How to overcome insertional Achilles tendonitis

The Ultimate Runners Guide to Achilles Tendon Injuries

John Davis

This is most likely an article you dont want to read. Heres why: Yourachilles probably already hurts when running. It achilles may feel sore during your run, be creaking after your run, and feel tight and stiff as you walk around. Every day you have that sinking feeling that something is wrong, you wondershould I run or is it time to stop running till it heals?. Achilles tendon injuries can be stubborn, painful and depressing. If youre reading this, then you likely have one. Luckily, were here to help, and not just by telling you to ice your achilles and rest. This guide will explain why achilles tendon issues occur, and what you can do to limit the time it takes to heal it if you are suffering from achilles tendon aching, soreness after a run, creaking, or heel pain. The Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel. Virtually all of the force generated when you toe off the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon. As such, its prone to injury in many runners, but particularly those who do a lot of speed training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men. This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors. Achilles tendonitis (or achilles tendinitis as it is actually known in the medical world) typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes. If you continue to train on it, the pain in the tendonwill be more sharp and you will feel it more often, eventually impeding your ability even to jog lightly. About two-thirds of Achilles tendonitis cases occur at the midpoint of the tendon, a few inches above the heel. The rest are mostly cases of insertional Achilles tendonitis, which occurs within an inch or so of the heelbone. Insertional Achilles tendonitis tends to be more difficult to get rid of, often because the bursa, a small fluid-filled sac right behind the tendon, can become irritated as well.

The common causes ofAchilles tendonitis in runners

Heres the deal: The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon.

While the term tendonitis implies that inflammation (-itis) is the root cause of the problem, in fact, the true cause is real, physical damage to the fibers of the Achilles tendon itself.

Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.

How can Itreat my achilles tendon pain?

For a long time, researchers and doctors muddled about trying to address roulette factors like calf strength & tightness, ankle range of motion, and pronation, assuming that the Achilles tendon would heal itself once these factors were corrected. Unfortunately, it seems that the thick tendons of the body do not heal as rapidly or completely as wed like. The cause of this seems to be the collagen fibers: When a tendon is damaged, collagen fibers are ruptured. The body is able to lay down new fibers to replace the damaged ones, but it does so in a rather disorganized way. The new collagen fibers look much like a mess of spaghetti when viewed on a microscope, in contrast to the smooth, aligned appearance that healthy tendon fibers have. Unfortunately, it gets worse: While we might propose that runners do calf stretching to loosen up their calf muscles and increase their ankle range of motion, this often does more harm than goodtugging aggressively on the damaged tendon fibers is much like pulling on either end of a knotted rope.

Instead, the main objective in treating Achilles tendon injuries should be healing the damaged tendon. The exercise of choice is the eccentric heel drop, which has an impressive research pedigree backing its use.

How does the eccentric heel drop help my achilles get better faster?

The strength protocol consists of two exercises: a straight-kneed and a bent-kneed eccentric heel drop. The protocol calls for three sets of fifteen heel drops, both bent-kneed and straight-kneed, twice a day for twelve weeks. Standing on a step with your ankles plantarflexed (at the top of a calf raise), shift all of your weight onto the injured leg. Slowly use your calf muscles to lower your body down, dropping your heel beneath your forefoot. Use your uninjured leg to return to the up position. Do not use the injured side to get back to the up position! The exercise is designed to cause some pain, and you are encouraged to continue doing it even with moderate discomfort. You should stop if the pain is excruciating, however. Once you are able to do the heel drops without any pain, progressively add weight using a backpack. If you are unlucky enough to have Achilles tendon problems on both sides, use a step to help you get back to the up position, using your quads instead of your calves to return up. Whats the bottom line? The eccentric exercises are thought to selectively damage the Achilles tendon, stripping away the misaligned tendon fibers and allowing the body to lay down new fibers that are closer in alignment to the healthy collagen in the tendon. This is why moderate pain during the exercises is a good thing, and why adding weight over time is necessary to progressively strengthen the tendon.
This is most likely an article you dont want to read. Heres why: Yourachilles probably already hurts when running. It achilles may feel sore during your run, be creaking after your run, and feel tight and stiff as you walk around. Every day you have that sinking feeling that something is wrong, you wondershould I run or is it time to stop running till it heals?. Achilles tendon injuries can be stubborn, painful and depressing. If youre reading this, then you likely have one. Luckily, were here to help, and not just by telling you to ice your achilles and rest. This guide will explain why achilles tendon issues occur, and what you can do to limit the time it takes to heal it if you are suffering from achilles tendon aching, soreness after a run, creaking, or heel pain. The Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel. Virtually all of the force generated when you toe off the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon. As such, its prone to injury in many runners, but particularly those who do a lot of speed training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men. This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors. Achilles tendonitis (or achilles tendinitis as it is actually known in the medical world) typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes. If you continue to train on it, the pain in the tendonwill be more sharp and you will feel it more often, eventually impeding your ability even to jog lightly. About two-thirds of Achilles tendonitis cases occur at the midpoint of the tendon, a few inches above the heel. The rest are mostly cases of insertional Achilles tendonitis, which occurs within an inch or so of the heelbone. Insertional Achilles tendonitis tends to be more difficult to get rid of, often because the bursa, a small fluid-filled sac right behind the tendon, can become irritated as well.

The common causes ofAchilles tendonitis in runners

Heres the deal: The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon.

While the term tendonitis implies that inflammation (-itis) is the root cause of the problem, in fact, the true cause is real, physical damage to the fibers of the Achilles tendon itself.

Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.

How can Itreat my achilles tendon pain?

For a long time, researchers and doctors muddled about trying to address roulette factors like calf strength & tightness, ankle range of motion, and pronation, assuming that the Achilles tendon would heal itself once these factors were corrected. Unfortunately, it seems that the thick tendons of the body do not heal as rapidly or completely as wed like. The cause of this seems to be the collagen fibers: When a tendon is damaged, collagen fibers are ruptured. The body is able to lay down new fibers to replace the damaged ones, but it does so in a rather disorganized way. The new collagen fibers look much like a mess of spaghetti when viewed on a microscope, in contrast to the smooth, aligned appearance that healthy tendon fibers have. Unfortunately, it gets worse: While we might propose that runners do calf stretching to loosen up their calf muscles and increase their ankle range of motion, this often does more harm than goodtugging aggressively on the damaged tendon fibers is much like pulling on either end of a knotted rope.

Instead, the main objective in treating Achilles tendon injuries should be healing the damaged tendon. The exercise of choice is the eccentric heel drop, which has an impressive research pedigree backing its use.

How does the eccentric heel drop help my achilles get better faster?

The strength protocol consists of two exercises: a straight-kneed and a bent-kneed eccentric heel drop. The protocol calls for three sets of fifteen heel drops, both bent-kneed and straight-kneed, twice a day for twelve weeks. Standing on a step with your ankles plantarflexed (at the top of a calf raise), shift all of your weight onto the injured leg. Slowly use your calf muscles to lower your body down, dropping your heel beneath your forefoot. Use your uninjured leg to return to the up position. Do not use the injured side to get back to the up position! The exercise is designed to cause some pain, and you are encouraged to continue doing it even with moderate discomfort. You should stop if the pain is excruciating, however. Once you are able to do the heel drops without any pain, progressively add weight using a backpack. If you are unlucky enough to have Achilles tendon problems on both sides, use a step to help you get back to the up position, using your quads instead of your calves to return up. Whats the bottom line? The eccentric exercises are thought to selectively damage the Achilles tendon, stripping away the misaligned tendon fibers and allowing the body to lay down new fibers that are closer in alignment to the healthy collagen in the tendon. This is why moderate pain during the exercises is a good thing, and why adding weight over time is necessary to progressively strengthen the tendon.

