Ongoing achilles issue

January 15, 2018

Hi I’ve been struggling with an Achilles issue both left and right since May 2017 although I first noticed it in March the same year but didn’t realise it was an issue.

Started running again in October after rest and weighted heel drops which is going ok. I have some small sensitive lumps on my Achillies which sometimes react after longer runs 10k plus.

My question is what to do next? My plan is to slowly increase millage and continue with heel drops x3 per week with ankle mobility exercises. I’m also checking gait and joining a gym to add more strength work.

January 15, 2018

Hi Dan

Achilles are like 3 year olds – they’re really unpredictable…

You’ve done “some stuff” to try to help your Achilles which may or may not have been benefit.

Let’s go back a little….

Achilles are essentially overuse injuries. You’ve done too much to your Achilles without enough control – either too much loading for too long with not enough support or control around hip or foot, either due to muscular control, foot posture or shoe type.

The heel drops, whilst being ace for improving tendon strength don’t actually change why you’ve got an issue in the first place.

It’s always about being able to control the amount of load that is being put into your Achilles that is the issue. It’s a little like Goldilocks. You need the right amount of load, not too much or too little….and this is the tricky, unpredictable but.

So what’s next…if you want to load your Achilles to improve the tendon strength you need to lots more heel drops and must be body weigh PLUS – at least 30 reps a few times daily. You idea about mileage is spot on – little and slowly increase and always keep an eye on next day morning stiffness (tells you if you’ve overloaded it during the run). You can feel some mild discomfort when running (max 3/10) but no more.

Ankle flexibility is a bit meh, and certainly no stretching or poking your Achilles. Don’t forget some decent, controlled glute work including squats, lunges, hop ups etc etc.

Shoes, terrain and cadence are also a given.

And, if all else fails then absolutely get yourself in front of a decent Physio that can set you on the right path…it can be a  notoriously long path, but with the right loading strategy you will
get to where you want to go (but’ll take a little longer than expected!).

The Guru

Guru Responded

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