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Dr "No bike riding", me "So how many miles per week is that?"

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Dr "No bike riding", me "So how many miles per week is that?"

Old 07-21-16, 02:24 PM
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Podagrower
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Dr "No bike riding", me "So how many miles per week is that?"

I've apparently decided to add some excitement to the summer training for a September century (I'm going mostly to be a wind block). It was going to be easy, I did a solo century in June, I've been riding metric centuries pretty much every weekend, averaging 100 miles a week. And then Tuesday morning I woke up with a serious ankle pain, it only got worse and Wednesday morning I hobbled into the Drs office to learn that my "good" ankle (the bad one already has tendinitis and bone spurs) now has Achilles Tenditis.
I figured if he had the balls to tell me no riding, I could have the balls to ask how many miles per week that equaled; turns out it's zero miles. So, I'm off the bike, earning a big fat donut on Strava this week, I'm taking steroids and not biking, I'm not sure that was a well thought out plan on his part-I'm already suffering withdrawals. I have a follow up appointment on Tuesday for the Dr to evaluate my ankle and for me to evaluate his plan for my riding.
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Old 07-21-16, 02:26 PM
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Six Weeks No Miles....
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Old 07-21-16, 05:28 PM
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OK, this is one of those areas where you REALLY need to let your tendon heal up because if you aggravate it, it'll be even worse. Don't be a tough guy. See if you can swim or something in the interim, you can log that on strava now.
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Old 07-21-16, 06:33 PM
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Originally Posted by TrojanHorse View Post
OK, this is one of those areas where you REALLY need to let your tendon heal up because if you aggravate it, it'll be even worse. Don't be a tough guy. See if you can swim or something in the interim, you can log that on strava now.
Agree 110%. Focus on the healing now, else you'll have it with you a long time.
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Old 07-22-16, 06:17 AM
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Originally Posted by Podagrower View Post
I've apparently decided to add some excitement to the summer training for a September century (I'm going mostly to be a wind block). It was going to be easy, I did a solo century in June, I've been riding metric centuries pretty much every weekend, averaging 100 miles a week. And then Tuesday morning I woke up with a serious ankle pain, it only got worse and Wednesday morning I hobbled into the Drs office to learn that my "good" ankle (the bad one already has tendinitis and bone spurs) now has Achilles Tenditis.
I figured if he had the balls to tell me no riding, I could have the balls to ask how many miles per week that equaled; turns out it's zero miles. So, I'm off the bike, earning a big fat donut on Strava this week, I'm taking steroids and not biking, I'm not sure that was a well thought out plan on his part-I'm already suffering withdrawals. I have a follow up appointment on Tuesday for the Dr to evaluate my ankle and for me to evaluate his plan for my riding.
Tendons need rest or the take forever to heal.

Steroids? That is so 90s, all the cool kids are on EPO these days...
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Old 07-22-16, 07:46 AM
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Time to work on core.
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Old 07-22-16, 08:35 AM
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I'm not a doctor so take this as you will. That said, how is bicycling any worse than lots of other things you could be doing. Walking on it is more stress than a bicycle puts on it. "Working on your core" could put more stress on the ankle than riding.

Personally, I'd find a second opinion. Some doctors are quick to tell patients not to ride a bicycle because they don't understand that bicycling is about the least stressful exercise on joints there is. You aren't impacting the joint like you are when running or walking.
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Old 07-22-16, 08:56 AM
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Agree that getting a second opinion would be smart, preferably by a sports medicine DR.If rest is needed take it and get better.
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Old 07-22-16, 08:58 AM
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Old 07-22-16, 10:42 AM
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As I sit here stuffing my face I can only think, what excuses do I have for not riding this week besides my work travel and it being 105 heat index since I got back from my work trip. I am shaking like a drug addict waiting to ride again. I would hate to have someone tell me I couldn't. With that being said, heal up, you'll be back sooner than you think.
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Old 07-22-16, 11:29 AM
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Get a second opinon, sure but take the advise, you might/could/will make it much worse.


I have a good friend who had a medical issue, doc said no riding, he said screw that rode, made injury much worse. Instead off 3 weeks of the bike he spend 14 months off the bike and a surgery because he was stubborn. Now he is not able to ride a road bike either, saddle issues so he now rides a cat trike.....he learned the hard way.


