bicyclequeen

OK fellow bicyclists. I have a raging case of insertional Achilles Tendinitis (tendonitis?). What do I have to do to get rid of this? My usual routine: from sleeping to getting out of bed > I warm up my calf with a heating pad then gently rotate ankle; after about 15 minutes of warming up I put my feet and legs over the side of the bed and Gently move my legs and calves and ankles to get a blood flowing. Sometimes I use NSAIDS. I just came off of three weeks of Celebrex use thinking all was fine. Then the Celebrex wore off and I was back at square one. Sometimes I wear an ankle lace up brace. I always ice it as soon as I go to bed. I take ice to bed with me and leave it at the foot of the bed and just lay my foot and Ankle on it as I sleep on my side. I have a night sock (Stratford). Not sure about using it and how to use it. I have the back of my tennis shoe cut out. I am wearing moderate shoe lifts on top of the inserts in my tennis shoes. I see my foot doctor again in about six days. What am I missing here folks? Thank you in advance for any responses.

hockey

Strassburg Sock and foam roller. Worked great for me.

Wildwood 

Youtube is your friend for taping techniques.

FrenchFit 

Eccentric heel drops and dynamic stretching before and after workouts. It's a long road to full recovery.

Bassmanbob

I'd get a Night Splint instead of the Strausberg sock. It's much more effective and your medical insurance may cover it too. Heel lifts in both shoes to relieve the pull of the Achilles' tendon temporarily. Stretching the calves and the essentric strengthening exercises mentioned above are great too.

Slow and steady. This can be a long recovery.

Retro Grouch 

You're going to a doctor who spent 8 years studying this stuff and you're asking for advice from a bunch of yahoos on the internet.

Back in my marathon running days I messed up my achilles pretty badly. It got so that I could hardly climb out of my car after driving to work. My doctor said he could fix mine with surgery but the recovery process seemed more appropriate for somebody who couldn't walk and I was only at the point where I couldn't run. I solved my problem by switching back to bicycling. That was 30 years ago and my ankles still aren't "right" today but at least I can still walk normally, I just can't run anymore.

bicyclequeen

I'm asking people who do my favorite activity in the world---well---almost favorite activity. What I want to do is get back to bicycling---and who better to ask than a ragged, motley hoard of fellow bicyclists, some of whom have most certainly suffered from the same malady.

bicyclequeen

Do I do these through pain?

bicyclequeen

I have a strassburg sock, but how much do I dorsaflect the foot/ankle. I don't want to pull then tendon and injure it.

JerrySTL

My wife messed up her Achilles tendon last month. X-rays showed what might be a tiny tear, but mostly it was tendinitis. The doctor made her wear a heavy boot to immobilize the ankle. He also gave her an excuse to not work for two weeks and told her to stay off her feet. After that he gave her some heel cups and release her back to work. Now a month after feeling the pain, she is allowed to slowly start training again for a half marathon in April. That is with the understanding that if there is any, ANY, pain in that area, she stops training and see the doctor again.

My youngest daughter's competitive bike racing was all but ended by an Achilles problem. She tore it rollerblading and had to have it immobilized for 6 months.

What I'm trying to say is this: short of surgery, the only way to get rid of tendinitis is to quit doing what caused it until it's healed. Then make adjustments so it doesn't come back again.

hockey

Begin with a very gentle pull. Increase slightly night after night. Do not overstretch at any time.

Retro Grouch 

It has been 30 years so I assume things are different now but my surgeon told me the recovery would involve 6 weeks in a hip length cast followed by 6 weeks in a knee length cast followed by physical therapy. Then they'd do the other leg. You can see why I didn't want to do that if there was anyway that I could avoid it.

FrenchFit 

I am a certified non-medical Yahoo! in his 60s, but I have returned to hill, interval & LSD running after a little educated self-therapy. I am aware that your issues aren't my issues, but this is what worked for me: Some pain doing EHD is necessary, you are actually creating and aligning micro-tears as I understand it. But I stopped if it reached the point where I felt I was causing any real damage. There were some mornings where I could only do 2 or 3, then came back to it later to do another 5, etc. Eventually, you reach the point (over months) where it's simply no big thing, you add a dozen to your dynamic warm-up for routine exercise or add them to other stretches. Note: Watch out for minimal shoes, flipflops, bare feet, etc... unless you are a youngin' you need the heel elevation until the area rebuilds strength and elasticity. I would also caution against putting weight on the back of your heel, like sitting back with you foot elevated on a desk or firm ottoman.

