Has anyone got any advice or experience with Achilles problems please?

About 6-7 weeks ago I was running the Leeds Half marathon and on the morning of the run when I was stretching, my Achilles was clicking slightly. Nothing painful but clicking when I tried stretching it. I was a bit worried about it on the day but did the run anyway and had no problems with it during the run and nothing untoward afterwards either.

With the run out of the way, all I’ve been doing since is riding the mountain bike and I’d all but forgot about it. Then last night, I jumped on the road bike for the first time in 3 months as last minute training for a 60 mile sportive at the weekend.

Again, all fine but when I walked down the steps last night, my Achilles clicked and sent pain up my leg. When I looked at it, it had swollen a bit and was sore to the touch.

Woke up this morning and all seemed fine again with the swelling down and no pain, until I got up from my chair at work and it clicked again and the same shooting pain.

Anyone any idea what it could be? Should I be rushing to the quacks to get it looked at? Anything I can do to cure and prevent? And importantly, is it likely to keep me off the bike??

Thanks in advance!

I have been plagued by Achilles problems for the last three years. Usually triggered off (some time afterwards, bizarrely) by running or standing. I have now reluctantly had to give up running – even running for the train in the evening can fire it up for days. Your symptoms sound similar – my clicking is the Achilles swelling and getting caught in the little tunnel that it lives in. It’s not helped by having very tight hamstrings, poor co-ordination and a dodgy back.

The full blown tendonitis which I have had a few times now is absolute agony, really don’t recommend it. Have to go into work on crutches – level agony, as I cannot put any weight on that foot.

Have had extensive physio and the cause is bad posture causing my arches to collapse which overloads the Achilles in any sort of impact activity. My heel bones also appear to have fused, but they don’t know if that’s cause or effect.I am now on orthotics in my shoes to try to correct it all, but it’s a long haul.

Clearly the above is me and it’s taken a long time to work it out, yours might be completely different so strongly suggest you get to a good physio (they vary!).

The good news is that biking seems to ease it, so long as I remember to stretch.

Good luck.

(Sorry – edit – just re-read your post and realise you are asking for experts – to be clear I am no way any sort of expert! I just know what hurts.).

Yeah, prob best to get the Dr to assess to make sure it’s not an achilles rupture, and can offer advice in person too…

DrP

In summary:

Should I be rushing…

No

..to the quacks to get it looked at?

Yes

DrP

It shouldnt affect your biking too much unless it is really damaged.
The blood flow is very poor so they often take a while to settle. I would just recommend ice and anti inflamatories if you can take them.
You could do some eccentric stretching but I wouldnt do any other stretching exercise as they will likely make it worse.
Dont touch it or let anyone else touch it as in my experience it does no good unless it is in really bad shape and you cant walk.
One good thing about achilles pain is that it you can often train through it but obviously at a reduced level depending on the discomfort. I have suffered on and off with it for years and you may find after a warm up it improves and even whilst training it can gradually disapear. Obviously if it is very painful then you will have to rest for a while.

DrP, you are clearly in the industry from your user name, my experience of our (very good) GP is that he said straight away that he was out of his depth on such a specialist area (the clue’s in the title “General Practitioner”) and he referred me straight to the subject experts. I suspect that is what Crag’s GP will do if he/she’s good.

I’m an expert in Achilles pain 🙁

I have been having problems with mine for a while (which stems from footballing injury from a few years ago) and since I’ve upped my running mileage it aches pretty much every morning and during exercise until I’ve warmed up a bit. I went to the physio and he said I have two choices.

First choice was to stop all exercise until it stops hurting and then go back to him for some strengthening/flexibility exercises before gradually introducing more cycling and running. The second choice was basically MTFU, carry on running and cycling, but be sure to do plenty of eccentric stretches and RICE. The only advice I was given contrary to Surfers was not to use an anti-inflammatory during excercise because they can reduce the blood flow?

I took the second option. The worst case scenario was that it could go pop completely and would need an operation. Luckily this hasn’t happened and it’s better this week than it has been for ages. I hardly had any soreness this morning after a long run yesterday.

To start with; I am not a doctor or medically trained.

Now to the anecdotal stuff; I’ve suffered with this on and off for about 3-4 years and agree with DrP’s comments (not surprising as he seems to be a real professional). Get to your GP where you will probably get a referral to the right specialist depending on the GP’s initial assessment

In my case it involved lots of strong painkillers to start with followed by some Physio, a Chiropodist, a podiatrist and finally some inserts for my shoes and some good advice about the sort of shoes I should (and more importantly shouldn’t) be wearing

On the plus side, even when my heel is really bad I can generally cycle fine. In fact I rode my bike alongside my family when they went for a walk in the New forest as I was fed up with staying at home 😀

+1 for DrP’s advice, get it checked out. Seek out a professional with experience in treatment, Podiatrist/Physio (pod here). I would advise painkillers/anti-inflammatories if you can, along with ice therapy, and see if you can get a small heel raise (6mm) under the heel inside your shoe to reduce strain on the achillies in the interim.

It’s not ruptured, you’d know about it if it was.

Chances are a small tear, get an X-ray and plenty of rest?

you would not be aware of a partial rupture, or a longitudonal one, and it definately would not be picked up on x-ray, jus’ sayin’ like!

Rupture is total is it not?

First choice was to stop all exercise until it stops hurting and then go back to him for some strengthening/flexibility exercises before gradually introducing more cycling and running. The second choice was basically MTFU, carry on running and cycling, but be sure to do plenty of eccentric stretches and RICE. The only advice I was given contrary to Surfers was not to use an anti-inflammatory during excercise because they can reduce the blood flow?