My point is head your docs warnings 6 weeks is a long time but it might be worth it in the end.


good luck, heal fast!!
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Old 07-22-16, 06:45 PM
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I feel your pain. I had abdominal surgery on the 5th and cannot ride for four weeks! I'm so tempted because I feel about 99% but I'm sticking with doctor's orders since I don't want to chance damaging my repairs and starting over.
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Old 07-22-16, 07:14 PM
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Achilles issues in your case might be traced back to your bike fit, and particularly that your saddle might be too high. Maybe the doctor is right in this case, and instead of complaining, you should take the opportunity to identify why your Achilles is bad and rectify it, so that when you do start riding longer distances again, you won't have a recurrence.

PS: I am coming from this as someone who has had Achilles issues because of too high saddle in the past. It took both ankles a long time to (a) come right and (b) reduce the scar tissue around the tendons.
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Old 07-24-16, 08:18 AM
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My Achilles issues came from years of wearing high top boots as a construction worker, they made my ankles feel well supported during long days of ladder work, but left my ankles no room to flex and work as intended, weakening them over time. The Achilles issue in my "bad" ankle is what got me into biking for exercise.

I didn't discuss duration of time off the bike with the Dr, his concern is that I could rupture the tendon in the state it was in on Wednesday. It is a lot better after 4 days of steroids (I can almost walk normally), it doesn't hurt to step on, but I can feel how tight the tendon is in my calf now. I've started stretching it slowly with lots of low intensity reps and I'll find out Tuesday morning what the future holds.
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Old 07-24-16, 09:52 AM
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In my experience you're lucky if it's just six weeks. For me it has been an issue that I need to manage for about 10 years, with periods of a month to 6 weeks of no sports regularly. I got it under control now, but that's with daily 15 seconds stretching and walking in real boots, with a heel. Those boots were my own idea, but the doctor thought it was a good idea and said I should give it try. The idea is that if I take a relaxed stroll on those 3 cm heels, the tendon is relaxed through the angle of the foot with the calf, so it's movement, but without stress on it. I still wear sneakers sometimes, but a lot less and the ones I wear now have a little heel on them also. And don't wear special shoes or insoles during sports, it's about the relaxing of the tendon after and before.

There are also cushions or wedges you can put into your shoes, but those are bit tricky, because they can make your feet tilt a bit from left to right or right to left, and that's really bad for the tendons. It makes them rub against bone and that will worsen the problem.

So if I were you I would obey the doctor and prepare for years of paying attention to the state of your tendons, and consider some questionable fashion choices.
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Old 07-24-16, 11:24 AM
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Definitely give it a rest for a few weeks. But when you come back, I agree to check your bike fit. As previously mentioned, make sure your saddle isn't too high. Next, slide your cleats farther towards the back of the shoe to take pressure off the Achilles by reducing the "ankling" motion. If you have Speedplay pedals, you can get a fore-aft extender base plate to move even further back. Conventional wisdom has always been that the pedal spindle belongs under the ball of the foot, but with rigid sole shows we now have that is less important. Some fit experts even advocate a mid-foot cleat position:
https://www.stevehoggbikefitting.com...leat-position/

I don't go that far, but find that running my SPD-SL cleats at the back of the slot of my Pearl Izumi shoes helps keep Achilles pain down.

You likely will also need to move the saddle forward and down slightly to compensate for the cleat position change.
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Old 07-25-16, 09:04 AM
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Originally Posted by cyccommute View Post
I'm not a doctor so take this as you will. That said, how is bicycling any worse than lots of other things you could be doing. Walking on it is more stress than a bicycle puts on it. "Working on your core" could put more stress on the ankle than riding.
Tendinitis is a repetitive stress injury. It's a whole different thing. It's not a few incidents of large stresses, it is many repetitions of small stresses. It's usually something like building up scar tissue on the tendons or something and then when they get inflamed they don't fit where they're supposed to. You don't really have any choice but to let the inflammation go down or you damage them more.


RSIs never go away, you're stuck preventing flare ups and avoiding use when you can't.


