Achilles troubles and steps taken to alleviate them


The 8x300m training on Tuesday had me hobbling down the stairs in pain the next morning, bracing myself against the wall to minimize the weight I’d have to put on the left foot. Needless to say, the left achilles tendon was giving me a lot of trouble again.

Traditionally, over the course of the past ten years or so this is the point where I went on an extended break from athletics. Nowadays, I look back at training logs or GPS history from the months following achilles tendon trouble and am surprised that there is often no evidence whatsoever of athletic activity for weeks, maybe even months. While this passive approach might make some or all of the inflammation go away over time, it’s also easy to lose fitness and speed and basically ensure that I rarely reach ambitious goals. Basically, the achilles tendon is slowly improving while I watched the gains I worked so hard for over the previous months vanish.

Instead, I sat down the next morning and asked myself: “are you really doing all that you can to improve things?” All too often, it’s easier to admit defeat and feel sorry for oneself while not actually doing anything pro-active that might help make the problem go away faster.

So I decided that this time around, I’d try and make a better effort at fighting back. What follows is a break-down of the different methods that I’ve used, and intend to use more.

Electro muscle stimulation

Two large Compex electrodes on my left foot, with the Compex running in low-intensity “Capillarization” mode

Over the last couple of years, I’ve already experimented with using my old Compex electro muscle stimulator on the achilles tendon, running in low-intensity “Capillarization” mode to hopefully increase blood circulation in the affected area. It’s not a miracle cure, but it always feels like it’s doing some good; especially if I’m diligent about using it for about an hour a day. I used it for a total of 100 minutes on Wednesday (four 25-minute sessions).

Eccentric heel drop exercises

I also made it a point to do the exercises outlined in a Runners Connect article that prescribes regular use of flat-ground eccentric heel drop exercises to treat Insertional Achilles tendonitis.

See a doctor

Finally, after a long-lasting refusal to go see a doctor because of past experiences, I decided to make an appointment so I could get a professional opinion.

I was lucky enough to get an appointment the next day. The doctor diagnosed an “enthésite achille” (as far as my non-medical translation skills go, this seems to correspond to the English usage of “Insertional Achilles tendonitis”) and also sent me to get an X-Ray to rule out anything more serious (like a heel spur). Again, I was lucky enough to get this done on the same lunch break without either an appointment or a large wait at a local hospital.


Compression, cold and taping

In the evening, instead of merely plopping down in front of the TV, I got a large plastic trash can and filled it with cold water. I submerged the foot (the water went up over half of the calf as well) for ten minutes, and then later repeated this procedure once more. I’m hoping the cold and also the compression effect from the water will assist in further reducing the inflammation.

I’ve also started experimenting with kinesio tapes. While medical studies seem inconclusive on whether there’s much proven benefit, I’ve seen some positive effect not just when wearing the tape throughout the day but also during night. I suppose what helps at night is the compression effect of the tape that prevents the achilles tendon (and soleus muscle?) from going into its shortest possible position (toes pointed down, away from the body); which in turn means when I get up in the morning I feel less of that painful unstretched effect.


Of course none of the items outlines above are miracle cures. But if I can keep up all of them over the course of a few weeks (or better still, make them baseline habits for as long as I want to live an athletic life) the combination of several small factors will hopefully not just make my current troubles go away, but also assist in keeping them from coming back during future endeavors.

Training Log 18/Dec/2013

Running, Track

Track training today. We started off with the usual 2km warmup on pavement (at a leisurely 6:15 min/km pace). The main training was 8x300m. The ground was covered in frost near the 100m, but given how the left achilles tendon was feeling I still opted not to use spikes. Throughout the training I was never really feeling it, and felt slow and sluggish; plus mix in some increasing irritation in the achilles tendon and it wasn’t a motivating evening. Timing-wise, I started off slow (ten seconds behind the leading athletes) and got gradually slower. Towards the end, my only motivation was to complete the training. I clocked in the 8 repeats in 54″2, 53″6, 54″0, 55″2, 55″2, 57″5, 57″0 and 56″6.

Training log 5/Jul/2013

Hiking, Injuries

Friday was uneventful. During my lunch break, I walked to the fitness center (1.5km) and back (1.5km). At the gym, I did a variation of my usual program, and was glad to see that a gluteus exercise that I hadn’t been able to do well in over two months due to my hip issues was almost pain-free again.

