Recovering from Achilles Tendonitis

Is that in the opinion of a medical professional?
I actually agree with your advice. Unfortunately, I’m one of those people that have had terrible experiences with PT’s over the years. I actually doubt that many of the PT’s I’ve been to could be classified as medical professionals.

A PT is not the be all and end all. You’re better off consulting an actual specialist and educating yourself before expecting a PT to fix your problems.
Too many PT’s like to pretend they can perform an MRI based diagnosis without the MRI and specialist involvement.

I like the advice and links provided in this thread. They are on target for my situation. They also follow the same theme as the advice from my PT in regards to this ailment.

I had this happen years ago and I think it was from too much heel drop and too much riding early in the spring.

I was off the bike for 40 days to fully recover. Did strength exercises and stretching, ice massage, and used KT tape for a while.

For the mental side, i had to admit to myself that I was 100% injured and 100% NOT RIDING. I wanted to recover and thought of the long game. I’m so glad I did. Missing one season is better than missing them all. I came back and had a decent end of summer stint.

Rest up and fully recover.

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Update: getting recovered. I’m now able to ride at tempo with some hard sweet spot efforts thrown in. Nothing over 5-10 min sustained though. I have been doing 2hr rides on the weekends and riding mostly at Coggan Z2-Z3 wattage. Nothing huge, just mostly aerobic, with a little tempo sprinkled in. Zero tenderness or morning stiffness the day after.

I’m still doing two forms of eccentric heel drops. Straight leg and bent knee. I’m able to do both with 45-55lb of added weight and have noticed a HUGE improvement in calf strength. I’m also foam rolling the tendon and calf muscle 2x daily…this helps A LOT.

My rehab protocol has been all done at home under the guidance of a handful of published articles and some information from phys. therapy articles. Haven’t had to see anyone, yet. This has been a journey as I’m now 65 days post injury.

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KT tape was beneficial for me, whether placebo or not, but really felt like it helped to continue to aid in circulation to that area.

I didn’t read the whole thread but ice massage also helped to break up scar tissue…freeze dixie cups with water and peel them back, then massage the tendon.

all the best to you and hope that you stay injury free

Really battling with this now (last 3-4 weeks).

Been doing the eccentric calf raises. Up to 3x20 with no pain, aiming for twice a day but realistically only once a day. Think its time to start adding some weight.

Frustratingly the tendon is still tight and “creaks” during the day. No pain on the calf raises but walking around the office is still an issue!!

Edited to add: I’ve done some stretching and foam rolling too but probably not regularly enough. Need to up this

A couple of weeks ago it went to see my PT as I started to have problems with my achilles as well.
He told me the creaking is caused by fluid that has gotten into it.

I am not sure if adding weight is the right thing to do, I would consult someone first before doing that.

One of the options I talked about with my PT is to do dry needling on pressure points in my calve to release the tension temporarily but we would work on finding out the causes for the tension to get to a root cause analysis/solution.

Fortunately for me, the stretching and the raises worked good enough for me that we don’t have to dive deeper on it.

Thanks. My PT is so busy he can first see me next week Wednesday and my impatience is starting to get the best of me.

Perhaps I’ll heed your words of caution on the weighting and continue unweighted for now.

I understand, I didn’t have patience with injuries in the past and in the end it took way longer to recover.

So try to have patience and you might only see your PT next week whilst impatience might mean you will see your PT a lot more the coming months.

Update on my condition in hopes that you might find some help as well. I have not seen a professional as a twice daily regimen of 3x30 weighted (35lb kettlebell in one hand) heel drops along with 3x30 standing jumps has really helped the condition.

I can ride hard with no swelling or irritation and the creaking/squeaking that you speak of is completely gone. The tendon feels more elastic now.

Another thing that is essential is rolling the upper part of the tendon or mid-low calf (think just below the calf muscle) and entire calf. I’ve been using a Nalgene bottle for this along with weighting my legs so I can apply a lot of pressure. This seems to really help release the calves.

It has taken a full 12 weeks for things to “heal”, and I’m still doing calf drops 1-2x weekly for maintenance as well as incorporating jumping rope, and some other light plyometric jumps that target the calf and tendon.

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So an update for anyone also battling this kind of thing. Saw PT…he couldn’t treat me until I had an ultrasound so he could see exactly what was wrong.

Ultrasound shows : The sheath around the tendon (peritenon) has a partial tear and the The Kager’s fat pad is inflamed.

PT has prescribed 5 days of anti-inflammatories + no exercise at all (swimming is allowed but no cycling, running, or even excessive walking)

Follow up appointment scheduled for 2 Sept to see hows it done.

I’m hating not being able to ride but happy I at least have a diagnosis and plan to work towards.

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I feel you, I completely tore, snapped, my achillies earlier this year and required immediate surgery. PT once a week, plus my own exercises and rehab in the gym. I am unsure Ill get full movement back again but I can race. Look at your runners your wearing and they are giving you very good support. This has helped me a lot.

Update again. After two weeks off the bike I did 60min this morning on TR (saw physio yesterday) and no discomfort!!!

