Advertise on Bikeforums.net



User Tag List

Page 1 of 2 12 LastLast
Results 1 to 25 of 28
  1. #1
    Junior Mint jimn's Avatar
    Join Date
    Mar 2006
    Location
    Brooklyn, NY
    My Bikes
    http://nachlin.com/bicycles/
    Posts
    100
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Prolonged Achilles Tendonitis (tendinitis) and cramped calves

    Never had it before, but I have bad tendonitis of my achilles tendons. It started when I had a long cold. Came back into training, no stretching, did a couple 60-mile rides right off the bat and got tendonitis. No surprise there -- I am an idiot*. The bummer is that it's been 7 weeks and it seems to be getting no better.

    Went to an acupuncturist and he pointed out that my soleus muscles (a muscle in the calf) are more or less permanently flexed. He stuck a pin in them and I could feel them release. The next day it was a bit better for the first time in a month, but now it's back.

    I've tried massaging the calves, which might be helping, as well as ibuprofen, rest (haven't ridden hardly at all for 4 weeks), and icing.

    Anybody here ever had anything similar? What happened? How did you get better?

    I've gotta get back on the bike. Not excercising is driving me crazy!

    Thanks!


    * Not really an idiot, just that I'm new to this kind of training, I'm getting older (35), and I'm a bit too gung-ho for my own good, sometimes.

  2. #2
    Long Distance Cyclist Machka's Avatar
    Join Date
    Jan 2003
    Location
    I ride where the thylacine roamed!
    My Bikes
    Lots
    Posts
    39,939
    Mentioned
    42 Post(s)
    Tagged
    0 Thread(s)
    Go to a Dr, who will then send you to a physiotherapist. Try to get one with ACT (active release therapy) qualifications. If you've damaged your achilles tendons it can be months before they will heal and the quicker you start getting help for them the better.

    And take a good look at your saddle height, if your saddle is too high that's one of the main causes of achilles tendon problems in cyclists. Too low can be bad too, but the recommendation is that if you're going to be cycling in hills it is better to have the saddle slightly too low than too high.

    You might also want to learn how to wrap your ankles for an achilles tendon injury, or find a good brace. 5 years later I still wear my braces on long and/or hilly rides.

  3. #3
    Fattest Thin Man Az B's Avatar
    Join Date
    Sep 2005
    Location
    Directly above the center of the earth
    My Bikes
    Miyata 610, Vinco V, Rocky Mountain Element
    Posts
    2,649
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Stretching helped me immensely. Go easy, yoga is excellent for stretching without damage.

    Az

  4. #4
    Junior Mint jimn's Avatar
    Join Date
    Mar 2006
    Location
    Brooklyn, NY
    My Bikes
    http://nachlin.com/bicycles/
    Posts
    100
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    A few weeks on I thought I'd post my progress as it could be helpful to others.

    I've been to a regular doctor, a Chinese doctor (who does acupuncture and massage), a sports-medicine specialist, and a physical therapist, as well as consulting the internets. I've got overlapping, sometimes contradictory, and sometimes complimentary advice.

    The regular doctor recognized what I have as tendonitis and recommended the standard week of rest, 600mg of ibuprofen 4 times a day. I did this but nothing got better.

    Rest is hard for me, as I tend to be extremely gung ho, and I want to ride my bike as fast as possible until I fall off. Even commuting 20 minutes by bike without getting all sweaty takes great self-control on my part.

    The Chinese doctor pointed out that my soleus muscles, in my calves, were clenched. He stuck pins in me and released the clench (which I could not do on my own) and the next day I felt better than I had been in a while. He is also a lifelong martial artist, and spent 2 hours with me, which never happens with a Western doctor. I am a skeptic when it comes to Eastern medicine, but at the same time, two hours with a seasoned athlete who spends his days analyzing the joint problems of other athletes is going to be valuable. He noticed a lot of detail about how I carry myself, how my posture and muscles are working, and suggested some things I would never expect anyone to address. For instance, I carry tension in my shoulders, and use my lats to pull the tense shoulders down. He suggested not doing that, just letting my shoulders go up if they will. He gave me some good exercises to try to build core strength and balance.

    Still, I did not feel well. I got pain just from standing around, and by the end of the day it was sharp.

