Achilles tendon swelling

Jorge Duque

Hi Team.

Last weekend I went through race rehearsal weekend and it was brutal. I felt some minor discomfort on day 3 (Monday Long run) in my left leg  but thought it was just from being tired from the previous two days of extended workouts. Yesterday I had another long run (15 miles) and after running I saw a big swelling in my left Achilles. It's not very painful but there is definitely some major discomfort. Just as general info I am not running on old shoes.

I have started Ibuprofen (200 mg every 6 hours) and ice twice a day; I am using an insole to lift my heel too. My race (IMCA - which is my first IM) is 23 days away and I am not sure what to do here with the training volume ahead. The questions I have are the following:

1. Based on your experience is it safe to bike or could that create more damage? I am on week 17 and there is a lot of bike hours ahead.
2. How long should I stop running? (I have already done the longest run of the season)

Any advice is greatly appreciated

Doug Sutherland

Sorry to hear it Jorge

Sadly, I too have a long history with Achilles tendon nidus. Mine hit in May 2016. I am still dealing with residual tendinitis on a daily basis even at this time. 

 I think the pertinent question here is did you actually tear your tendon or is it just inflamed. The more swelling there is I understand there's a higher likelihood of a tear. If you have a tear or a partial tear then my orthopedic surgeon told me strictly no running for at minimum six weeks as long as three months. Full tears get surgery.

 If it's just tendinitis alone my surgeon told me to not run for an entire month the whole time doing stretches and exercises and using daily NSAIDs.  I can only tell you having followed his advice strictly that my tendinitis never really resolved completely it only became more manageable. 

 Since your bill to Canada was already compromised by one surgery, and now this, if I were in your shoes personally I would differ I am in Canada take time to heal and be prepared for Iron Man Arizona in November.  But without going to see a surgeon and potential he getting an MRI of your ankle this device may be ill advised

Jorge Duque

Thanks Doug. I hope it's nothing major. This IM has been 7 years in the making and one intense year of training. It would be extremely frustrating to quit within less than a month of the race. I have talked to my Orthopedist and we will meet on Monday. 

In the meantime he send me to the ER to have a valuation before doing any exercise. I will keep you posted. 

Patrick Marsh

I hade achilles tendonitis in 2014, and I still feel twinges of it.  To Doug's point, if it is just a series of minor tears causing inflammation, then you should be able to deal with it by lots of rest, calf stretches, NSAIDs and ice.  However, rest is really the only thing that will cure it.  I got it training for a marathon on an unwisely accelerated timeline and ended up hobbling around for a few months afterwards waiting for the inflammation to go away.  I stretch my calves about four times a week, but in reality I should be stretching my whole body and doing strength/core exercises everyday, year round.  Good luck, and be sure to get a doctor's opinion.   

Jorge Duque

@Patrick Marsh @Doug Sutherland

Thanks guys. Went to the ER on Friday and there is no tear. Just came out from an appointment with my Orthopedist and he says the tendon is strong and he didn't feel any tear. He told me he is so confident that there is no real damage that he wouldn't even consider an MRI at this point. This is a guy I trust and respect his opinion. 

For now he put me in a boot until race day. I can swim as much as I want and bike according to plan but no running until race day. It's nerve racking to show up to my first IM and not have a clue of what will happen on the run, but I will take this over a DNS.

19 days to heal!!

Doug Sutherland

That is great news Jorge. Indeed. Since you have a dance to the show in Tempe, a IMC aquabike (if it came to that) would be less painful, but if no pain, I see a IM medal in your near future!