Is this Achilles Tendonitis or not?

[drekkly]

Quick summary. Got diagnosed with AT (para) in January after a 10 mile run and too many training miles. Had 10 weeks off and did a lot of eccentric drops and raises. A week ago last Sunday I ran in a race and the achilles was fine (had been training and competing on it no problems) Then the soreness came on gradually over 2-3 days. More on the right hand side of the right achilles and foot. However by Thursday I was pain free and by Saturday I was able to run 3 miles with no post exercise pain. Ran again Sunday with no immediate post exercise pain. However the soreness came on slowly after this run and is still sore now. It feels different to the last AT I had and there is no pain walking (and no pain when I ran) but there is a tightness down the right side of the achilles and soreness on the right side only and not so much at the back and none on the left hand side. This doesn't sound like AT to me as it doesn't come and go like that does it - what else could it be - a trapped nerve? I do have a sore spot right on the arch of the right foot which has been there for a while so not sure if that's connected. Any AT experts out there?

Similar Threads:

• Rehab achilles tendonitis - foot strengthening
• Achilles tendonitis
• ehlers-danlos syndrome - achilles tendonitis
• Achilles Tendonitis
• Achilles Tendonitis and Strains

[physiobob]

Sounds like it is still an achilles issue to me. Could be a tendinitis on top of a more chronic tendinosis. Rest doesn't stop the cause and longterm pain relieft would not be instant. it often takes several months to get to the painful stage. 10 days rest won't resolve and heal the tissue. More like 6-12 weeks. The eccentric work needs to be done with a slightly flexed knee to work the soleus and not bias the gastrocnemius (which would be the case with a straight knee).

I'd also suggest getting a running show with a higher heal than the toes area, e.g. a Nike Air Pegasus. If not you can add 5mm or so of heal life in your existing running shoes.

[drekkly]

Sounds like it is still an achilles issue to me. Could be a tendinitis on top of a more chronic tendinosis. Rest doesn't stop the cause and longterm pain relieft would not be instant. it often takes several months to get to the painful stage. 10 days rest won't resolve and heal the tissue. More like 6-12 weeks. The eccentric work needs to be done with a slightly flexed knee to work the soleus and not bias the gastrocnemius (which would be the case with a straight knee).

I'd also suggest getting a running show with a higher heal than the toes area, e.g. a Nike Air Pegasus. If not you can add 5mm or so of heal life in your existing running shoes.

After the first AT trauma I had 10 - 12 weeks off from running. (still cycled) I did both straight leg and ben knee eccentric heel drops until I was pain free. Then I incorporated some heel raises as well to start the strengthening process. First with no added wieghts and then with small weights added to a backpack. Eventually I was running and competing pain free. This period lasted about 4 - 5 months until the recent issue a couple of week backs. This pain is completely different to the previous pain - in that it disapeared completely for a few days but when it does return it is pretty much constant in intensity (pretty low intensity as well) Before if I walked for 30mins at lunch the pain would increased - with this pain this does not seem to happen as much. Also there is no pain when running which I had with the previous AT. Someone suggested a trap nerve further up the linetic chain could be causing it? Assuming it is AT then I guess I should just continue with what I have been doing previously - ice, heel drops and using a heel raise in my work shoes and for running. I have 2 more races left this season and then will rest up for a few weeks - if it still bothering me after that I will get a full assesment done.

[Cherilegrace]

Have you seen a physiotherapist? Do you have any history of low back problem? You could also have plantar fasciitis-- Plantar Fasciitis - Symptoms, Treatments, Causes of Plantar Fasciitis - from WebMD -- or scarring from from AT. It would be nice to have a professional guide your recovery. Also, try to avoid uphill running.

Good luck!

[drekkly]

Have you seen a physiotherapist? Do you have any history of low back problem? You could also have plantar fasciitis-- Plantar Fasciitis - Symptoms, Treatments, Causes of Plantar Fasciitis - from WebMD -- or scarring from from AT. It would be nice to have a professional guide your recovery. Also, try to avoid uphill running.

Good luck!