    The sports medicine doctor asked a lot of questions about what I do, looked at the shape of my feet, confirmed the diagnosis, and explained a lot. He's also a professor at a local medical school, so maybe that's why he was willing to spend so much time with me. He said that cramped muscles are a normal reaction found near an inflammation. He said I had no bumps on my tendon, which is good. The tendons, and especially near the feet, have bad blood flow and take a long time to heal. He said I could stop taking the ibuprofen, and even start cycling again, gently. His recommendations were to stretch a lot, for more than 45 seconds per stretch, and to ice and elevate the ankles.

    When asked how much time to spend elevating the feet, he said as much as possible.

    He explained that the tendons are like taffy, in that they will stretch slowly with a long gentle pull, not like a rubber band where you can pull as hard as possible.

    He cautioned that even after the pain goes away, I should take it easy for 4 weeks. The tendons will not be fully healed, and this is when everybody tends to re-injure themselves. Given my overenthusiastic nature, I will need to be careful about this.

    The physical therapist told me not to start cycling again.

    She could feel the swelling in my tendons. I had biked to her office, and so they were probably a bit more swollen than usual. She is using ice, electrical pulses, and massage. She points out that I am not flexible. I need to stretch a lot. I can not touch my toes. This may be the root of the problem. Over the winter I got even stiffer. A lesson there is that stopping exercising is a bad idea. Also, I need to stretch.

    Hopefully, that's useful to someone.

  5. #5
    Senior Member dagna's Avatar
    Join Date
    Jul 2005
    Posts
    690
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I may have missed you mentioning if you tried it or not, but one of the standard things runners do for achilles tendinitis is put heel pads in their shoes (all shoes, not just their running shoes). Dr Sheehan, the famous medical running guru from the 70s, recommended putting in multiple spenco heel pads, up to an inch worth. Anything that releases the tension on your tendon for extended periods of time will help give it a respite to heal. When I had achilles tendinitis that wouldn't go away, I finally started wearing 3-inch high heels to work every day, and the tendinitis was gone in a few weeks. But, guys probably can't get away with that particular treatment .

  6. #6
    Senior Member
    Join Date
    Nov 2004
    Posts
    372
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Consider moving the cleats on your shoes all of the way back (towards your heel). That decreases the amount you can use your foot as a lever, which eases everything from the foot to the knee.

    Through an incorrect pedaling technique (dropping my heel) during a double century last year I bothered my right achilles tendon. Previously I had no issues with either achilles. One thing I did was to move the cleats.

  7. #7
    Junior Mint jimn's Avatar
    Join Date
    Mar 2006
    Location
    Brooklyn, NY
    My Bikes
    http://nachlin.com/bicycles/
    Posts
    100
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    @dagna: good advice. My doctor had recomended that, but I forgot. I'm wearing them now and there is a difference in how long I can stand or walk around.

    @ronsmithjunior: Yes, I already have them all the way back, but otherwise this is what I would do. What do you mean by "dropping my heel"? You mean that your heel was lower than your pedal?

    For those following along, currently the pain is better but not much better. Rest, elevation, ice, and stretching is the current regimen, as well as several insoles and heel pads in my walking shoes.

    I have not been on my road bike in 2 months. Lame! (Literally)

  8. #8
    Senior Member
    Join Date
    Nov 2004
    Posts
    372
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by jimn
    @ronsmithjunior: Yes, I already have them all the way back, but otherwise this is what I would do. What do you mean by "dropping my heel"? You mean that your heel was lower than your pedal?
    Right, my heel was lower than the pedal spindle. Think of the right angle your foot makes with your lower leg. Anything where the foot is "up" from this position can be considered dropping the heel. A lot of people do this naturally, so it is not a bad thing in itself. Some people keep their foot positioned the same as they pedal, some people "wave" their foot up and down. I have heard good and bad things about both. If you tend to keep your foot angle the same, and then for some reason change it (I got sloppy because I was pushing too hard), you could have problems.

    To see somebody with a lot of heel drop, take a look at Floyd Landis during Stage 17 of last year's TdF. He had a huge of amount of drop when climbing. Obviously he knows what he is doing.

    Btw, even with your cleats back all of the way you may be able to do better. When changing from my old shoes to my new ones I noticed that the slots did not match up. With my old shoes the cleats looked to be fairly far forward. However, with the cleats on the new shoes they looked to be fairly far to the back. This is with the same position relative to my foot. Some riders will drill holes in the bottom of their shoes to move them even farther back.