I'd agree that it is likely that something in the OPs bike fit is off if he's doing something to his Achilles, but I'm also not a doctor, just someone with tendinitis.
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Old 07-25-16, 04:55 PM
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Originally Posted by kc0bbq View Post
Tendinitis is a repetitive stress injury. It's a whole different thing. It's not a few incidents of large stresses, it is many repetitions of small stresses. It's usually something like building up scar tissue on the tendons or something and then when they get inflamed they don't fit where they're supposed to. You don't really have any choice but to let the inflammation go down or you damage them more.


RSIs never go away, you're stuck preventing flare ups and avoiding use when you can't.


I'd agree that it is likely that something in the OPs bike fit is off if he's doing something to his Achilles, but I'm also not a doctor, just someone with tendinitis.
I'm not unfamiliar with tendinitis. I also know that walking is just as repetitive as cycling and hurts much more when tendinitis does flare up. Tendons are also required for "working on the core" which I doubt his doctor would suggest either.

So are you suggesting that Podagrower simply stop doing anything until the tendinitis stops and go on bed rest? I doubt that's much of an option nor would it be good for him. I would still suggest a second opinion for someone who specializes in sport injuries than just a GP.
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Old 07-25-16, 07:30 PM
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I had critical Achilles Tendon problems a few years back. This was caused by an improper shoe fit, and the podiatrist said about 70% of the tendon was gone.

I did PT, a raised heel support. and a lot of stretching, but the main thing beneficial was acupuncture - specifically to get the blood moving in the tendon - which has very little blood flow to start, and is greatly decreased with the tendinitis. It was amazing, as each visit we could see the needles move in and out more easily and measure progress that way.

Today - absolutely no problem, full range of motion, no pain, no anything. I do long hikes, swim, 40 mile bike rides, etc.

I am a "senior senior "
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Old 07-27-16, 01:28 PM
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Originally Posted by andr0id View Post
Sallah, I said NO camels! That's FIVE camels; can't you count?" ―Indiana Jones.
They missed a bet leaving him out of the 4th movie, perhaps as the wedding planner or something
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Old 07-27-16, 09:52 PM
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I can tell you, between my own heel spur, Haglund's Deformity, gout and now my remaining original knee issues, Have limited my return to cycling. It took me three years after breaking my back 5 years ago, to even get back on a bike. I managed to get quite of of riding last year, but gout became a problem. But I got back on a bike indoors. Then the heel spur became a problem. Six weeks in a boot was little help, and I am looking at possible surgery. Well, it never rains but pours for me. My remaining knee has decided it doesn't like me any more. I had my left knee replaced nearly 6 years ago, and have had great success. So, I am not afraid to do it. But would rather not if I can avoid it. Already been through the gel injections, and next is scoping. So, yeah. I understand the frustration... More frustration, since I don't currently ride outdoors, my wife won't allow any new N+1...
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Old 07-28-16, 07:23 AM
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Officially released to ride (with the warning that if I hurt myself I could be looking at surgery). After 4 days of steroids I didn't have pain when transferring weight on/off my ankle, but I still had a limp because my AT had gotten so tight. I've been doing slow, easy stretching and walking is almost normal again. Planning to commute tonight and in the morning, debating on riding platform on that side vs. turning the clip tension all the way down.
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Old 08-08-16, 06:20 AM
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Okay, I am going to talk about my own achilles tendonitis experience and may encounter a LOT of flack but I'm not recommending anything just saying what worked for me.

Years ago.. sedentary except for commuter biking.. my mum told me that I had better start training because she signed me up for a triathlon and a regional tour.

I started running right away (couch to 5k podrunner intervals) in the cold, with barefoot shoes that I was new to. Stupid, I know. The achilles pain grew until I had to stop training and then I could barely walk, half a km was too much for me. I decided to start cycling and short distances... 10-30k in the toe shoes on a daily basis were the only thing that made the pain go away. My thoughts are that it was gentle movement and stretching that was not strenuous enough to aggravate. If I did not ride for a few days the pain would come back. The daily gentle pumping and flexion/extension was really important to maintain.

This has worked for clients who developed achilles tendonitis due to excessive running on an incline treadmill or other repetitive tendon strains. I think the barefoot shoes require a lot of movement and foot and calf strengthening and are excellent when used intelligently, and with purpose. Otherwise you'll hurt yourself.

Lastly, since you're already inflamed, ALSO look at your diet for inflammatory factors. Not everyone is very sensitive, but some foods and substances are highly inflammatory to others and will cause joints, tendons, muslces to flare up.
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