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Achilles tendon pain

Well, so much for my delusion of invulnerability.  Did the half-mile interval z4 runs last Wednesday and afterwards felt a bit of an ache in my right Achilles tendon, but it went away.  Did the half- and one-mile interval z4 runs on Saturday, and the pain came back stronger and hasn't gone away.  I have my first-ever triathlon - a sprint - coming up in a week on May 2nd.  What should I be doing to maximize my chances of being race-capable by then?  And what should I be doing to prevent the injury from re-occurring?

The pain is in outside of my right Achilles tendon area, about 3" off the ground (the insertion point?).  There's no noticable swelling.  I feel the pain when I push off with the right foot while walking or running; I don't feel it when walking flat-footed, or when biking.  I have not had this (or any other) injury before, but then again I only started running last August.  I think I'm running with decent form: 90 strikes/minute/foot, leaning forward at the ankle as if pulled forward at the hips, torso straight up, midfoot strike, trying to feel the inward roll from little toe to big toe.  A month ago I switched to lightweight racing flats (Asics Piranha) for all my running.  My warmup consists of running slowly for the first mile or so before starting the main set.  I don't stretch beforehand but I do hamstring and calf stretches afterward.

Since this flared up yesterday, I've iced and elevated the foot several times, taken some Aleve (but stopped now that I've read the forum), tried to stay off the foot and cut out the running workouts.  I've asked my local tri club to recommend a good sports PT.  I've ordered a TPP Grid Roller, though it's backordered at the moment. 

For immediate recovery, should I be self-massaging the pain point and/or my right calf?  Are there specific stretches I should be doing, and should I start them now or wait until the pain goes away?   Should I run out and get a foam roller now and start using it this week to help me recover, and if so, which specific things should I be doing with it?  What else should I be doing or not doing this week?

For future prevention, it sounds like eccentric load exercises (weighted calf raises) would help, though I should wait until I'm pain-free first, right?  What should I be doing before I run?  What should I be doing after each run?  I've read through the forums, but it's difficult to put it all together, and some resources (such as the pictures for the calf stretching thread) are no longer available.

Thanks in advance for any wisdom you experienced team members can pass along here.  There are so many things to learn and master when starting out in triathlon, and throwing the injury treatment/prevention topic into the mix is just about maxing me out!  Help!

 

 

Comments

  • I am 95% sure you can do those eccentric exercises right now even as you care for it (Strengthen and Lengthen is okay), but icing is critical now to. Will follow this...

    P
  • Hi there,

    I hope I can help.

    The calf stretches and massage are in the wiki I believe placed in there by Leigh Boyle,PT. She is amazing!

    You need to be icing like it is your job. 20 minutes every hour.

    You should self massage it gently.

    Get rid of the racing flats. I am serious about this. Hide them. Go back to supportive trainers. Don't run until painfree. If you hurt walking minimize your walking. Add a heel lift under both heels to take the pull of the Achilles. You are catching this early which is good.

    You need the entire TP kit. Especially the small roller to address the calf, back and both sides.

    Stretching only after rolling and if painful don't do it. Wait until it only feels like a stretch.

    The tendon runs through a sheath and this sheath gets stuck to the tendon with inflammation. Maggage the sheath /tendon gently to keep it supple.

    I do not think you should race in pain. Let's get the pain to go away:-)

    Carrie Chavez, PT

  • Thanks P, Carrie!

    That much icing, eh?  I've started, sounds like I'll be a Kevsicle by the time this is over. 

    The TP grid roller has shipped, and I have a PT appointment scheduled for Wednesday.  I'll go back to running in my trainers when I feel up to running again, and see if that makes a difference.  Leigh's videos look really helpful, and I'll be working my way through them so I know what to do once my roller arrives.  The pictures on the calf stretching thread aren't showing up for me, which is wierd because the pics in the back stretching thread work fine.

    I'll probably go ahead and start Sunday's tri because I can learn a lot even if I have to DNF the run.

  • Just got back from the PT - turns out the source of the problem is that my right leg is a quarter-inch longer than my left. (A funny thing to learn after 48 years in this body.) Deep massage found a pain line running straight up the center of my right calf, so it's not just the tendon at the insertion point. He recommended using the foam roller and tennis ball as well as self-massage, gave me some exercises (heel lifts, single-leg knee bends) to program proper mechanics into my right leg, and gave me a referral for orthotics although he didn't sound convinced that I should go that route yet. Also, if the road surface is curved, I should make sure my right leg is on the low side. He's OK with me doing the sprint tri on Sunday but I probably shouldn't go all-out on the run.

    Gonna call my bike fitter tomorrow and ask whether he noticed this, and if so, how he dealt with it in the bike fit.

    Have any of you seen this condition before? Anything else I should do for it?
  • Hey Kevin, here's a link to some tips for digging out the calf on you own. image

    As far as the leg length is concerned, I'd wait on the othotic decision until your pain free. Heal up the calf and see how things really stand. If you've had the leg length this long without problem, it could just be it was the final straw for an otherwise cranky leg, not the outright problem.

    When you talk to you fitter- ask him specifically about your cleats and shoe alignment. Might be worth temporarily sliding your cleats back to take some of the load off the calf for your race on Sunday.

    Also, here are those calf pictures (sorry, in my reorganizing...I moved stuff and forgot about stuff linking back!)

    The first is a standing gastroc stretch.....keys: keep the knee straight as a board and drop that heel down first. Then lean forward. Go easy- will be a heck of a stretch. goal is to hold x30 seconds for 4 reps.

    The second is for the lower calf muscle, the soleus. Keys: start in a lunge position and keep your whole foot flat on the floor. From here lean forward over that front foot (try to keep your weight over the big toe to really stretch the ankle). You should feel the pull in your ankle and lower calf. Same holds- 30 seconds x 4 reps.

     

  • I like this thread. In regards to the awesome videos from Leigh...where do you find the time?

    Carrie...In your opinion then with regards to the heel lift, would running in Newtons be a no-no for someone with a history with achillies issues? I have an athlete that loves them but he had to DNF at Oceanside with a strained Achillies and he loves Newtons. His problem started after his coach raised his seat on the TT bike3/4 to 1", which dropped his HR and raised his wattage on a trainer BUT caused a toed-down riding position on his short leg side...

    Vince
  • Wow, Leigh, what great resources, thanks so much! I started rolling out my calves and hamstrings with the Grid last night per your videos, along with trigger point pressure on the pain line that runs all along my right Achilles tendon. Last night's session was pretty painful, but this morning's far less so. Did the stretches too. My ankle doesn't feel anywhere near as stiff now. I'm starting to see how doing all of this on a consistent basis could help ward off future injuries.
  • glad to hear things are on the mend, Kevin. Keep us posted! image

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