  9. #9
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I am starting to deal w/ this now. When I mention the calf-cramping, everyone says HYDRATE!!!! Fair enough, I don't drink much but coffee... The achilles issue, which coincides w/ both an interruption of general exercise and attempts to start running, people are saying I need more ankle support, even on the bike.

    So I got some inserts for my bike shoes (and moved my cleats back and lowered my saddle a bit). Meantime, the running is going on hold, and the biking is getting cut back to pretty much my commuting minimum, and I'm looking at all my footwear for how much arch support it is giving me (not much in most any of it). Potentially more inserts on the horizon...

    Just taking the weekend off from biking, my achilles are not throbbing, so that seems like a good start.

  10. #10
    Senior Member
    Join Date
    Sep 2003
    Location
    SoCal
    My Bikes
    Trek7300, GT Palomar
    Posts
    271
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Took me about a year to get over my tendonitis! Take it easy for a long while.
    I love to commute and ride. Keeping a positive focus.

    http://tickers.TickerFactory.com/ezt...UFk/weight.png

  11. #11
    Senior Member
    Join Date
    Apr 2006
    Location
    Ohio
    My Bikes
    vintage Raleigh
    Posts
    654
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Tendonitis of any sort is very frustrating, I know. I have been dealing with Bilateral Hamstring Tendonitis which is mainly affecting me behind the knees thus being from overuse to the hamstrings. I think many cyclists don't realize how much hamstrings are used in cycling. I used to think it was all quads until a sports medicine doctor and PT informed me otherwise. Yes, backing way, way off the intensity is required. I was dealing with mine at first toward the end of last season so was able to use the winter months to help recover. Basically I did all recovery rides no more than three times a week. Yes, it was boring but it had to be done. Now that I'm back on the road I still feel it coming on at times. I feel like a junkie from all the ibuprophen I take. I found out from the threapy how much stretching I was missing out on. I believe that correct stretching is the key to prevent injury and as someone above already mentioned, yoga would help for the stretching. Now when I feel the "twinge" coming on, I can reduce it with a strech here and there on top of my regular streching routine. I used to be able to only bend over and reach to the front of my knees (while not bending the knees) and now I can bend over and touch the floor. It really helped me.

  12. #12
    Junior Member
    Join Date
    Jun 2007
    Posts
    16
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I've had the same problem for over 1 1/2 years now and I was even off of my bike for almost three months. The two things that I've found that work the best are: Absolutely NEVER walking barefoot and doing negative sets with my calves. To accomplish the first I wear sandals around the house and don't take them off until I'm sleeping. For the second one I stand on the side of a step with my calf raised and slowly lower it. Then I use my other foot flat on the same step to push back up using quads/hamstrings. I was told by my PT that doing this type of excercise creates far more benefit than the standard calf raise. There was an article online somewhere last year that had a study on this and the numbers were amazing how much better this type of lift was for achilles tendonitis than any other.

    I hope this helps and good luck! Achilles tendonitis is a horrible injury and it definately takes time, just be careful and try to find some things that work well for you.

  13. #13
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by acro
    To accomplish the first I wear sandals around the house and don't take them off until I'm sleeping.
    I felt a difference doing that yesterday. Wow!

    Quote Originally Posted by acro
    For the second one I stand on the side of a step with my calf raised and slowly lower it. Then I use my other foot flat on the same step to push back up using quads/hamstrings.
    I'm trying to picture this. Are your heels hanging off the steps? Do you have only one calf raised at first? Do you lower it so your formerly raised heel is now below the step, and the other foot remains level the whole time?

  14. #14
    Junior Member
    Join Date
    Jun 2007
    Posts
    16
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    One other thing that I almost forgot to tell you about since it's been in my shoes for so long is a heel lift. If you noticed a difference with wearing sandals, you'll definately feel a difference within a week from doing that. Mine is only about 1/8-1/4 inch tall but it works great.

    When doing the negative calf lifts just make sure you never push up with either foot. I have no idea why it works but BELIEVE me, it made a huge difference over doing regular calf lifts. You can do them by pushing up on a rail to get back to the starting point or the way I do them (sorry it's really simple but I can't think of a better way to explain it): 1. Put your foot on the edge of the stair with your heel high (not weighted yet). 2. Put full weight gradually on your foot. 3. Once all of your weight is on one foot, slowly lower it until your heel drops below the step. Never relax your calf fully, otherwise you may overstretch your achilles. You do want to feel some stretch, just not your whole weight bouncing on your achilles. 3. Then place your other foot on the step flat footed so you don't use that achilles either and push up to return to the starting point.

