake of it as it is probably tight for a very good reason - it is providing function and/or stability for another muscle that is not working. And Orthotics - they are almost never the answer as they do not address the cause, just a band aid.
Maldwyn
#13 Posted : 01 September 2013 14:52:13(UTC)
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amanda thompson Offline
#14 Posted : 26 January 2014 08:28:27(UTC)
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Just seen this on FB, posted by Claire. http://achillestendonresearch.com
Take part in this survey if you suffer from achilles problems.
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Short Circuit (Howard Kent) on 26/01/2014(UTC)
Richard Self Offline
#15 Posted : 26 January 2014 10:47:29(UTC)
Richard Self

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Thanks for resurrecting this thread Amanda. I am now back running. I am not sure which of the following worked

1 Stopping running totally for four months. Keeping fit with gym, bike and swim.

2 Shock wave therapy. Eye wateringly expensive and painful.

3 Accepting a certain amount of pain.

4 Accepting that this is a result of an aging beaten up body. You can't drag race a vintage car, so enjoy the shorter races, low mileage training, cross training and enjoy just taking part. Be content with the achievable.

5. Avoid tarmac as much as possible.

Thanks for all the support over the last few months. I'm back, slower and wiser.
jamesthebruce Offline
#16 Posted : 26 January 2014 15:49:58(UTC)
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Richard,

Its great to have you back running again.

Short Circuit (Howard Kent) Offline
#17 Posted : 27 January 2014 15:28:56(UTC)
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Yes, good to see you back.

Looks like I've been thro' 1 to 4 of your list in the past. Still going OK tho'...Mellow
Smoke me a kipper, I'll be back for breakfast!
tim o'sullivan Offline
#18 Posted : 27 January 2014 18:13:35(UTC)
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Quote:
"I'm back, slower and wiser" ((Richard))

Make that 'Marginally less fast' maybe?!

Plod with me and I'll teach you the meaning of the word

...slow

RollEyes

Marcus Coles Offline
#19 Posted : 02 February 2014 01:34:56(UTC)
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I have suffered with 2 achilles problems both in the left ankle in the past. Each time it took me out of running for around 3 months, so I really sympathise with you there Richard as there is nothing more frustrating than seeing runners on the streets and you know that you can't get out there and run as it will probably knock your recovery back further. The second time I injured my achilles was due to picking the wrong trainer when I bought two pairs in America which I would pay a lot more back home, but not having done my homework, I picked a neutral trainer and not a over pronation trainer which I do when I run. Nowadays I am running more mileage than I ever have and rarely suffer from any nagging pains now. There a few changes that I have made which I feel has probably made this difference which are:

1. A vast amount of my training has been done on a treadmill, now I know this may not sound favourable to some, but it has brought me on really well over the past year as I have been able to increase my mileage and really push myself in some sessions in confidence that I don't get sore after it. I know this may not work for everybody, but it has paid me dividends.

2. I have dropped 18 pounds in weight which I did between February to August last year and now maintaining my weight around 151 - 153 pounds, I won't go any lighter than this now for my height.

3. Buying the correct training shoes by getting an assistant who knows my running gait and picking the shoes which they recommend.

4. If I do feel a little sore, than what is the harm of resting for an extra day or so to get over it. Missing one or two training sessions ain't going to knock your performance down, but it might if you force yourself out and train hard again on it and then get an injury.



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Short Circuit (Howard Kent) on 02/02/2014(UTC)
Short Circuit (Howard Kent) Offline
#20 Posted : 02 February 2014 21:24:22(UTC)
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Marcus, your comment on 3 months out to deal with Achilles is my experience too.

If you've dropped 18 pounds in weight, that's going to make a massive difference! Well done! I wondered what the difference was when you went past me today in the Handicap 10! I daren't drop any more than 1 pound or I'll be below my BMI (damn!)

On your point about shoes, I'm having some success with Hoka One One's. They have a rolling motion which I find forgiving on the flat, but I wouldn't recommend them for off road. They are not stable enough, (risk of turning an ankle). I'm also told some ultra runners use them.

From personal experience, & talking to other qualified coaches & competitors, you should get better results by training intensively & allowing for recovery.

Edited by user 02 February 2014 21:26:03(UTC)  | Reason: Not specified

Smoke me a kipper, I'll be back for breakfast!
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