Taking Wednesday off to let any inflammation go down and then trying again on Thursday and seeing how it goes.

Havent run for two months now and likely to be awhile still before I can

I did the same 3 years ago. Surgery, 2 weeks cast, 3 months boot. I saw a physio 2x a week + did the exercises I was given + got back on the bike 3 1/2 months after the original injury, just spinning, no power for a month. I couldn’t stand on the pedals for maybe 6 months (calf weak) but recovered quickly. My left calf is still a bit thinner than the uninjured one but I have full range of movement and same power as before.

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I had tendonitis approx 10 years ago just from cycling (no running). I had only been riding for a year or 2 and my pedalstroke was irregular + I was a masher. It took 2 months and 3 cortisone shots and some inserts under my cleats to sort out. Been fine since. I am a bit nervous about doing high torque intervals so avoid those but no other effects.

Hopefully people have found this thread beneficial. I wanted to provide some resources that I found useful and helped me with recovery from (self diagnosed) achilles tendinopathy. I read a number of research papers and blog posts from PTs and developed a little protocol based on my findings. I even spoke to a couple of sports PTs via email. I think you could likely save yourself some time and money by doing the same. However, I’m not a doctor and these are just tips/exercises that worked for me.

A Proposed Return-to-Sport Program for Patients With Midportion Achilles Tendinopathy

This article really detailed it all. It hits on all of the points you’ll likely find elsewhere, but offers a nice return-to-sport protocol.

The takeaways are this:

1. Load the tendon eccentrically in the form of heel drops

2. GO SLOW
Each drop should be done on a 3-5 second count. This really emphasizes the eccentric load on the tendon.
3. Start with 3 sets of 15 reps at bodyweight 2x per day
This was actually surprisingly difficult for me for the first week. My calf and surrounding ligaments and tendons were not ready for this and became quite tight. Foam rolling was essential.
4. Progress by adding weight, reps or sets.
The key is to add load so that you’re consistently strengthening the calf muscles and adding load to the affected tendon.
5. Incorporate seated heel raises in addition to the eccentric calf drops.
While elevating my foot 5-7" I would sit on a chair with my hamstring/quad parallel to the floor and a perfect 90º bend in the knee. I used a 35lb kettlebell on the top of my knee and would raise and slowly lower as many reps required until a solid burn in the calf was felt. I wish I had more weight available because 35lb wasn’t enough.
6. Foam roll
This was so crucial to keep the calf loose (not tight) as tightness is the enemy here and can lead to further injury. I would foam roll 2-3x daily. At first most of the calf pain and tightness originated at the Gastroc head up near the knee, but as I continued to do these exercises it shifted to the mid-portion of my lower leg. I found that a Nalgene bottle worked really well. I have the hard plastic version that can bear load. Great little thing for rolling out the tendon and calf.
7. Incorporate proprioceptive exercises
Keep the tendon moving and loose by working on balancing and body weighted proprioceptive movements.


8 Incorporate dynamic exercises
After 4-6 weeks I started jump roping and doing small jumps to load the tendon(s) in other ways. I think this really helped keep things fresh and offer different stress on the affected tendon. Just take it easy. I started with double leg hops (3 sets of 10x) and progressed to single leg hops (30-60 reps, 3x)

Some other things that I did throughout recovery were related to my bike. I dropped my saddle by 1/2", moved my cleats back to the furthest possible point, and continued riding my bike at endurance/recovery pace to keep the tendon used to that motion.

I took a good 12 weeks before the swelling, creaking, and soreness to dissipate. Just keep at it. Be ruthless about recovery and know that full rest can often be the enemy of repair.

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Plus 1 for the top exercise, I found out recently that I cannot stand on my toes on the leg that was hurt. SO now I do a lot of toe raises. This may also help the inflexibility that my right foot has in total.

This week I completed a goal I didn’t think I could, back to deadlifting and a personal best 129kg for 3 reps x 4 sets.

So you can come back from this injury, I am still working hard towards being the cyclist I used to be, going from A, b and now C in Masters has been humbling. Recently set a 30min PB 346w, you have to believe in the process. Re do goals, start small, and continue to build.

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One point i’d add - is that if suffering from insertional tendonitis rather than the classic scenario which is further up, exercise 1 should be done on flat ground, not a step.

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Very similar symptom (bulge and thickening is what I am experiencing since past 1+ year)…yet to find a way out. It flares up quickly even if I do an easy paced 20 Kms.

Had been through a good bunch of PTs and multiple sessions. Doesn’t seem to help. Most of them talk about muscle strengthening, stretching, dry needle and ultra sound therapies. None seem to solve the problem, just handles the symptoms for a short while.

I was ruthless about doing the eccentric heel drops for the full 12 weeks. It became a part of everyday life and eventually my achilles healed. It took the better part of 10 weeks to get to a point where I could really ride hard. It’s a slow going process. Take a look at the protocol I laid out in this thread, I can’t promise it will help you, but I would invest time in trying these exercises and trusting in the process.

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