    I started doing this 3 X's a day (1 hr after I woke up, lunch, and sometime in the evening) with 6-10 reps each and it worked great. I did normal calf lifts for about two months and it seemed to make it worse so that's why my PT made me switch. Let me know if you have any other q's!

  15. #15
    Gios my baby hiromian's Avatar
    Join Date
    Dec 2005
    My Bikes
    Gios 96, Mercier 72, Peugeot 74 X 2, Sears full suspension High rise banana seat, Kona 94, CCM Rambler 70s.
    Posts
    1,135
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I had this bad in one tendon. I commute by bike to work and train and race.

    Here is how I fixed it.

    1. Moved cleats back,
    2. Moved seat down...Tendonitis was on my shorter leg,
    3. shimmed my cleat 1/8 inch on my short leg,
    3. Went to and followed my physiotherapist instructions.

    Physio consisted of 2 different stretches held for 60 seconds each twice a day and calf strengthening exersises twice a day for 6 weeks.

    Solutions worked.
    "Aiyah...Oh no"

  16. #16
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Finally saw MD today. He thinks podiatrist is overkill but that I could use insoles (superfeet). He recommended p/t to make sure I'm stretching properly, so starting that next week. The p/t has good rep w/ bikers more athletic than me, so I'm looking forward to that. Hopefully get some more help dialing in saddle and cleat location.

    I am still not sure what to make of the leg length discrepancy. I've actually got my right leg pretty happy w/ my current location of saddle and cleat. The left (shorter, or lower hip anyway) one, I'm still moving the cleat around (farther back than the right one but not all the way back yet). Hopefully p/t would recognize, upon closer inspection, if a podiatrist really would be the way to go.

    Was that 1/8" shim really about the length of your leg discrepancy? Chiro gave me a 7mm heel insert for my downhill leg.

  17. #17
    Junior Mint jimn's Avatar
    Join Date
    Mar 2006
    Location
    Brooklyn, NY
    My Bikes
    http://nachlin.com/bicycles/
    Posts
    100
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Hey acro, sorry to be obtuse but I still don't get it. Do you mind explaining a third time?

    Thanks!

    Jim

    (on my 12th week of this tendonitis)

  18. #18
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    PT thinks I shouldn't mess w/ bike at all (saddle height, cleat location), figuring I will be all thrown off when I do recover and hurt my knees. She is focusing on hamstring/calf stretches for now, and is appalled at what she called very very very flat feet. That's an escalation in description of my foot shape (or lack thereof). She figures all my problems come from my feet. I'm curious to find out. I hope she's completely correct.

    It's funny how she is so up on the biomechanics, I had suspected the MD would not be, and I was right, but I needed to get a referral from him (which he was eager to do, ship me off to someone who he knew would actually know the details of this stuff beyond just the theory).

    And, oh yes, there was an interesting question on the paperwork for the PT place, do I learn best by listening, reading, or doing? And generally I am an academic of sorts so reading gets me pretty far, but I definitely checked 'doing' for this, 'cause that's where I get the actual muscle memory from...

  19. #19
    Junior Member
    Join Date
    Jun 2007
    Posts
    16
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Here's one of the studies on the eccentric calf raises for achilles tendinosis. I'm trying to find an article that explains it better than me but I haven't had any luck yet.

    http://www.evidenceinmotion.com/CAT/...sisCAT8-05.pdf

  20. #20
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Had my 2nd PT visit today. She is mostly just having me do hamstring stretches at home, and focusing on my posture and stuff to do w/ flat feet, pronating, yadda yadda. Brutal, *brutal* myofascial release on my calves during our visits. Holy cow.

    (I just found that link through google; have to laugh at penultimate paragraph. I think I can laugh again, an hour or two later...)

    Anyway, the unanswered question is what happens to my stretched, floppy achilles tendons after my incredibly tight calves and hamstrings are finally loosened up?

    And, on the bright side, I haven't had any cramping in calves or hammies since I started this.

  21. #21
    M_S
    M_S is offline
    All Mod Cons M_S's Avatar
    Join Date
    Dec 2006
    Location
    Face down in a snowbank
    My Bikes
    K2 Enemey Cyclocross franken build; Redline D660 29er, Volpe SS Cross
    Posts
    3,694
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I had Achilles tendinitis about a year ago. It put me out for an entire season of track

    All I can say is take it slow. Fortunately, mine does not seem to bother me at all when cycling, only during running. It's good that you seem to have caught it early. Accept the fact that you will lose some of your training...maybe a lot of it. Nip this thing in the bud (do everything your PT tells you to, mine had me doing exercises) in order to avoid problems later on. It sucks, I know, but you'll pull through.