Yahoo! out.

fietsbob

BQ <gender assumed Female> may have worn the Stiletto heels, shoes too much,

and the shortened tendons are now stretched wearing flat & sensible bike shoes .




Doing Physical Therapy & Yoga for gentle stretching?

Null66

My posterior chain gets quite tight...

epsom salt baths seem to help a lot.

BlazingPedals

Make sure you warm the tendon, then stretch. You can use a towel around the ball of your foot and pull up, or you can do heel drops on a stair. Anything that tends to shorten the tendon (toe points for instance - or heel shims) is BAD. You need the tendon to be longer and more supple, not shorter and tighter.

You also need to rehab the tendon by strengthening it. I did it by reverse heel lifts on a stair. Stand on a stair facing the up direction, with both heels hanging off the stair. Using both ankles, raise your heels up. Then, using only the problem heel, slowly lower your heel down until it is stretched. Repeat. I did 3-4 sets of 20 per day.

On the bike, drop the seat a bit and make sure you SPIN don't mash. In fact, try to pedal heel-down, as much as you can without turning your pedal circles into total squares.

John E

I think the yahoos on this site are giving pretty good advice here. My primary consideration in selecting health insurance is freedom of choice, and one of my prime criteria in choosing a health care provider is medical conservatism. Surgery can admittedly work miracles in some cases, but I generally view it as a last resort. Likewise, I am not big on steroids and certain other medications, although I do eat a fair amount of turmeric and other anti-inflammatory spices.

I have had waterfall area tendinosis of the right Achilles for almost 5 years, but I have successfully self-managed it to where it now only rarely bothers me and almost never interferes with my normal activities of bicycling, fast walking, and a bit of jogging on hard sand or similar cushioning surfaces. I do foot flex-extensions on a machine at the YMCA, and I do careful hamstring and calf stretches. My younger son, who is three months into a Dr. of Physical Therapy program, has been a great source of advice, as well. Three years ago I could not lift my entire body weight by standing on just my right foot and then extending the foot -- now I can easily do so perfectly normally, with little, if any, pain or discomfort.

Since I have also had a bit of plantar fasciitis, I wear Dr. Scholl's cushioning inserts in all of my shoes. The inserts add just a bit of lift at the heels, which, as others noted, takes some of the stress off the Achilles.

CrankyFranky

So OP, do tell what transpired at your last doctor visit?

bicyclequeen

My doctor's appointment is on Friday, tomorrow. The tendon has settled down a little, but I am just walking around. I got some nice heel lifts from the local "foot solutions" store. I am just being conservative until talking to the doctor and probably advised to do PT. While in bed, I ice it while I am sleeping (on and off) and before I get up for the night (I work nights), I warm the calf up with a heating pad and start moving the foot around. I am afraid to do anything else. I have a professional method of icing due to my chronic tendon problems. I take a small beer cooler to bed with me (no beer, but thanks for asking....) with two icing bags, and three coleman frozen ice packs. I ice when I first go to bed, and then when I wake up occasionally, I get some more ice out, and ice the area. This ensures I always have ice in bed without having to get out of bed on my unwarmed-up ankles. Then before I get up to go to work, I warm up the calf with a heating pad, move it around, and then put my shoes on and go about my business. I have had personalized shoe inserts for several years. They were form fitted for my feet and cost around $300.

BlazingPedals

I'm sure you've looked it up, BQ, but insertional Achilles tendonitis is different from the 'regular' tendonitis we're used to dealing with. I guess icing would be indicated for reducing inflammation, but I'm not sure that icing it multiple times during the night is accomplishing anything. I hope you report back with your doc's recommendation because you've got me curious.

MoAlpha

Do people still use eccentric resistance exercise for tendinosis?

BlazingPedals

I did when I pulled my Achilles. Insertional isn't injury-related though.

MoAlpha

I thought it was good for chronic conditions, as well.

bicyclequeen

Yes. I have insertional achilles tendonitis. People have been talking about eccentric heel lifts etc. What I read in a runner's world (on the internet) was for insertional achilles tendonitis, you are supposed to do modified eccentric heel drops. Which go like this. Step up on something (i use a large book) using my good leg/ankle> lower myself on injured ankle (using a heel drop)>back up on good leg, drop down on injured ankle X 15 3 sets. It is supposed to elongate the tendon etc. I was using it for a while. I want the opinion of a physcial therapist doctor now.