After work, I walked to the hairdresser and back, for a total of 2km, therefore clocking a total of 5km of walking for the day.

Did quite a bit of Compex on the left achilles tendon, but it seems that electro-stimulation works better when the achilles tendon itself is sore, not the part where it connects to the heel (people on the internet seem to refer to this as “insertional achilles tendonitis”).

Training log Thursday 04/Jul/2013

Road, Running

Once again, I woke up with a painful left achilles tendon, mostly towards its base at the heel. Walking downstairs was painful in the morning, but after putting on my Asics running shoes (with a positive heel-to-toe drop) things improved – which is to be expected, since the higher heel in the shoe means that the achilles tendon isn’t stretched as much.

During my lunch break, I threw caution to the wind and went for a jogging around the Petrusse and Alzette valleys. I was once again wearing my cadence meter , and contrary to Tuesday purposefully tried taking smaller steps. My average today was 84 steps per minute, an increase of 5% over the previously recorded 80spm. I was faster too, although that was probably caused by running on paved surface rather than forest trails. I ended up doing 7,47 km with a 5:45 min/km pace, climbing only around 115m of elevation.

The pain in the achilles was fairly noticeable in the first 1 or 2 km, but then faded into the background. Later on, I put the Compex (electro-stimulation) on the achilles heel and tendon and did three “capillarization” programs in a row, for a total of 75 minutes. The advantage of these is that I can do them while sitting at the office and working, since the program requires no input and all I need to do is kick off my shoes and lower the socks. I’m still not sure if the Compex is really helping or if it’s just a matter of placebo effect, but I always feel better afterwards.

Once again, I then came home and had dinner instead of getting on the stationary bike. I still feel like I could stand losing some weight, but food cravings are stronger than my willpower. The achilles tendon is feeling a little better tonight.

Training log Wednesday 03/Jul/2013

Hiking, Injuries

On Wednesday, I woke up feeling like I was back in the year 2000. Meaning, my left achilles tendon was acting up again, and I had trouble even just descending the stairs to the kitchen after getting out of bed. Memories of the surgery that I had on the tendon in late 2000 after a partial tear was diagnosed came back; but of course then and now are very different times.

With the car requiring another visit to the mechanic, I was looking at 4.5km of walking from the car dealer to work and back. The morning walk to work went OK, even if the first few meters were once again painful. During my lunch break, I walked to the fitness center and did my usual program; including eccentric calf muscle exercises I’ve been doing regularly for the past half year and that, prior to the latest achilles episode of the past few days, have worked in keeping any major pain at bay.

After work I walked back to the car dealer and drove home, once again without major pain. I had been toying with the idea of riding my stationary bike in the evening, but instead upon getting home I ate entirely too many comfort foods and called it a day.

Training log Tuesday, 2/Jul/2013

Road, Running, Track, Trail

My achilles tendon had not been happy on Monday and Tuesday morning. Quite why I ended up doing quite a large double program on Tuesday, I don’t really know. Stubbornness, I suppose.

At lunch, I did a 10km loop around the Petrusse and Alzette valleys near work. I tried to stay on forest trails as much as possible, which means running on a softer more uneven surface almost 50% of the time. I went quite slow (6:44 min/km), although it still felt like I put in quite some effort. The 240m of elevation change didn’t help, probably.

This was also my first outing with my new Garmin 910XT GPS watch and cadence monitor. It was interesting to finally see detailed statistics about how many steps I take while running. Turns out that my cadence on this run at least was quite a bit lower than the 90 to 100 steps per minute that a lot of people seem to recommend. Now sure how my average cadence of 80 fits in with that, or if I’m still in the “reasonable” range because I’m taller than your typical lightweight distance runner.

In the evening, I did a lone sprint training (the others were doing starts, which I can’t do yet): 8x300m with short breaks was the plan. I ended up doing only 5x300m, which is when my running form went to hell. My left achilles tendon was probably really happy about that too, although during the runs it didn’t feel too bad. I wasn’t very fast, just cruising along at a speed I thought I could maintain without too much pain in the hip or achilles tendon: 53″9, 53″5, 52″0, 54″3, 51″6.

The left achilles tendon (or rather, the insertion near the heel) was not happy at all once I had cooled down at home.