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Is there anything else I can do to speed healing?

While you are addressing the damage to the tendon fibers through eccentric heel drops, there are some steps you can take to help ameliorate some of the other contributing factors to your injury.
  • While calf tightness and ankle range of motion are legitimate concerns, I still dont think that aggressive calf stretching is an ideal solution, because of the tugging action on the tendon. Instead, try foam rolling your calves and applying a warm water bag to the muscle (but avoid heating the tendon!).Foam rolling your calf muscles can loosen them up without tugging too much on the Achilles tendon. Just make sure you are not making the 4 most common mistakes runners make when foam rolling.
  • Read our Post on Are you doing the correct calf and achilles exercises to prevent injury?
  • You can also stretch out your shins by leaning back in a kneeling stance to aid ankle range of motion.
  • Footwear concerns should also be addressed at this point. If you have been wearing low-heeled minimal shoes, racing flats, or spikes, you ought to stick to more traditional shoes with a higher heel until your tendon is healthy again. Once youve healed up, you can gradually do some running in low-heeled shoes or even barefoot (on grass) to help accustom your Achilles to moving through its full range of motion. Poor casual footwear choices should not be overlooked too, especially for women. Some shoes can also put pressure on the back of your heel, irritating the insertion of the tendon. Generally, the closer a shoe is to looking and feeling like a running shoe, the better it is for your foot.
  • Doctors and podiatrist may be keen to have you try out a custom orthotic to treat your Achilles problems. While it might be worth a shot, there isnt a whole lot of scientific evidence backing their use in this case. Orthotics dont reliably alter pronation, and even if they do, its uncertain as to whether this will increase or decrease stress on the Achilles.

Outline of treatment

Conservative treatments

These are cheap, easy to perform treatments that you can do it home in your own time. You should try to do as many of these as possible each day.
  • Eccentric heel drops
  • Icing after each run
  • Heating before each run with warm water or heating pack
  • Contrast bath during the day take two small buckets/trash cans and fill one with hot (hot bath temp) water and the other with ice water (cold enough so some ice still doesnt melt) and put your whole leg (up to the calf) in the cold. Hold for 5 minutes and then switch to the hot for 5 minutes. Repeat 2 or 3 times, ending with cold. This helps rush blood in and out of the area, which facilitates healing
  • Dont take anti-inflammatory like Advil or ibuprofen. These stop the bodys natural healing agents and we want as much natural healing to occur as possible.
  • Avoid excessive stretching only very light, easy stretching until healed
  • Massage your calves with a foam roller or The Stick.
  • Heel lifts are a possible temporary solution. They restrict the Achilles range of motion, so can be helpful to get over the initial hump of the injury, but should be taken out after you are recovering.
  • Switch to more supportive or traditional running shoes (higher heels) during your runs and while walking around until your pain is completely gone, and avoid flats and high heels!
  • Ankle strengthening and mobility exercises.
  • Sleep in a Strassburg sock or nightsplint to gently stretch the Achilles while sleeping.

Aggressive treatments

These treatments are a little more expensive or time consuming and are only suggested for if you suffer from chronic Achilles pain or the conservative treatments are not working for you.
  • A custom orthotic might help alleviate the pain from excessive pronation. This is not a proven treatment, but for those runners who respond to orthotics, it can help.
  • Iontophoresis with dexamathasone. This is a treatment offered by physical therapists that involves propelling anti-inflammatory steroids into the tendon. You need a prescription and a physical therapist to administer the treatment, but research has shown the potential to have a positive effect on the treatment of Achilles issues.

Cross Training While Injured and During Recovery

Cross training is recommended while youre injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement. Your feet dont actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up. Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same cant be said for biking and swimming. The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If youre lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

Inone study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

Ina second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It gets better:

Research has also demonstratedthat aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If youre interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs,Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while youre actually pool running.

This has been an absolute game changer for me when I am injured.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, its changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

Thats why weve partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product hereand then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If youd rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up 1:00 hard, 30 seconds easy 1:30 hard, 30 seconds easy 2:00 hard, 30 seconds easy 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just dont care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if youre going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

Youll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your sprint marker that youll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your medium interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, youll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when youre injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through theFluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.

When can I return to running?

You can still run during this twelve-week period, but only if your Achilles does not flare up while doing so. Use warm water to heat up the tendon before you run, and apply ice afterwards, even once youve started feeling better. Using a foam roller and hot water packs to loosen up your calves in the morning and at night is also not a bad idea, and dont forget to take a look at what youre wearing in your daily life. If you have insertional Achilles tendonitis, use the modified flat eccentric heel drop exercise instead of the two variants off a step. A custom orthotic or heel lift may be helpful, but should not be a first-line treatment option.

Is there anything else I can do to speed healing?

While you are addressing the damage to the tendon fibers through eccentric heel drops, there are some steps you can take to help ameliorate some of the other contributing factors to your injury.
  • While calf tightness and ankle range of motion are legitimate concerns, I still dont think that aggressive calf stretching is an ideal solution, because of the tugging action on the tendon. Instead, try foam rolling your calves and applying a warm water bag to the muscle (but avoid heating the tendon!).Foam rolling your calf muscles can loosen them up without tugging too much on the Achilles tendon. Just make sure you are not making the 4 most common mistakes runners make when foam rolling.
  • Read our Post on Are you doing the correct calf and achilles exercises to prevent injury?
  • You can also stretch out your shins by leaning back in a kneeling stance to aid ankle range of motion.
  • Footwear concerns should also be addressed at this point. If you have been wearing low-heeled minimal shoes, racing flats, or spikes, you ought to stick to more traditional shoes with a higher heel until your tendon is healthy again. Once youve healed up, you can gradually do some running in low-heeled shoes or even barefoot (on grass) to help accustom your Achilles to moving through its full range of motion. Poor casual footwear choices should not be overlooked too, especially for women. Some shoes can also put pressure on the back of your heel, irritating the insertion of the tendon. Generally, the closer a shoe is to looking and feeling like a running shoe, the better it is for your foot.
  • Doctors and podiatrist may be keen to have you try out a custom orthotic to treat your Achilles problems. While it might be worth a shot, there isnt a whole lot of scientific evidence backing their use in this case. Orthotics dont reliably alter pronation, and even if they do, its uncertain as to whether this will increase or decrease stress on the Achilles.

Outline of treatment

Conservative treatments

These are cheap, easy to perform treatments that you can do it home in your own time. You should try to do as many of these as possible each day.
  • Eccentric heel drops
  • Icing after each run
  • Heating before each run with warm water or heating pack
  • Contrast bath during the day take two small buckets/trash cans and fill one with hot (hot bath temp) water and the other with ice water (cold enough so some ice still doesnt melt) and put your whole leg (up to the calf) in the cold. Hold for 5 minutes and then switch to the hot for 5 minutes. Repeat 2 or 3 times, ending with cold. This helps rush blood in and out of the area, which facilitates healing
  • Dont take anti-inflammatory like Advil or ibuprofen. These stop the bodys natural healing agents and we want as much natural healing to occur as possible.
  • Avoid excessive stretching only very light, easy stretching until healed
  • Massage your calves with a foam roller or The Stick.
  • Heel lifts are a possible temporary solution. They restrict the Achilles range of motion, so can be helpful to get over the initial hump of the injury, but should be taken out after you are recovering.
  • Switch to more supportive or traditional running shoes (higher heels) during your runs and while walking around until your pain is completely gone, and avoid flats and high heels!
  • Ankle strengthening and mobility exercises.
  • Sleep in a Strassburg sock or nightsplint to gently stretch the Achilles while sleeping.