  22. #22
    Kwisatz Haderach fillthecup's Avatar
    Join Date
    Oct 2005
    Location
    central Illinois
    My Bikes
    1998 Nishiki Montana, 1972 Schwinn Super Sport, 2007 Trek 520
    Posts
    160
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    My contribution is to say, "SUCK IT UP AND RRREEESSSSTTT!" Sure, you WANT to go forth and kicketh ass. You've got the chutzpah, the cajones, the rama-lama-ding-dong. But SHOULD you?

    Being gung-ho is great, but do yourself a favor and give your body the time it is TELLING you it needs. Sometimes it takes MORE (sorry for so many caps) discipline to go easy than it does to over-extend ourselves. Suck it up by taking it easy. Massage, stretch, light exercise, repeat.
    Attack inactive, passive healing with the same vigor you'd attack hardcore training.

  23. #23
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by acro
    Here's one of the studies on the eccentric calf raises for achilles tendinosis. I'm trying to find an article that explains it better than me but I haven't had any luck yet.

    http://www.evidenceinmotion.com/CAT/...sisCAT8-05.pdf
    My PT pulled this exercise out for me yesterday, 3rd visit I think in 3 wks (4th is Friday). Basically she had me stretching to loosen up my muscles for 3 wks and then gave me this exercise to start to strengthen my calves. For me, it is basically starting flat-footed, going up to tip-toes, then lifting one foot off the ground and lowering the other foot back to the ground. No stairs (I think I was confused by your earlier stair description 'cause I've seen stretches using stairs to stretch the foot below flat). There is some weight-shifting for me (use the foot that will be off the ground to lift more of the burden, since the lowering is the actual exercise I am aiming for, to be focused on the um gastrocnemius I think it is).
    Last edited by HardyWeinberg; 07-04-07 at 10:17 AM.

  24. #24
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by fillthecup
    My contribution is to say, "SUCK IT UP AND RRREEESSSSTTT!" Sure, you WANT to go forth and kicketh ass. You've got the chutzpah, the cajones, the rama-lama-ding-dong. But SHOULD you?
    And that, too. PT wants me to cycle through 20 increasing amounts of those calf lift thingies (stepping up only when I can do each step w/ no symptoms the next day) before I start thinking about running again. But it's so nice out!!!

  25. #25
    GATC
    Join Date
    Jul 2006
    Location
    south Puget Sound
    Posts
    6,620
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    So, at the end of my PT, I am now ~halfway through those eccentric calf lift thingies she gave me, and I have come to one particular conclusion: it's a good thing I went to an expert, i.e. PT, 'cause she figured my achilles tendons were loose and floppy from too much flexing in the past, so my muscles were screaming tight but I never lost any flexibility 'cause my tendons gave a long time ago. The calf stretches I was trying to help my suffering achilles were actually aggravating the problem by continuing to stretch/stress the tendons themselves, and not loosening my calves much at all.

    The PT has had me focus on stretching my hamstrings, reducing their pull on the calves, so the calves are hopefully loosening up from the other end (in addition to the brutal manipulation of my calves she was doing, I mean; and focusing on keeping my heel at ~90 degree angle to shin unless there's a good reason).

    I don't really have any assurance that my tendons will tighten back up again so I can more directly stretch the calves, so slow and steady it is for the foreseeable future. The eccentric calf lifts should strengthen some muscle(s) in my calves so they may take up some tendon slack, otherwise it's just wait and see.

    I am going to try resuming running in Aug (after having cycled through the calf lifts w/ increasing weight and reps), 15 min every other day for... well, increase after 2 wks if I can keep it up that long. If I can keep it up, could be up to some 30 min runs by September.

    All the while, I've maintained my minimal level of utility cycling, 60-90 miles/wk, so the injury hasn't completely crushed my lifestyle, like it could have. Just no weekend or lunchtime rides, or am or pm commute extensions. I no longer get achilles tension from biking home (even pretty vigorously). I ice my ankles more after the calf lifts than I do after bike rides.

    So, some progress is happening, anyway.

Page 1 of 2 12 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •