Author Topic: Preventing Achilles Tendon Injury  (Read 1354 times)

Bigfoot_Mike

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Preventing Achilles Tendon Injury
« on: 17:36:34, 21/10/18 »
Does anyone have any tips to help prevent reoccurrence of an Achilles’ tendon injury?
I first injured this while running 10+ years ago, I think through overuse rather than a single injury. This left me with a bit of a bump in the middle of the tendon. This year I got back into hillwalking with a view to getting fitter for some longer, higher hikes. I was walking twice a week, wth a 6 mile walk (1500 feet ascent) midweek and up to 10 miles (2000 feet ascent) at the weekend. On other days I would try to get 10,000 steps at the office, or around the village. This came to an abrupt halt at the end of June, due to severe pain where the tendon joins the heel. I couldn’t put any weight on the foot. I am now back to walking on the flat and up stairs without pain, but there is some soreness afterwards with pressure on the tendon. I want to get back in the hills without doing further damage.
Are there any exercises or boot inserts, strapping, etc. that anyone has found helpful?

ninthace

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Re: Preventing Achilles Tendon Injury
« Reply #1 on: 17:53:55, 21/10/18 »
I have found a pair of Boots heel orthotics beneficial in the past after a bout of tendonitis.  I used them for several months.  Rubbing with Ibuprofen gel helped - has to be several times a day to work though, not just when it hurts.
Solvitur Ambulando

Maggot

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Re: Preventing Achilles Tendon Injury
« Reply #2 on: 19:36:57, 21/10/18 »
Seriously, get to a physio.


My right Achilles snapped completely 18 months ago, I was not doing much at all for 18 weeks, seriously, it was absolutely properly crap.  18 months in and I am back to full function, but with significantly reduced power and flexibility in my right foot.  Look after it, trust me, you don't ever want to hear the sickening crack I heard on July 1st last year  :-[


Luckily I took the opportunity 20 years ago to actually marry a physio, but even with daily assessment and monitoring the rehab took me the very thick part of 12 months before I was seriously walking anywhere.

Mel

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Re: Preventing Achilles Tendon Injury
« Reply #3 on: 00:23:16, 22/10/18 »
Does anyone have any tips to help prevent reoccurrence of an Achilles’ tendon injury?


......This left me with a bit of a bump in the middle of the tendon.


I feel your pain.  No, I actually do.  If you have a bump in the tendon then that is most likely scar tissue from the original injury.  I also have this from a previous injury.  This is different to "normal" tendonitis.  It's permanent damage.



Are there any exercises or boot inserts, strapping, etc. that anyone has found helpful?


No, not really.  All I do now is manage the pain.  I have found that wearing boots makes it worse (the heel cuff makes the tendon tissue over-heat, causing swelling which causes the pain when the swollen tendon scar tissue is rubbed by the tendon sheath).  I now wear walking shoes to reduce this.  I also stop frequently and rest my ankle - even just standing for a minute with the weight off my "bad" leg helps.  I do ankle rotations regularly throughout the day, along with pressure massage (advice from my physio) to stop it seizing up and un-seize it when it does.  It's all about pain management and damage limitation for me nowadays.


My GP told me to ice pack it and take Ibuprofen.  Oh and to do those stupid heel lift things on the edge of steps.  I personally find the ice-pack makes it worse / more stiff.  Ibuprofen makes me constipated (too much information  :D ) and the heel lift on steps things just aggravates it and causes a flare up that I need 2 days to recover from  >:(






So yeh, if you haven't already done so, see your GP to get it confirmed that it is indeed ligament damage/scar tissue and take it from there. 


Slowcoach

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Re: Preventing Achilles Tendon Injury
« Reply #4 on: 09:38:25, 22/10/18 »
I had achilles problems for a couple of years when i was running. My physio told me that it was scar tissue preventing the achilles moving freely. She told me to put vaseline on the achilles area and with fore finger and thumb either side of the achilles to massage up and down the length of the achilles to break up the scarring. It was incedibly painful to start with but it did work.
It's all uphill from here.

pdstsp

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Re: Preventing Achilles Tendon Injury
« Reply #5 on: 09:52:10, 22/10/18 »
Hi Big_foot, I have suffered with this for 2 1/2 years now.  It first came on on an easy flat walk up the Sefton coast path, firstly feeling like a bit of a hotspot on the heel, then becoming quite painful, and eventually leading to me heading inland and getting a train back to my start point.  In the ten minutes on the train my foot locked up so that I was hardly able to walk at all.  Some physio and exercises helped, and got rid of the worst of the pain , but I still have to manage it.  We are all different, and unlike Mel I find that ice works for me - when I get back from a walk I ice it for about 20 minutes, then have a shower and then do another 20 minutes icing.  I find that immediately after icing the foot is stiff, but that this wears off quite quickly and then I am pain free.  I use ibuprofen gel sparingly at other times and I also ice it occasionally when I've not dome much on it.


With regards to footwear, my physio advised me to wear boots as much as possible, even in every day life, as they support the heel.  I did buy some lightweight walking boots but don't wear them so much now as I found they had the same effect as Mel describes below, but I do wear boots in the hills and don't suffer the same issues as Mel describes - mine are Meindl Bhutans and I find them very comfortable, but again, I think it is a matter of finding what works for you.  They are certainly not boots I would wear to work/around town!



I have accepted that I will have to put up with this, and it does impact a little on multi day walks, but I still manage to get in the hills virtually every weekend (touch wood).  My physio was happy for me to go hill walking, he just gave plenty of advice about management, and I go back if the problem becomes acute rather than chronic.  The biggest change I have made is that I now walk a little slower, as this puts less strain on the tendon.

Doddy

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Re: Preventing Achilles Tendon Injury
« Reply #6 on: 10:55:10, 22/10/18 »



+1 for what Slowcoach says. Massage the scar tissue out; it is reducing the length of the Achilles so reoccurrence is likely. I still nick the back of the shoes and the heel notch support wings at the side of the notch to give more freedom, the Achilles gets rubbed every step; which is many times a run. [/color]  
I have no medical background but have read a lot and done five marathons and several triathlons. I similarly nick my hiking trail runners. I only wear boots in deep snow; boots need to fit well; they can restrict ankle movement.[/color]  

« Last Edit: 11:03:40, 22/10/18 by Doddy »

Maggot

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Re: Preventing Achilles Tendon Injury
« Reply #7 on: 21:52:25, 22/10/18 »
If you haven't, then you could try putting heel raisers in your shoes/boots.  They raise your heel and take some of the pressure off of your Achilles.


Maybe get some kinaesiology tape and do a bit of strapping? 


https://youtu.be/p7OAD4zIBos  strapping is really good if done well, and you can get all funky colours of tape too  ;D

dav

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Re: Preventing Achilles Tendon Injury
« Reply #8 on: 14:12:10, 23/10/18 »
Some good advice for Achilles Tendonitis there.However, first of all you have to get the correct diagnosis as to whether it is a 'True' Achilles Tendonitis or simply an Achilles Tendon Sheaf injury.The symptoms are almost identical. Any irritation to the back of your heel/tendon area will be uncomforatble so you have to prevent this. Some runners with Sheap problems cut away the top of their shoe heel tabs.

Bigfoot_Mike

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Re: Preventing Achilles Tendon Injury
« Reply #9 on: 21:25:49, 23/10/18 »
Thanks for all the advice.
I do wear heel inserts in my work shoes for support. I will have to look into some alternative insoles for my walking boots. I will also try out taping my Achilles as suggested. I have tried the exercise where you stand on a step and lower the heels, but I found this made things worse. I am pretty sure both injuries were from overuse, rather than a sudden injury. I tend to be impatient and overdo exercise. I probably just tried too much too soon. I will reintroduce myself slowly to the hills. The frustration is 4 months out, plus the loss of fitness gained in the previous 3 months. If I had built up more slowly, I would have climbed more hills and be fitter.
« Last Edit: 17:08:06, 24/10/18 by Bigfoot_Mike »

dav

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Re: Preventing Achilles Tendon Injury
« Reply #10 on: 16:55:21, 24/10/18 »
If you wear heel inserts in your work shoes then you need to wear similar support in your walking shoes/boots. Heel inserts are ok when you need them to relieve stress on injured Achilles Tendons for a temporary period whilst they heal, however using them permanently at work will shorten your calf muscle/tendon. Then if you go walking without the inserts your Calf/Achilles Tendon is being stretched beyond what it is used to. Ladies who wear heels at work are particularly prone to this problem. Also you may need to pay particular attention to the walking shoes/boots that you wear as some on the market now have a zero or negative heel to toe drop. Anyone with tight Calves or Achilles Tendon needs to wear footwear with a higher rather than lower 'heel to toe' drop, which is exactly what heel inserts provide.

Slowcoach

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Re: Preventing Achilles Tendon Injury
« Reply #11 on: 18:35:39, 24/10/18 »
I suffered a torn calf muscle a couple of years ago. This was as a result of achilles tendon damage. I was referred to a bio mechanics clinic and was told the achilles damage was caused by pronation problem which made my achilles slide through the sheath at at angle which caused abrasion and then scarring. I was precribed half shoe inserts to straighten my foot angle, i bought a second pair for my walking shoes and boots and have had no futher issues. So getting to the root cause of the achilles prolem is very important. Otherwise you are dealing with the symptoms not the cause.
It's all uphill from here.

Bigfoot_Mike

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Re: Preventing Achilles Tendon Injury
« Reply #12 on: 18:43:00, 24/10/18 »
I suffered a torn calf muscle a couple of years ago. This was as a result of achilles tendon damage. I was referred to a bio mechanics clinic and was told the achilles damage was caused by pronation problem which made my achilles slide through the sheath at at angle which caused abrasion and then scarring. I was precribed half shoe inserts to straighten my foot angle, i bought a second pair for my walking shoes and boots and have had no futher issues. So getting to the root cause of the achilles prolem is very important. Otherwise you are dealing with the symptoms not the cause.


Very interesting. I have a definite over pronation problem with my right ankle. In earlier years I badly sprained the ankle a few times and my right foot naturally (?) points out at about 15 degrees. Were you referred through a doctor or a physio?

Slowcoach

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Re: Preventing Achilles Tendon Injury
« Reply #13 on: 18:47:42, 24/10/18 »
I saw my doctor who revommended a private physio as the NHS waiting list was months long. The physio then wrote to my gp that she considered it was not simply a sports injury. The doctor then arranged an appoitment with NHS bio mechanics clinic. The consultation lasted about 40 minutes.
It's all uphill from here.

 

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