/ Achilles tendonitis

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I suspect that's what it is anyway.

Would you bother going the GP / NHS physio route (presume that's slow, I've never tried) or just go straight to a private physio?

somethingelse - on 19 Mar 2013
In reply to Dan Bailey - Didnt get much help from my GP, very unsympathetic. Eventually convinced her to send me to physio, who took one look at me and referred me to a podiatrist, who made some insoles for me (which I never wear - no good for fell running). Whole thing took about 2/3months. Went to a private physio in the meantime, combination of massage to relieve tension in leg muscles and some strengthening exercises to correct over pronation (I had a weakness in my iliacus - in my hip) seem to have made it much more manageable, although I run a lot less than I used to and it still flares up after lots of climbing/walking/running. Don't know how much that helps, but thats my story anyway. They reckon I had insertional achilles tendinopathy.
CT - on 19 Mar 2013
In reply to Dan Bailey -

Go straight to a physio if you're in doubt, get a full assessment & treatment. I'm about to do that after 4 months and wish i'd gone sooner as it was obvious the pain was more than a usual over use injury.
My GP was helpfull in that he's snapped his so understood and confirmd a diagnosis. All they can do is reccomend rest, ice, anti-imflamatories, gentle stretching etc. and if that not improving things after several weeks then they'll refer you to a physio which will take many weeks.

Good luck & hope you have a speedy recovery.
JamButty - on 19 Mar 2013
In reply to Dan Bailey - Yep find a physio. My GP said - do you run on roads? I said yes, he said what do you expect at your age then!!

But don't leave it, it tends to get worse if you don't get it looked at!
tony on 19 Mar 2013
In reply to Dan Bailey -
> I suspect that's what it is anyway.
> Would you bother going the GP / NHS physio route

No. I've never had any joy with GPs dealing with muscular problems. The captain of our running club is a GP and he goes straight to a private physio any time he has a problem.

> just go straight to a private physio?

In reply to somethingelse: Ugh, insertional looks nasty. Reckon I'm the other sort. Thanks!
In reply to CT: Thanks CT
In reply to JamButty: I've a tendency to leave things but I guess you're dead right. Ta!
In reply to tony: I'm detecting a trend in these answers. Private it is then. Thanks
yorkshireman - on 19 Mar 2013
In reply to Dan Bailey -
> I suspect that's what it is anyway.
> Would you bother going the GP / NHS physio route (presume that's slow, I've never tried) or just go straight to a private physio?

I've been plagued with this and after an informal diagnosis over a pint with my mate who is in the 2nd year of 3 year physio degree, it is more likely tendonosis (eg. from chronic overuse as opposed to an acute tear), but that's getting pedantic.

We came to the conclusion that there's not much you can do apart from stop running for a while. Some ice will help and I've found it helps after runs. Ibuprofen is a waste of time.

Potentially some deep massaging on what is essentially scar tissue on the tendon can help, but sounds very painful to me at the moment based on how tender they are so I've wimped out (and not managed to find a physio yet).

Please note don't take anything I say too seriously. However seeing a Dr is just likely to result in him/her telling you rest. I've used private physio who are normally much more helpful (as they're taking your money, or BUPA in my case) so they might shed some light on it.
Jim Hamilton - on 19 Mar 2013
In reply to Dan Bailey -

have a go with a foam roller - loads on the net - worked for me
Banned User 77 - on 19 Mar 2013
In reply to Dan Bailey - private physio..
Cam Forrest on 19 Mar 2013
In reply to Dan Bailey - I was very fortunate in seeing an excellent GP who managed to arrange for yet another excellent GP (different practice) who had a specialism in sports injuries to see me. Evaluation, which included ultrasound, showed my problem was tendonosis (not an inflammation). I was given a graduated programme of exercises to do myself which were based on "eccentric heel drop". This wasn't a lot of fun to begin with. I was told that it would probably take months to sort, but to persevere, and the pain would almost certainly quite suddenly disappear. After over six months exercises (including a cancelled trip to Rjukan and a missed ski holiday) sure enough, within the space of a week, the pain went from severe to gone. That was two years ago, and the problem has not recurred.

PM me if you think any more info would be helpful.
MG - on 19 Mar 2013
In reply to Dan Bailey - Try the sports clinic at the Edinburgh University sports centre. They know what they are talking about and are "climber sympathetic"!
Axel Smeets - on 19 Mar 2013
In reply to Dan Bailey -

I've been plagued with this over the past six months. I recently saw a pri vate physio (mate)who has given me some exercises to do and also recommended stretching the calf and hamstrings every day. A thorough stretch too, not just a few minutes messing around. This has made a massive difference already (3 weeks since I saw the physio). You have my sympathy as this appears to be a real pain to get rid of.
wilding - on 19 Mar 2013
In reply to Dan Bailey -

First, I would check your shoes. I got rid of my flats when I developed this condition. I also took up hot yoga, which kept me sane while I couldn't run. Might have helped as well, but who knows.