Aggressive treatments

These treatments are a little more expensive or time consuming and are only suggested for if you suffer from chronic Achilles pain or the conservative treatments are not working for you.
  • A custom orthotic might help alleviate the pain from excessive pronation. This is not a proven treatment, but for those runners who respond to orthotics, it can help.
  • Iontophoresis with dexamathasone. This is a treatment offered by physical therapists that involves propelling anti-inflammatory steroids into the tendon. You need a prescription and a physical therapist to administer the treatment, but research has shown the potential to have a positive effect on the treatment of Achilles issues.

Cross Training While Injured and During Recovery

Cross training is recommended while youre injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement. Your feet dont actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up. Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same cant be said for biking and swimming. The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If youre lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

Inone study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

Ina second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It gets better:

Research has also demonstratedthat aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If youre interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs,Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while youre actually pool running.

This has been an absolute game changer for me when I am injured.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, its changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

Thats why weve partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product hereand then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If youd rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up 1:00 hard, 30 seconds easy 1:30 hard, 30 seconds easy 2:00 hard, 30 seconds easy 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just dont care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if youre going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

Youll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your sprint marker that youll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your medium interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, youll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when youre injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through theFluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.

When can I return to running?

You can still run during this twelve-week period, but only if your Achilles does not flare up while doing so. Use warm water to heat up the tendon before you run, and apply ice afterwards, even once youve started feeling better. Using a foam roller and hot water packs to loosen up your calves in the morning and at night is also not a bad idea, and dont forget to take a look at what youre wearing in your daily life. If you have insertional Achilles tendonitis, use the modified flat eccentric heel drop exercise instead of the two variants off a step. A custom orthotic or heel lift may be helpful, but should not be a first-line treatment option.

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References

1. Taunton, J.; Ryan, M.; Clement, D.; McKenzie, D.; Lloyd-Smith, D.; Zumbo, B., A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine 2002, 36, 95-101.2.
2. Marti, B.; Vader, J. P.; Minder, C. E.; Abelin, T., On the epidemiology of running injuries-the 1984 Bern Grand-Prix study. The American Journal of Sports Medicine 1988, 16(3), 285-294.3.
3. Maffulli, N.; Wong, J.; Almekinders, L. C., Types and epidemiology of tendinopathy. Clinics in Sports Medicine 2003, 22(4), 675-692.4.
4. Ryan, M.; Grau, S.; Krauss, I.; Maiwald, C.; Taunton, J. E.; Horstmann, T., Kinematic analysis of runners with Achilles mid-portion tendinopathy. Foot & Ankle International 2009, 30(12), 1190-1195.5.
5. Alfredson, H.; Pietilä, T.; Jonsson, P.; Lorentzon, R., Heavy-load eccentric calf muscle training for the treatment of chronic achilles tendonitis. American Journal of Sports Medicine 1998, 26 (3), 360-365.
6. Jonsson, P.; Alfredson, H.; Sunding, K.; Fahlström, M.; Cook, J., New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. British Journal of Sports Medicine 2008, 42 (9), 746-749.
7. Nigg, B., The Role of Impact Forces and Foot Pronation: A New Paradigm. Clinical Journal of Sports Medicine 2001, (11), 2-9.
8. Neeter, C.; Thomeé, R.; Silbernagel, K.; Thomeé, P.; Karlsson, J., Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain. Scandanavian Journal of Medicine & Science in Sports 2003, 13 (6), 376-382.

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194 Responses

  1. Greg Strosaker says:
    November 1, 2012 at 2:10 pm

    This is a great summary. I dealt with Achilles tendinitis for several months earlier this year and tried much of what you mention here, both conservative and aggressive approaches. While most of my experience is consistent with what you have written, I think going against the prevailing wisdom in certain areas actually promoted my recovery. I found not only custom orthotics to be a waste of money, but heel lifts also aggravated the situation for me in fact, the more time I spent barefoot or in my Nike Frees, the better I felt. Shoes with a traditional heel-to-toe drop made things worse. The night splint definitely helped, but what finally got me back on the streets was ART treatment.
    My chiropractor stated that running more miles can actually help one overcome AT by thickening the tendon and making it more able to work around damaged fibers, but I havent investigated whether there is research to support this.
    I spent most of this marathon season on the edge of recurrence, and finally found that active isolated stretching and foam rolling were the best tools for staying healthy enough to train fully. Now Im counting on your Achilles routine (and a bit of Artemis) to get truly healthy for next year.

    Reply
    1. Johan says:
      May 20, 2014 at 10:31 am

      I also tried eccentric training several times for about two years. The issue was temporary resolved- but always came back when I increased my running. Desperately, I finally switched to forefoot striking and shoes with lower heels. Problem solved. I have now been symptom free for a year.

      Reply
    2. Chris Carrier says:
      October 21, 2014 at 3:39 pm

      I also have insertional AT. It was pretty bad when I first started running three years ago due to some dumb training decisions. I took time off, got PT and it hasnt been as bad since, but is still there. I ran a second marathon this year and I have to say my IAT has been less sort this year. My training was harder this year, and this may support the theory of healing through strengthening.

      Reply
    3. John Bowman says:
      April 28, 2015 at 5:51 pm

      Your comments make me feel a bit better about my assumption of my AT issue. I have ran for years now in a minimalist shoe although during that stretch I had a bit of inconsistency. Ive been back running consistently (4-5 times per week) for about 6 months now and decided to try incorporating more of a traditional trainer into my routine with half my runs coming with the trainers and half with a minimalist. Just two weeks into that I am having Achilles pain in my left leg. I had decided to go all minimalist this week and see if it helped, but I am afraid I might be too far gone for that alone to get me back 100 percent.

      Reply
      1. Coach Tina says:
        April 29, 2015 at 4:29 am

        Glad we were able to help John. If you are interested in the minimalist style shoe type, you may enjoy our podcast with Harvard professor, Dan Lieberman, you can check it out here: https://runnersconnect.net/rc47. Keep us posted, and good luck with your return to running. Be careful with how quickly you change your shoes, any changes within running should be made gradually. Hope this helps!

        Reply
    4. Janette Moss says:
      August 3, 2015 at 5:06 am

      I have insertional Achilles tendonitis. Started the eccentric heel exercises daily and within one day the pain decreased and continues to do so. I take an anti-inflammatory when walking only 3 times per week at this stage, and not at other times. Pain decreasing daily. YAY!!!

      Reply
      1. Coach Tina says:
        August 17, 2015 at 3:31 pm

        Hi Janette, sorry to hear about your achilles problems. We are glad to hear that things are moving in the right direction. Our guide does work Keep it up, and hopefully by now you are feeling much better!

        Reply
  2. Jeanne says:
    November 21, 2012 at 7:50 am

    Thank you for pointing out the difference between insertional and midpoint Achilles tendonitis. Its a distinction that is often neglected and has important treatment implications. I was recently told I have insertional Achilles tendonitis, which probably explains why weeks of doing the traditional eccentric heel drops hasnt helped much. I recently modified the heel drops, as you suggest, by doing them on flat ground, and am hopeful I will now finally see improvement.

    Reply
    1. Coach Jeff says:
      November 21, 2012 at 9:52 am

      Hi Jeanne,

      I am glad the article was helpful and the specific advice on the insertional tendonitis gave you some new strategies to attack the injury. I hope it clears up quickly for you. Best of luck!

      Reply
  3. Steve-o says:
    March 13, 2013 at 7:27 pm

    Ive been following the rehab protocol for about 4 weeks. Ive been gradually increasing the weight without experiencing any pain during the exercise, however, about an houjr after Im finished, I start experiencing some pain that varies in intensity from about 1 through 4 on a scale of 10. The pain remains for the rest of the day but its gone when I awake in the morning. Any explanation as to what is going on? Do you think I should continue with the program?
    Thanks for any extra help you could give me.

