UKC

Ive had a recurrance of achilles tendonitis, albeit self inflicted from doing too much running (3x ultras in 2 months)
Any specific suggestions on relief - aside from the usual RICED - and suggestions on preventing future episodes e.g. specific stretches (I dont stretch much I must admit but do use a foam roller often which has helped various muscle issues).

Thanks/Diolch!

In reply to Pesda potato:
These are the stretches I was recommended by a physio and seemed to do the trick. Also, I was advised to make sure my shoes have arches or cushioning. i.e.no deck shoes

http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/a...

Soleus stretch

Soleus muscle stretchTo stretch the soleus muscle the back leg should be bent. Place the leg to be stretched behind and lean against a wall keeping the heel down. A stretch should be felt lower down nearer the ankle at the back of the leg. If this stretch is not felt then a more advanced version is to place the forefoot of the front leg against the wall with the heel on the floor and push the from knee towards the wall.

Stretching on a step

Calf stretch on a stepThis stretch can be performed to further the stretch on the calf muscles and achilles. Stand on a step with the toes on the step and the heels off the back. Carefully lower the heels down below the level of the step until you feel a stretch - make sure you have something to hold on to!

Hold for 15-20 seconds. This should be performed with the knee straight and then repeated with the knee bent to make sure you are stretching both muscles. You should feel a gentle stretch. Be careful not to over-do this one.

In reply to Postmanpat:

Just recovering from my second bout of AT, which was caused in the first instance by excessive hill running. As above ensure you have insoles to match your arches/pronation, I use orthaheel sports.

For me any stretching of the muscle (i.e. soleus stretch above) aggravated the tendonitis. Your body may be different but I only started recovering when I stopped stretching and focused on eccentrics.

The 'Alfredson protocol' of heel drops is very effective at removing AT at the midpoint of the tendon. Start with assisted drops ( taking some weight on your hands ) and progress to one-legged and even wearing a weighted backpack one-legged. Volume is king so try to build up to a large number of reps morning and night. You can also do the heel drops with a bent knee, which I believe works the soleus (?).

However, that protocol won't get you anywhere if, like me, you have AT pain at or near the insertion point of the tendon (essentially the big bumpy bony point at the back of your heel). One of Alfredson's research minions found that only a very small percentage of insertional AT sufferers were cured by the heel drops on stairs. In fact these exercises aggravate the condition.

If you have insertional AT perform the heel raises on a flat surface, and without bending your knee. A follow up study by Alfredson's minion found this to be very effective.

With both protocols make sure you reset the exercise using your calf muscles. I.e. don't perform a calf raise but use your other leg to step up onto the bottom of your stairs etc.

Good luck

In reply to Pesda potato:

https://www.google.co.uk/url?sa=t&source=web&cd=9&ved=0ahUKEwjg...

In reply to maxsmith:

cheers, last time was at insertion point and I had a tear, took months couldnt even wear a shoe with a back on it.
This time its about 3 inches up from insertion point.

In reply to Pesda potato:

Yeah my trainers currently have the heel tab cut out, I feel your pain! I'd start with the full heel drops ( bent and straight leg ) but don't take the eccentric too far. You may find that the pain moves downwards towards insertion point over the coming weeks. If that happens switch to the flat floor exercises.

In reply to Pesda potato:

also with regard to the orthaheel insoles - do you find there is enough room in your shoe after they are fitted? Ive tried a different brand and they were so thick (with original insole removed). I couldnt use them.

In reply to Pesda potato:

From experience, I'd suggest:
1. Foam roller or sports massage for tight leg muscles (esp. calf muscles).
2. Get your gate properly checked in case you're overpronating (for example).
3. Read up in eccentric exercises and, if it's suitable for what is wrong with you and the stage you're at with it, focus more on this than stretching (although see 1).
4. If you need to ice it use an ice cube and run it along the tendon (easier to get into the sides than an ice pack).
5. If it's anything other than really mild go and see a sports injury specialist asap.

In reply to Pesda potato:

Orthaheel are a slightly bigger profile than the standard insoles I replaced but nothing that stops me getting my feet into my boots. You will need to trim them down to size with scissors though (insoles come in size 11 and I cut down to size 9ish). I almost wish I had started with another brand though because they are damn expensive and I don't want to switch in case it aggravates AT..

In reply to cathsullivan:

yup already foam rolling
my gate is fine, gets oiled as needed
ive had my gait checked on a treadmill but as the physio told me it isnt really representative of what you do whilst running (off road). I did overpronate but have corrected that, my arches are both average / normal, but that changes 40+ miles in to a run!
Good idea on the ice cube

In reply to Pesda potato:
Stretching,stretching and more stretching.

I've had AT a couple of times and the last time a couple of years ago resulted in me having mild discomfort for months and months. (I'm an old crumbly!) Eventually a very fit ex Royal Marine friend told me I need to do more stretching and not resting. I obviously wasn;'t persisting with the stetching (twenty minutes a day sort of thing I'd been doing previously so I upted it to half and hours stretching - all I could be bored to do!). I got so fed up when winter came and it still persisted, and there was now snow on the ground - I though bugger this and went off X-country skiing.

That cured the AT in one go!!

In reply to Pesda potato:

I'd look into the eccentric exercises too then.

In reply to maxsmith:

I ordered some online as no shops near me stock them, they are huge! its not a case of trimming them down, just they are so thick theres no way I can get my foot in the shoe with them in too (and yes i did take the original insole out).
Just thought Id share my experience incase someone else thinks they are a good idea after reading this post.