I can recommend this exercise. The Achilles heel-drop protocol. I looked up the cochrane reports. This is a medical organisation that combines a lot of scientific studies to determine the best treatments. Apparently the heel-drop is the best available treatment - do not do heel raises.

Here is a descripiton, it isnt too onerous

Also here is some background, i just got it from googling. The advice seems legit.

Main thing i have noticed, DO NOT run up hills until you have fully recovered. Also, DO NOT do any speed training. Just become a bumbler for a while.
In reply to Cam Forrest: Thanks Cam, I've mailed you
In reply to MG: I've had good results from them in the past, thanks
In reply to Axel Smeets: I've been following a stretching regime for tight hamstrings for a while but admittedly have got steadily more lazy about it in recent months. Must get me some discipline. Ta
In reply to wilding: I've always been a bumbler, so no change there ;-)
In reply to Dan Bailey - Thanks everyone, some really encouraging replies there
James Hotchkis - on 19 Mar 2013
In reply to Dan Bailey -

Thanks for posting this - I have the same problem and have found the replies very helpful
Paul Evans - on 19 Mar 2013
In reply to Dan Bailey -
Went to private physio, very useful. Lots of different root causes, mine ended up being cured by a combination of stretching and sorting out my posture.

As others have said - PM if you need more details.

wibb20 - on 19 Mar 2013
I had the same condition. A combination of physio and custom insoles from a podiatrist sorted it out - and all on the NHS....
AlH - on 19 Mar 2013
In reply to Dan Bailey - I use a private physio specialising in sports injuries. Some good thoughts here on eccentric exercises and care when stretching
In reply to AlH: Only just seen this. Thanks, plenty to think about there. A bit different to the routine I've been put on by my physio (to date no improvement...hmmm..)
jazzyjackson on 17 Apr 2013
Wainers44 - on 18 Apr 2013
In reply to Dan Bailey - Dan, this is a bit of a thread hi-jack, but I feel your pain....

I am entered in a 100mile walk in exactly 5 weeks time (48hr limit). Training (moorland running up to 20ish K) going really well until 4 weeks ago, then pain....sore tendons, mega tight calf muscles etc. As well as the running I have also walked a total of about 250-300K with a full back packing pack on alternate weekends since early feb.

So I rested from the running for 3 weeks (kept the walking going), just did the stretches and heel drops. Pain went finally, so last weekend tried to go for a run again. 6K along the sand my calf went so tight I could hardly walk let alone run! After 10min of stretching I limped home.

Sod it, no more rest, I am now running (stiffly) every day, kill or cure. Withdrawl from the event is not an option, so given the 5 weeks left, any ideas of exercise/regime I could try....anyone??
ankyo - on 18 Apr 2013
In reply to Wainers44:

That's almost exactly what I did except I was training for a mountain marathon then a road marathon. I managed both, although the MM was in a fair degree of pain.

The tendonitis became chronic tendonitis and I have never run properly again. Every time I try to train again after about 3 weeks it flairs up so much it hurts just walking.

Please be very careful.
cathsullivan on 19 Apr 2013
In reply to Dan Bailey -

I have a tedious history of achilles tendon trouble. I did try my GP years ago, but he just scared me to death by telling me he thought I might have ankylosing spondylitis (which I don't have, luckily for me).

I have heard of people having good experiences of accessing podiatry and physio on the NHS, so I think it's always worth a try. Seems to vary a lot depending on where you live and who your GP is.

Based on my own experience (and no relevant qualifications), I would say that it's best to get proper advice even if it costs money. And don't leave it to get worse 'cos it just costs more and ... well, gets worse.

I've been doing eccentric heel drops as mentioned above but when reading about them I gleaned that they only work with certain kinds of achilles problems and got the impression they could make things a lot worse with other kinds (I think it depends whether the problem is as the insertion point or higher). I've also had success over the years with custom made orthotics, very painful and protracted cross-friction massage on the achilles and deep tissue massage on calves and with using a foam roller on my legs. But my experience and reading has left me thinking that really it all depends on why you have the problem - and it's hard to work that out without consulting somebody who knows what they're on about. For me, it all seems to be about hypermobile joints in my lower body. I have pain in my achilles but have been advised that there's not a massive amount structurally wrong with the tendons themselves (good news) and it's more about other issues to do with my legs and pelvis.

Good luck.

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