I took the second option. The worst case scenario was that it could go pop completely and would need an operation. Luckily this hasn’t happened and it’s better this week than it has been for ages. I hardly had any soreness this morning after a long run yesterday.

As a long time runner I generally hobble around first thing in the morning and after being stationary for a while. If I dont run for a few days that disapears but I see it as a price worth paying.
I think it is very unlikely to go “pop” simply because it is painful or even swollen I think there would be a whole load of warnings before that happened (I am no expert though!)
As above. No disrespect to GP’s but they are only likely to refer you and if you are unlucky you may get to see a physio who prods around for a bit and makes it even more painful.
If its serious I would find a physio who is recommended and has experience dealing with such injuries and go to see them. seeing an inexperienced physio make make it worse at least in the short term.
Regarding stretching as above only use eccentric. I would recommend never stretching at all prior to running (nor after IMO) but before a run walk/jog very slowly to get warmed up.

wish it was Haze, but no. Good MTBer friend partially ruptured his achillies, 12 weeks of full leg plaster changed every 2 weeks to re-position his foot. He thought he had just pulled his calf a bit as it felt a bit weak, booked up to get some massage from a physio and was sent straight to A&E!

I did mine playing badminton a few years back, I can only liken it to the feeling I had when I’d broken ankles previously. Dull and numb, knew straight away that something was up.

Was a ‘full’ rupture though so maybe a big difference in sensation between the two.

Take your point on the X-rays, I always thought they only showed up bone but they definitely took a few pics after my Thompson test.

I was used to a few sharp pains in my tendons from a youth spent skateboarding, so I guess it’s no surprise one of them went eventually.

Feels stronger than ever now though and get no hassle whatsoever. Not that I’d suggest going out and busting them for the long term benefits!

Ouch!
No achiilies pain is good, or a price worth paying IMO, but thats probably because I get patients who tell me they’ve been in pain of years and years, but still want me to fix them up in 30 minutes!

A neighbour (it was well documented in one of thos ‘fly on the wall’ hospital programmes) snapped one achiiilies running after some kids who kept knocking at his door one night and legging it… he had left his mobile by his chair, so had to hop back home, and snapped the other one on the way!

Thanks for all the input guys.

So, as long as its not ruptured then I should be OK nursing it through a bit of exercise along with eccentric exercise and a few anti-inflammatories.

I don’t have a chance of getting in to the GP’s any time before the weekend so I’ll rest up today and tomorrow and see how it feels after the sportive on Sunday.

In terms of professional advice, with the GP being a Jack of All, Master of None (no offence DrP) would I be as well just making an appointment at a decent sports physio and letting them check it over? Or would you go GP as first port of call?

Has anyone got any advice or experience with Achilles problems please?

If mine is anything to go by, get a below knee amputation and be done with it.

I may be somewhat bitter and keen on a drastic solution in that I’ve been having problems with the whole foot for the past 14 years…..

In all honesty the point where it snapped was not that bad, certainly not as painful as you’d think.

The recovery however was horrible, I could not imagine the hell of trying to recover from rupturing both.

OP, I’d say get some proper rest. 3 months easy now is better than 6+ very long months later!

OP, I’d say get some proper rest. 3 months easy now is better than 6+ very long months later!

The problem is if you rest until there is no pain or stiffness then you may never enjoy any activity. Plus there is no guarantee that 3 months off will resolve the problem. IME it simply needs to be managed. Carefully of course I’m not saying take any risks or exercise through real pain but you may have to introduce some exercises and put up with a bit of early morning stiffness 😯

DrP, you are clearly in the industry from your user name, my experience of our (very good) GP is that he said straight away that he was out of his depth on such a specialist area (the clue’s in the title “General Practitioner”) and he referred me straight to the subject experts. I suspect that is what Crag’s GP will do if he/she’s good.

If you’re out of your depth in any subject, then of course it’s good practice to seek additional help on that subject.

However, don’t think that Gp’s don’t know anything!! Most, I imagine, would be perfectly happy in diagnosing (or ruling out) a ruptured Achilles tendon. Of course, if a rupture is suggested, then orthopaedic input is probably useful (I shan’t go into the research I did into why I use the word probably… I’ll keep it general… 😉 ), but Achilles tendinitis shouldn’t really need ‘specialist’ input tbh….

It’s funny, the concept of the ‘specialist’ seems very attractive on paper, but in reality it’s the generalists that keep the nation healthy (ed doctors and nurses, community doctors and nurses etc etc).

In fact…it was the ‘idea” of the specialist that could have cost my son his arm when he broke it two weeks ago (we were abroad)… What we needed was a generalist ED (A&E) doctor, not a lazy orthopaedic consultant who hadn’t been at the ‘coal face’ for a trauma scenario for half his lifetime…..
Mini rant over- me and Sailor jerry have been spending the evening together, and I do do a little ‘eye roll’ when people think GPs are unable to manage anything above a cold…!

DrP

Damaged mine learning ballet as an adult…. now I know why kids learn it when their tendons are young and stretchy! Didn’t think twice about going to the Drs, it was very painful – hurt to wear most shoes, boots were out of the question. Had NHS physio, inc Ultrasound which was *amazing*. Was also given stretches which I still do every day, after I’ve been for a run. No further problems. Go to the Dr!

Oh, and a Theraband, that was also marvellous. Now I don’t need it for my Achilles, I use it as a grip to get lids off jars 🙂