I saw a physio back in January who said it was para tendonitis of the achilles. No lower back problems. Did wonder if it was connected to sore spot on sole of foot ie PF - but was told that was much more painful. This is a low grade soreness on the right side of the achilles which is constant now but only hurts if I push the tendon and doesn't hurt to run or walk or when I get out of the bed first thing in morning. I had a sports massage last week and she said the achilles felt smooth with no indication of scar tissue. I am going to see a physio at the end of the season but if it doesn't hurt when I run I wondering how important it is to get sorted? I live in a very hilly place so training and competing on hills is unavoidable!

[drekkly]

AT or not? Update. I raced a triathlon on Sunday and there was no pain during. Afterwards it was very sore to the touch and I though yes it must be AT but after an afternoon of ice it is not sore anymore? This is not what I had before where it got very sore after a race and stayed that way for a couple of months? Surely AT is either there or it's not there - it doesn't come and go. Someting is irriating to the sheath of the tendon I think causing the inflamation and soreness which quickly goes? Could it be a trapped nerve somewhere? I have heard of someone thinking he had AT but it ended up being a trapped nerve in his glute? Now this morning my right glute is sore which may just be coincidence?

[Podiatry]

This kind of problem in the AT area can be difficult to diagnose and sometimes you may get conflicting advice, if you see a decent podiatrist/physio they should be able to suggest some long term stretches, with attention to the whole leg not just the achilles/foot area. There are various treatments to try from acupuncture to massage, ultrasound and of course the stretched... there are many to try, it really should be a long term plan though and probably good to stretch before,after and even on days when you're not running. Footwear, as already suggested, could be an additional area to look at.

[Cherilegrace]

I would still recommend you to see a physiotherapist for a short period of time to resolve the tendonitis. You may want your physio to guide you better with training and prevent yourself from getting a major injury in the future. If it gets resolved soon then you may not even need to see one at the end of the season.

Goodluck.

[Podiatry]

Agreed, hope it gets better soon.

[drekkly]

As an update - I wento to see a podiatrist who diagnosed heel rub from my trainers. There was a worn area (small) on my trainer at the exact same spot my achilles was sore so he reckoned that had aggravated the achilles and caused para tenonitis. He said not stretching or massaging for a couple of weeks and cut a slit at the back of the shoe to prevent any further rubbing. That was 2 weeks ago and the pain had got much better but after sone light running last night it is now sore again. On examining my old trainers I found bother trainers worn at the back at the achilles area. So that was either the cause of my initial trauma in January or it is a secondary cause and not the underlying cause - and anyway why is it only effecting one side?

I am now thinking it's an overuse injury possibly made worse by my pronation. Not sure whether to treat it the same way as the original injury now with lots of eccentric stretching and heel rises to build strenght. I am also going to look at taking my running back to basics with a move to fore foot running and ditching the stability shoes for some newtons and also some minimal trainers such as Merrels.

[sarahkelly]

Hi Drekkly,
I suspect that you have achilles bursitis, and possibly a slight Haglunds deformity (if your heel has been eroding your shoes)
Achilles Bursitis Health Byte - YouTubeYou describe it as being much different in nature from you achilles tendonopathy pain but in a similar area.
I reckon it's the bursa that's aggravated!

[Podiatry]

As an update - I wento to see a podiatrist who diagnosed heel rub from my trainers. There was a worn area (small) on my trainer at the exact same spot my achilles was sore so he reckoned that had aggravated the achilles and caused para tenonitis. He said not stretching or massaging for a couple of weeks and cut a slit at the back of the shoe to prevent any further rubbing. That was 2 weeks ago and the pain had got much better but after sone light running last night it is now sore again. On examining my old trainers I found bother trainers worn at the back at the achilles area. So that was either the cause of my initial trauma in January or it is a secondary cause and not the underlying cause - and anyway why is it only effecting one side?

I am now thinking it's an overuse injury possibly made worse by my pronation. Not sure whether to treat it the same way as the original injury now with lots of eccentric stretching and heel rises to build strenght. I am also going to look at taking my running back to basics with a move to fore foot running and ditching the stability shoes for some newtons and also some minimal trainers such as Merrels.

The heel rises sound good idea, and concentrating on muscle stretches further up the leg may help too, if you imagine, the muscles taper down to the heel, this has helped me.