    Reply
    1. Coach Jeff says:
      March 14, 2013 at 5:18 am

      Hmm, tough to say exactly, but I think what might be happening is that the tendon fibers are restructuring themselves after you do the lifts. Its a good thing, since thats what you want, but the pain is likely the result. I would continue with the program, but you also might want to see a PT, just to be safe.

      Reply
  4. Alex Prittie says:
    March 13, 2013 at 10:36 pm

    Hey,

    I have been struggling with insertional AT for about a year now and have been trying to do everything I can to get rid of the swelling and pain for the past 4 months. I play basketball and do a lot of basketball related drills (plyometrics and strength training) that most likely have contributed to my AT. I sleep in night splints and have drastically limited my activity in the last four months however, despite this rest I still have swelling and slight pain when I play. Its significantly better than when I played on it four months ago but I am doing a lot less than I did back then. Im reluctant to continue playing through the swelling because I dont want to back track in my recovery. I am only 21 so its very discouraging that my body is rebelling against my typical physical activity. Is complete rest beneficial in any way because relative rest didnt seem to work? Does insertional AT ever TRULY go away?

    Reply
    1. Coach Jeff says:
      March 14, 2013 at 5:21 am

      Sorry to hear youre having such problems, Alex. I would suggest seeing a podiatrist or PT. Its possible you have some interference between the heel bone and the achilles. Sometimes, this causes rubbing/tearing between the two and can result in consistent swelling like youre experiencing.

      Reply
  5. Jani A. says:
    March 20, 2013 at 5:41 pm

    Ive been diagnosed with achilles tendonitis on my left ankle before and now Im having similar symptoms again. This time Ive begun to question whether tendonitis is the actual condition Im having. For example, I have no swelling of any kind around the tendon, no crepitation and the area around the tendon isnt tender even if I squeeze it doesnt hurt at all. Running doesnt hurt either. But I do feel something is not right with my ankle when Im going about my daily business. The feeling isnt pain its more like a mild discomfort. Its transient in nature.

    I stumbled on this youtube video (http://www.youtube.com/watch?v=DgHoePuZaPw) where they explain that often times similar symptoms can be caused by tightness of the soleus muscle and recommend massaging the calf using a rolling pin. Ive tried this and indeed it does make the feeling go away. In fact, just a little massaging of the calves does the trick, but the discomfort always returns after a while. What is interesting about the rolling pin is that after an exercise you can use it to locate painful spots on the calf muscles. This is interesting because the discomfort I feel on my achilles tendon correlates with my calf having these painful spots.

    So, is it likely that this is a mild case of achilles tenditinis or a problem with my calf muscles? What do you think?

    Reply
    1. Javier says:
      July 2, 2015 at 12:59 am

      Hi Jani.
      I came across your post and was astound after reading how your description of your Achilles issue is exactly how I would describe mine. I have seen drs/podiatrist/pt and they all look at me like I am insane when I describe my issue, almost as to say well if you dont have any pain your fine but I know my Achilles is far from fine. Anyways I was just wondering if you have had any luck resolving your Achilles issue as Im almost certain we are dealing with the same issue. Please reply when you get a chance, your response is greatly appreciated.
      Thanks in advance,
      Javier

      Reply
  6. Kayvon says:
    March 23, 2013 at 1:22 am

    Yo.
    Thanks for all of your advice. So this insertion tendosis is the worst running injury Ive ever had (10+ yrs of running 60 mpw). Ive tried everything without success: eccentrics for months, physical therapy ART, nitro, kineso tapping, total rest, heel lifts. MRI shows less than 5% tear with retro calcaneal bursitis. There really appears to be no Improvement, and just a certain stepping or jogging shortly can exacerbate the tendon which remains symptomatic for days (typically only with gentle stretching). My sports doc (who is also a runner), states it can take up to 9-12 months (holy sh#%). Do you or anyone know any better the Natural History of this disease (insertional), better than it can take 9-12months. I mean why 12 months and not 24? What is the median months of return to running? Because at this point Im going to have to drop a grand on a bike and kiss running goodbye, which would really suck. Anyway, hope all you suffers heal as quick as possible.
    Peace.

    Reply
    1. Lesley Wright says:
      April 5, 2013 at 4:44 pm

      I have had insertional Achilles tendonopathy since last November. My GP gave me Achilles exercises which, after 6 weeks, did not help at all. I then saw the physiotherapist who told me that the exercises I had been given only made it worse! He has given me the exercises recommended for insertional AT and, though painful, appear to be helping. This week I was actually able to walk the dog with my husband, something I havent been able to do for months. No-one has given me a time frame for getting better.

      Reply
    2. jsca says:
      April 5, 2013 at 10:47 pm

      I got IAT for the second time now, because of minimalist transistion to fast. The first time it took from sept 2011 to April 2012 to heal. I tried lots of stuff and Im still not sure what made the difference. Maybe just time was necessary. One error for sure I was making was running everyday, the injury just came back, rest for week and try again. When I started running once every two days, it took 2 weeks and I was fully cured! But I had months of Eccentric calf drop done and Im sure it help a lot. During the summer 2012 I overtrained again a got a stress fracture on the other foot, but my AT was OK. This winter I got IAT again with just 30Km/week training? Is it the cold? I was running twice a day to go to work, is that a nono? Anyway its two months now and still no improvement.

      Wish you all good luck.

      Reply
      1. kairo says:
        August 12, 2014 at 9:03 pm

        Ive had insertional tendinitis for over 3 years and have been sent through a raft of incorrect diagnoses. I initially went to a podiatrist who gave me some stretches to perform (eccentric steps 1 & 2 from the directions here) and saw no improvementobviously seeing as the diagnosis was incorrect. Later after completely stuffing my achilles up on hardfloor courts, i went to the GP who said i had IT and needed to see a physio or sports podiatrist to get sorted. I went to the physio and all seems to be recovering well for the first time in 3 years. That bulge on my right heel is also growing smaller. He said it would take 6 months plus to get it back to health again though.

        Time did me no favours with IT. Only made it worse. Accupuncture was also relieving of the pain symptoms and for improved blood flow to the area. Heat packs have also been helpful.

        Reply
  7. Abi says:
    April 2, 2013 at 3:44 pm

    Hi, I have (midpoint) archilles tendonitis and the only advice I have been given is to take painkillers and rest it i.e. stop running. I have an upcoming charity run which I still want to take part in and so am unwilling to just rest my foot.
    Every step i take on my bad foot results in sharp pain which increases in intensity as i run and even more so after a run. By continuing to run do I risk further damage to the tendon?
    Are there any other techniques you could suggest which will allow me to continue training with less pain?

    Many thanks, Abs

    Reply
  8. Afra Ramadan says:
    April 6, 2013 at 8:45 am

    I am now using a walker control after having a cast for 30 days. not sure what type i havebut it seems it will take longer time than usual since I am over forty an I am afraid that I have stopped training and started gaining weight.. any advice please

    Reply
  9. Darren Thomas says:
    April 11, 2013 at 3:53 pm

    I have pain just above my right heel and under my heel in the morning. I like to train in the morning but it takes time for my Achilles to warm up I do stretching exercises then after about a mile Im pain free then after my run the pain comes back but not straight away do you have any suggestions what to do .i recently run a half marathon then Ive rested for 3weeks I tried a short run but the pain has started to trouble me again

    Reply
  10. Ellen Q says:
    April 24, 2013 at 5:45 pm

    How far down should you go re: the eccentric heel drops? Until theres resistance, as in, you cant go any further? Or should you stop before that? Thanks for the helpful information!!

    Reply
    1. Coach Jeff says:
      April 24, 2013 at 8:39 pm

      Good question. I would say that you should go until you feel a good stretch and then stop there. You shouldnt try to force it further than what feels comfortable.

      Reply
      1. Ellen Q says:
        April 26, 2013 at 10:00 am

        Thanks for the swift reply! I hope you dont mind three more quick questions:

        1. Am I supposed to feel the stretch primarily in my calves? Thats whats happening at the moment.

        2. How slow is slowly? I was dropping my heel so slowly that my legs were very sore after 15 reps, so Im assuming thats too slow, but I dont want to go too fast, either. Ive been dealing with this issue for months now and dont want to re-injure anything.

        3. Im feeling a good stretch with the straight-leg version and no stretch with the bent-leg version. Is that a good sign? A bad sign? Am I doing something wrong?

        Sorry to pepper you with so many questions! This treatment is so promising, though, that I want to do it right. Thanks again,

        Ellen

        Reply
  11. Holly says:
    April 25, 2013 at 4:51 pm

    I have had insertional Achilles tendonitis for 2 years now. I am told by the surgeon / ankle specialist I saw that surgery is really the only solution. However the success rate of surgery is not too encouraging.
    Has anyone else had surgery for this condition? What was the outcome?
    I wore a cast for 6 weeks and was pain free for 2 months afterwards but the pain then returned.
    Does anyone recommend shoes (not running shoes just for everyday wear)??

    Reply
    1. Whit says:
      April 26, 2013 at 9:52 am

      Holly,

      Im in the a similar boat. Ive now had IAT for roughly 2.5 years. I took a full year off of running the last time, yet I still cant run more than twice a week (12 miles total, tops) for fear of it returning full fledged. Currently, my heel aches for a few days after a run and I just wait for it to subside before attempting to get out there again. Im at a loss, I was thinking surgery was the only answer at this point, but reading your story really discourages me.

      Shoes that are almost over cushioned in the heel seem to make my IAT feel better. I have some Asics Blur33s that I wear around when not a work or not running.

      As far as running shoes go, Id like to get some advice, as well. When I originally got IAT I always wore light-weight training shoes and was a heel-to-toe striker. After the year off of running I tried to switch running styles to a mid-foot or fore-foot strike, also in light-weight training shoes. Neither style seemed to make a difference, as my IAT returned after a few months of training. Ive recently purchased a pair of Newtons and I like them a lot (dont have to think about mid-foot strike as they almost force you to mid-foot anyway), but they dont seem to be helping me anymore than my previous shoes (Saucony Kinvaras).

      Reply
      1. Holly says:
        April 26, 2013 at 12:17 pm

        Whit,

        Im sorry to discourage you re surgery! I think the stats are that for 70% surgery is successful; 20% get no benefit and 10% the pain becomes worse. So quite good stats in a sense! But having trained as a nurse I know that bone can often grow back after being cut away and I guess I just feel that surgery is a last resort thing for me that is.
        But it would be great to hear from those who have had it.

        I wore an aircast for 6 weeks to give it complete rest and then saw a great physio and began stretching exercises for the Achilles tendon. After a while I started doing eccentric heel raises on a step but this brought pain and now (3 months since aircast came off) the pain has returned largely through just living life! walking on pavements etc etc (havent done any running). I think my mistake has been not having good footwear and at times wearing flat shoes.

        I have just bought a pair of Asics GT 1000 and I noticed the difference immediately. The pain decreased considerably and I didnt hobble along anymore!
        So this has given me renewed hope. Having achieved a 3 month period pain free and now seeing the difference raising my heel makes (in order to stop the tendon rubbing on the heel,spurs) I have renewed hope. Ill also start doing the flat ground eccentric heel raises.
        i think swimming may have helped I did some for a couple of weeks . I may start doing that regularly ( not my favourite thing!)

        Best wishes

        Reply
  12. Mike says:
    May 5, 2013 at 7:06 am

    not clear exactly where insertional achilles is located along the achilles can U clarify with a diagram or clearer description Im unsure as to whether my injury is insertional or mid point ie where exactly is mid point?

    Reply
    1. E. McA says:
      July 14, 2013 at 10:59 pm

      Insertional AT is right at the insertion point, where the tendon attaches to the heel bone.

      Reply
  13. Sarah Tebi says:
    May 6, 2013 at 10:46 pm

    I have heard from a lot of others as well that the custom orthotics are a waste of money. But a lot of running stores have advised me to get insoles in addition to the structured shoes (Asics GT 2170) I own. Have you, or any of the readers, had any luck with them?

    Reply
    1. Coach Jeff says:
      May 7, 2013 at 7:33 am

      Hi Sarah, we have an article that examined the research on orthotics. Are Custom Running Orthotics Worth the Cost

      Reply
  14. holly holman says:
    May 22, 2013 at 1:13 pm

    I have had insertional achilles tendonosis for 2 1/2 years. I wrote about it in an above post. I just wanted to say that it seems to be cured after seeing a Podiatrist.

    He told me that the problem was the subtalar joint in my foot which was slightly dislocated. He manipulated it back into position and its better! I cant believe it feel like Ive got my life back after 2 1/2 years of limping around. Id seen a top surgeon and two physical therapists none of whom saw what it was. The Achilles tendon problem was a symptom not the root cause. The surgeon had said I needed surgery on my Achilles tendon/ heel bone SO glad I declined his suggestion.

    So just to say if you have insertional achilles tendonitis see a Podiatrist just to get another opinion. (They specialise in feet and ankles.) Im sure most IAT is not caused by a dislodged talus bone but its just worth checking out as none of the specialist recognised it.

    Reply
  15. Huw Davies says:
    June 11, 2013 at 5:16 pm

    I have been suffering from midpoint tendinitis for the last 3 weeks when should i start the heel drop protocol I ran 10k on Sunday and Monday there was pain that gave me a limp. Tuesday that pain has reduced i get through 3-5 reps before i think i should stop (there is pain in every rep but builds per rep)
    I dont want to be out of action for too long as i have a half marathon in September and dont want this achilles pain to affect my build up for that.
    Should i wait until the pain lessens before doing the protocol or do as much as i can now and build up?
    Huw

    Reply
    1. Coach Jeff says:
      June 11, 2013 at 5:20 pm

      I would wait until youre feeling 85-90% pain-free before starting the protocol.

      Reply
  16. una says:
    July 30, 2013 at 6:23 pm

    Hi there , i have just started a running club and although at present i am only doing a mile, I am really frustrated as I get very painful achilles while running! The pain eases off completely after a while, but like many others, would be stiff first thing in the morning. I have played ladies football in the past 15+ years ago (I am 43 now) and this has always been a problem for me. I did manage a leg of a marathon 3 years ago but again achilles pain was a big problem. Any advice where my first port of call should be?
    thanks
    una

    Reply
  17. Mike B says:
    August 7, 2013 at 1:06 pm

    Hi Jeff,

    I developed bilateral AT in Nov 2011. (Caused simply by too much forefoot landing and too much barefoot running on grass classic mistakes.) Since then I have read hundreds of articles on the subject and seen several professionals. I want to let you (and everyone else reading) know that this is one of the best articles on the subject that I have come across. There are other good articles out there but this one hits on all the major points and does a good job.

    There are a few things that your article doesnt mention, which maybe you can expand on:

    1) Should we ice after doing eccentrics? You mention to ice after running but not after eccentrics. Is this because running (and any other concentric-heavy training) is bad and should be iced to inhibit change in the tendon, while eccentrics are good and thus the body should not be hampered from doing its thing? Most PTs will tell you to ice after these exercises, but I wonder if icing would actually diminish the effect of the eccentrics.

    2) I realize that the jury is still out, but does it seem that by doing enough eccentrics one can fully heal themselves of this injury? Or will the tendon always remain in a weakened state no matter how much we do of the eccentrics?

    3) WARNING. I would like to caution everyone who is doing eccentrics. Dont load up on weight too fast, make every change very small and do that weight for a week or more before adding weight. This also goes for the amount that your heel drops below the step. I had worked up to a lot of weight and decided one day that I should be dropping my heal a little lower, thinking it would be necessary for running up hills. There was no pain during the exercises that day but guess what happened the next day? I developed bilateral Plantar Fasciitis and still have it a year later. Just like AT, PF is no joke. PROGRESS SLOWLY and BE CAREFUL. These eccentrics are not idiot-proof. (As I have shown!)

    Thanks Jeff for your answers to my two questions.

    Reply
  18. Peter says:
    August 14, 2013 at 5:09 am

    Great article thank you. I do not have any Achillies injuries but many around me do and these put them out of action for considerable lengths of time. As a preventitive measure should I routeninly incorporate some eccentric heel drop excercises and is it ok to use the dropped leg to lift my heel up after the drop?

    Reply
  19. Anne Dineen says:
    August 14, 2013 at 7:35 pm

    This was a very interesting and helpful article, as someone whos been running for over 35 years (varying in intensity through the years). My achilles tendon issues (20 years or so?) ebb and flow, with an increase in problems happening with more mileage. I have tried lots-rest, ice, advil, massage, electric stim, night splints, accupuncture. I also went to a place that analyzed my running gait for feedback about tendencies that may affect my achilles. Honestly, I believe that some of us are just simply prone to this despite some earnest efforts to make change and treat it. I have come to accept that this is part of running for me though I try to be careful, stretch more, get new shoes more often and avoid certain types of running that add to the problem (sprints, e.g.). For me, I treat it as one might who has diabetes or some other chronic medical issuejust trying to manage it, or keep the major pain at bay. Anyway, I feel for all of us who have it, as running seems so easy without it!!

    Reply
  20. Jennifer McKenzie says:
    August 22, 2013 at 11:29 am

    Ive never been much of a runner, but recently after completing the C25K for the 3rd time in about 5 years, I was challenged by twice in one day by two different people to forge ahead and set a new goal of running marathons. Im registered for a 1/2 in November and started training and immediately started having serious calf pain. I have a history of serious plantar fascitis (saw podiatrist, had steroid shots, regular PT, wore boot, heel lifts, better footwear had eventual recovery) and thought it might be relapse related to that and going back to bad daily footwear habits. When I found your article I started connecting my history of PF together with current calf and AT pain and treatment. At first the pain seemed to be referred to the soleus but I was pretty sure it stemmed from midpoint AT. The treatment you recommend has been spot on and amazingespecially compared to recovery rate on earlier PF. Ive followed your treatment diligently including icing after runs, heating the muscle before runs, diligent eccentric heel drops twice daily, rolling with The Stick, calf strengthening, sleeping with the support and general leg/hip/quad stretches. Over the last 6 weeks having just transitioned from C25K to 1/2 marathon training, the pain has subsided in the calf area but shifted into insertional AT. Im wondering if Im stripping away referre pain and getting to the real root of the problemback to the PF cause which was always AT related. My questions:
    1) Any evidence to back up this assumed connection?
    2) Ive been wearing low heel Merrells for walking one day a week. Should I ditch them and switch to my higher heeled running shoes for walking, too, for now?
    3) Should I also switch from eccentric to flat heel drops since pain has shifted?
    4) And, as someone asked earlier, should I ice following stretches or not? Thanks!

    Reply
  21. Ken says:
    August 27, 2013 at 9:42 am

    Ive been diagnosed with insertional Achiles tendonitis with significant calcification on the posterior exterior of the AT. Fortunately, based on an MRI, it appears that the calcification has been confined to the exterior of the AT, and there is tendon itself has only been compromised minimally. The condition has severely limited any running or tennis and has started to impact my ability to hike. Surgery was presented as the only viable course of action and has been scheduled for next week. First question: Even though the calcification is a result of the problem and not the problem itself, is removal warranted? Second question: Would I be correct in assuming that once the calcification has occurred, no amount of flat-ground eccentric heel drop exercises will remove the calcification? Thanks for an informative article and real world advice on this problem. Ken

    Reply
  22. Kat says:
    September 3, 2013 at 10:00 pm

    Hello, thanks for the informative articleI just started running about 2 weeks ago, nothing very intense (about 4-6 km at an easy pace), and Ive noticed that my Achilles tendons can get pretty sore during the run. The pain is relieved almost immediately after I stop and it isnt bothersome except when I run (mostly if theres an incline). Should I be concerned, or is this just a part of the process of getting used to running again? I guess what Im wondering is whether soreness in the area while running is a normal thing to experience, since the body is getting used to a new activity. Thanks in advance.

    Reply
  23. Ron says:
    September 8, 2013 at 9:30 pm

    I have dealt with insertional achilles tendonitis for >18 months. I think it was induced by taking Ciprofloxin for a sinusitis. It never really hurt while running but only afterwards and for days later. After 4 marathons and 2 IM triathlons, I was really wanting to fix it.

    So I booted it for > 1 month; then a PRP injection followed by 3 weeks casted; then another 3 weeks booted. How could this thing still be sore(even slightly) with those first steps when Ive been sitting awhile. . . seems like nearly 3 months would be allow it to cool off completely.

    1. Im cycling and swimming but not sure what to wait for prior to introducing running again. Should there be zero pain anytime?
    2. How much weight do I add for eccentric (flat surface) contractions? 30 lb dumbbell?
    3. Is the Cipro-induced tendonitis different? In that it takes time to recover and rest for exercise is irrelevant? (and thats why mine is still slightly tender?)

    Thanks. I need to get back to overtraining.

    Reply
    1. Cd says:
      January 20, 2014 at 5:08 pm

      Hi ron

      I wondered how you were getting on now? After a short course of ciprofloxacin I have been having some At issues. Never in my life before taking the medical. Im a 30 year old runner from uk. Im just wondering when Ill be able to run again. Switched ti swimming and cycling fir time being.

      Reply
  24. Garry Lee says:
    September 19, 2013 at 2:54 am

    Im 63 now and havent run for 25 years. About 28 years ago while running and cycling, I got achilles tendonitis for a year. Stretching was in vogue at the time and still is to judge by some of the bunkum above. After a year I stopped stretching totally and had heavy massage and Ive never had it back. Ive cycled about 7000 miles a year since. There is NO scientific evidence of any benefit of stretching and in fact most runners here in Ireland no longer stretch. My daughter is an international runner and Im a retired doctor and have extensively researched the literature on it. My daughters coach who was an Olympian himself often says.. Did you ever see a racehorse stretch?
    Stretching is hocus-pocus for runners.

    Reply
  25. Brian says:
    September 22, 2013 at 2:51 am

    Any specific running shoes that anyone recommends for AT issues. I currently run in the ASICS Nimbus. Has a really cushioned heel which I feel may be adding to the problem. Not sure if there is a shoe guide out there for a shoe with a stiffer heel area.

    Reply
  26. Mark Butler says:
    October 2, 2013 at 8:31 am

    Achilles problems can be some of the hardest injuries to overcome when training for a marathon. I had server Achilles problems training for the Paris marathon this year. In fact it almost prevented me from running completely. I decided to create a blog to document my struggle and the tips I used to overcome the injury and still finish my goal of a sub 4 hour marathon. You can find my blog here: http://achillesmarathonrecovery.com/ I hope you it interesting and useful.

    Reply
  27. Victor says:
    October 3, 2013 at 7:38 pm

    These exercises are amazing. After the stretches with tightness and soreness gone I am thinking about resuming my running full force. Because I am running Boston in 2014, I am worried about conditioning etc. and right now I run 3X a week and then stretch like mad. These are helping tremendously. Funnily enough I had the same issue with tendon on the other leg last year and did these exercises and was able to qualify respectfully for Boston. Thanks and I am this exercises biggest fan.

    Reply
    1. Outrunu says:
      November 25, 2013 at 5:38 pm

      Hi, just wanted to know how much you were running during the eccentric heel drop phase of your rehab. And was it slower that your usual training pace? Thanks for your time.

      Reply
  28. Allison says:
    October 5, 2013 at 5:19 pm

    After researching a lot of material, I initially thought that I might have IAT. But now, Im unsure if its that or non-insertional AT. Because of that, rehabbing it is confusing for me. Does insertional AT have to be directly over the heel bone? Or can it be literally RIGHT above the heel none in that softer spot where the back of the ankle contours inward? I see to have a little tenderness directly on the heel bone, but I also can feel a little tenderness immediately above the bone. It seems like the location of irritation for me is almost right between where the two different types manifest. Im really unsure. Can anyone give me some insight? Thanks!

    Reply
  29. Howard says:
    October 8, 2013 at 10:34 am

    I have been suffering from midpoint tendinitis about 3 month with lots of advice from various physios. I tried the eccentric heel drops and the pain subsided within 2 day. I very pleased. however I do have a bump about 7cms from my heal. My question is; when do I use ice? I have being icing after heel drops.

    Reply
  30. Outrunu says:
    November 25, 2013 at 5:36 pm

    Going on one year for midpoint AT. Eccentric heavy load up to 40lbs X12weeks did the trick to get it feeling normal. Then I raced a 5k and did a few other fast runs over a week or so and it CAME BACK. It seems to be a little higher in the tendon now. No pinch tenderness any longer, just a dull ache. I am now slowly increasing mileage (at slower that usual pace) and restarting the drops. I do drops with weight and eccentric stretches after runs daily. I am having slow improvement. Thanks for your time.

    Reply
  31. Ashley says:
    November 27, 2013 at 2:37 pm

    Cold Compression therapy really does the trick to keep inflammation down. There is a company that makes great wraps that target the Achilles Tendon that are comfortable practical to wear. I always wear them after a run whether I am hurting or not. This way it prevents the inflammation from building up. If you do consider these wraps, definitely look into purchasing the accessory strap as well. I have small ankles and need the additional cinching to make it a bit tighter. A lot of people do not consider cold as preventative action but it works well for me. Worth a look into at least for some.
    http://www.kingbrand.com/Achilles_Injury_Treatment.php?REF=34PV8

    Reply
  32. Alison says:
    December 4, 2013 at 6:04 pm

    The standard Doctors direction for most Achilles Tendon injuries is to rest the injury and let it heal over time. Doctors usually recommend patients try to stay off their ankle as much as possible. To ease discomfort doctors often suggest taking something for the pain. With this course of treatment, in most cases, the Achilles Tendon will heal itself within 1 to 3 months. If you want superior treatment though, anyone can choose the same treatment used for Professional Athletes.

    With more severe or persistent Achilles Tendon injuries, or due to time constraints such as in the case of professional athletes, time is critical and a proactive treatment plan is required. For the most important patients, a regular routine of BFST (Blood Flow Stimulation Therapy) is typically undertaken to significantly accelerate healing. Where rapid recovery and complete healing of the Achilles Tendon are required, BFST is also required.

    Reply
    1. Ashley says:
      January 9, 2014 at 9:47 am

      Where I get my cold compression wraps, they also make Blood Flow Stimulator Wraps. This is exactly what you are talking about. They must work. Maybe I will look into them. I posted the same link I did above to the company that makes them, straight to the ankle page.

      http://www.kingbrand.com/Achilles_Injury_Treatment.php?REF=34PV8

      Reply
  33. Guillermo Caceda says:
    January 14, 2014 at 7:04 pm

    I have insertional Achilles tendonitis, Could ride a bicycle help someway as part of the exercises?
    Thanks

    Reply
    1. Coach Jeff says:
      January 15, 2014 at 1:21 pm

      Unfortunately, the bike still puts stress on the achilles, so is not a recommended cross training activity. I would try swimming or aqua jogging instead.

      Reply
  34. bala murali krishna says:
    January 24, 2014 at 10:16 am

    Hello:
    Had plantar fasciitis since 2000. a year ago, I got some orthotics that seems to have eased the PF but the heel pain didnt go away. a recent MRI then found insertional achilles tendinosis. not sure how long I have carried it. Ultrasound, myofascial release, exercise over the past two months have significantly eased the heel pain butits not going away, even though I am not running. My physician is recommending PHP therapy. Should I be trying the eccentric exercises? any suggestions? thanks

    Reply
  35. bala murali krishna says:
    January 25, 2014 at 9:04 am

    That should have been PRP (plasma-rich platelets) therapy. thanks

    Reply
  36. marcel Barnaby says:
    January 27, 2014 at 9:02 am

    I was just wondering if doing eccentric heel drops on flat ground would have any good effect on midpoint tendonitis? I am aware the step variation is better for midpoint but i get better results doing the heel drops on the ground, if that makes any sense. Comments??

    Reply
  37. Steve Cotton says:
    February 1, 2014 at 5:19 pm

    Seeking advice. Have experienced what appears to be insertional Achilles tendinosis for 5+ years. Have run marathons every year until last year. Injury likely occurred when I changed training to include more speed work for Boston and also trained for Pikes Peak ascent (bad combo) in 2011. I quit running for 5 months this year and then did 4 weeks of eccentric drops. But Im still getting pain on back of heel when I run. X-rays show what looks like bone spur or growth and I do have a visible bump at back of heel. Out of options Im considering ESWT treatment. Will it be effective?

    Reply
  38. J M says:
    February 25, 2014 at 10:48 pm

    I have unbearable pain if I take out my heel cups even for a couple hours. It has been a year and a half and nothing has changed. I dont dare try anything here because I cant even walk without a heel cup! (and by unbearable pain, I mean unbearable) Even not moving for a few hours I will feel throbbing pain on my achilles -out of options, any ideas for me? Im about to move to Colorado where there will be all the mountain trails Ive always wanted, and yet I think I will be tortured by the fact I cant run on them instead while Im there. I was considering getting Hoka One One Conquest shoes but honestly I feel doomed no matter what I do.

    Reply
  39. Steve Beebe says:
    March 3, 2014 at 2:13 pm

    I have IAT that is quite uncomfortable at the moment. Cant run. Been running ~45 mpw with speed work, tempo runs, and a up tempo long run (Hansons plan).

    Would an elliptical be a reasonable cross training activity?

    thanks,

    Reply
    1. Coach Jeff says:
      March 4, 2014 at 7:58 am

      I find elliptical still aggravates the achilles. Try aqua jogging or swimming instead

      Reply
    2. MarkHab says:
      December 4, 2015 at 2:24 am

      Elliptical training puts much less strain on my achilles than running or cycling.

      Reply
      1. Coach Tina says:
        December 4, 2015 at 5:57 am

        Thats great Mark, if it works for you while your achilles is healing, keep it up!

        Reply
  40. Ian says:
    March 3, 2014 at 3:59 pm

    Excellent article, thanks.

    Do you know if collagen supplements will help with achilles rehab?

    If heel drops cause new collagen fibers to grow, then perhaps an oral collagen supplement would accelerate the process a bit. Or perhaps not. Ive searched around the web and cant find any testimonies to this working. Cheers

    Reply
  41. Mark Ballou says:
    March 18, 2014 at 4:13 pm

    Question: Should both legs be exercised even if only one is injured? If so, should one use a box or step to get in the upward position on the injured side?

    I have mild discomfort near the insertion point following some aggressive hill work. Am trying to prevent it from becoming a larger issue using the suggested flat protocol.

    Thanks for all the great info you provide. Youre a great asset to the running/fitness community!

    Reply
  42. Jay says:
    May 8, 2014 at 12:55 pm

    I have had moderate IAT for the past 8 weeks which developed from cross-country skiing after a period of inactivity. I am seeing a physiotherapist, doing daily eccentric heel drops, etc. and Im seeing a small amount of improvement, but progress seems to be slow.

    In the spring I usually add road cycling to my training regime, will cycling aggravate my IAT?

    Reply
  43. joey micky says:
    May 18, 2014 at 11:47 pm

    I twisted my ankle really badly 3 years ago since then my form for walking and playing basketball suffered due to weakness in the foot. I continued playing and got really bad insertional achilles tendonopathy with a retrocalcaneal heel spur. It hurts like crazy after I run even a sort while. Swimming is probably the best exercise for my condition, Ive given up hope and think this is a condition I will be suffering for the rest of my life. Surgery is really invasive and requires at least a year until you can be active again. Im gonna see a podiatrist and a Chirac who specialize this type of injury.

    Reply
  44. Mark says:
    May 30, 2014 at 2:13 pm

    Hi,

    I got pain in my tendons from getting 2x500mg ciprofloxacin for 10 days.
    Does anyone know what to do?

    Regards,
    Mark

    Reply
  45. Richard says:
    July 13, 2014 at 10:51 am

    Dear all a word of warning for any of you runners that also do explosive sports, eg squash or tennis. I have played the former to a high standard for 25yrs, had minor injuries but never an achilles issue. I also occasionally run. In April I developed what I now know was tendinitis from the running ignored this for 2 weeks played squash with a little discomfort then BANG = achilles rupture. So into the plaster,crutches, boot, physio routine. So, my message is, if you have these warning signs, you may get away with running, but lay off the explosive stuff. Cheers Richard

    Reply
  46. eamon says:
    July 16, 2014 at 9:15 am

    Davis! Thanks buddy, cool to see u got all sorts if good info. I got a bump in my achillies this shit was helpful mang! Hope ur well!

    Reply
  47. Yiannis says:
    July 17, 2014 at 5:57 am

    I have an achilies insert problem, had it for 7 weeks and no better, I have stopped running and last week only went swimming. I done squats the other day and now can feel it worse than before every so often when I walk. I read your site but confused on what to do as rest along is not working

    Reply
  48. Daniel says:
    July 21, 2014 at 3:38 pm

    Ive had insertional achilles tendonitis since last summer. I tried the eccentric heel drops which honestly didnt seem to do a thing for me. I finally took 5 months off with no running and the heel was still irritated. What finally helped me was the combination of switching to a shoe with a higher drop (12 mm) and being dedicated with the contrasting bath each day. Im back up to nearly 30 miles a week and while I occasionally have a bit of a stiff achilles in the morning it isnt painful at all. Im going to continue with the contrast bath the rest of the year to be sure but it looks like a good outcome.

    Reply
  49. Kathryn says:
    July 22, 2014 at 9:58 pm

    Thank you so much for writing this article! I developed an insertional tendinitis, I believe from switching shoes and wearing a pair that caused a lot of friction over the bursa.

    I find it very interesting that PT and Ortho MD recommendations vary quite a bit (Ortho recommends NSAIDS, stretching and rest while PTs seem to recommend foam rolling over stretching, no NSAIDS, and light easy running). I always trust PTs with soft tissue injuries more so I am going to try this method and hopefully Ill be back out on the roads soon!

    Love your site and I really value the information you give in these articles.

    Reply
  50. ross says:
    August 16, 2014 at 12:41 pm

    has anyone tried a BFST device? by either mendmeshop or king brand?does anyone recommend themor notwhy or why not?

    Reply
    1. Ashley says:
      January 21, 2015 at 4:45 pm

      Yes, I have used for ankle and most recently bought for my wrist for carpel tunnel syndrome. I think they are great. There is so much information on the web site. The main idea is get the inflammation down and stimulate the blood flow to help heal the damaged tissues. Worth a look into. They are also great to have on hand for future injuries.
      http://www.kingbrand.com/KingBrand-Home.php?REF=34PV128

      Reply
  51. Hollt says:
    August 26, 2014 at 10:45 pm

    Please can anyone help with some advice. I have developed severe bilateral tendonitis after a course if ciprofloxacin. It keeps getting worse and now the pain is v bad at night from very minimal activity. Any kind of training is out and I am limited to hobbling around the home. I am six weeks out of the last antibiotic and getting really concerned. Because it is in both legs it makes things pretty impossible. Worse, no one really seems to understand the mechanism by which this damage occurred and so are wary of treatment plans. My pt told me rupture can, and does, occur with these cases and they want to be very conservative. I am not even sure if I can use heat as the pt thinks there is more inflammation with cipro damage than the usual mechanism.

    Also, I want to warn others to be extremely careful of these drugs.

    Reply
    1. John G. says:
      April 14, 2015 at 11:01 pm

      Hi, Ive had similar issues, only in the left heel, from doing physical activity while taking Levaquin. Its been going on for five years. Doctors havent been much help. Someone clued me in to Hoka One One running shoes, which are about the softest shoes you can find, and even with them, I still add an orthotic on top of another orthotic, out of which Ive cut the heel and replaced it with gel pads, which I change every month, believe it or not. Im slowly working into these flat eccentric drops, but extremely slowly, and on both legs, not all weight on one. Reinjuring it is the worst thing you can do. Five years without being able to walk without a shoe, run, or jump. Where does yours hurt? Mine hurts right below the heel bone, where it meets the fatty part of the heel.

      Reply
      1. Coach Tina says:
        April 15, 2015 at 4:04 pm

        Hi John, thanks for sharing. Glad you have found some relief with the Hoka One shoes. It is good that you are taking the heel drops gradually, it is better to do them correctly, than to rush them and do them wrong. Hopefully you find some comfort from others within this forum!

        Reply
  52. Norberto says:
    August 30, 2014 at 10:17 am

    Chicks tend in order to give often be on interest your girlfriend thinking enjoying
    at just 45 degree incline with the bottom. First
    the fear is addressed, then the back pain begins to go away.

    This effect is found not only in chimneys but also in tall buildings.

    Reply
  53. Joe says:
    September 2, 2014 at 10:29 pm

    Ive had IAT now for 18 months. I had a boot on each foot for 3 months; now have pain in both heels all day. I started eccentric heel drops 4 weeks ago and the pain is continuing; sometimes it feels like it is getting a bit worse, though. I understand I will feel pain with eccentric heel drops; questions are how long before the pain should subside and how much pain is too much? I realize these are subjective questions; just looking for advice. Thanks.

    Reply
  54. Kevin says:
    September 7, 2014 at 12:22 pm

    I had trouble all of last year with Plantar Fasciitis and some AT following an Ironman event. The Strassburg Sock is the best. You wear it at night to allow a slight stretch and to allow everything to heal. I am now at a point where I only wear the socks in the morning for 10 or 15 minutesI make the stretch a bit more aggressive and legs feel great. Highly recommend the Strassburg socks.

    Reply
  55. Joe Van Steenbergen says:
    September 7, 2014 at 10:56 pm

    I am in week 5 of 12 with heel drops. I have noticed increased pain levels in the heels, but I understand that additional pain should be expected at first. Question is; how long before the pain stops if the therapy is working? Thanks.

    Reply
  56. Elliott says:
    October 2, 2014 at 7:11 pm

    Ive found that a very practical way to do heel drops is to go down stairs backwards. This avoids the little dance of switching to the other leg to go back up, and its especially helpful if like me you have both sides injured.

    Reply
  57. lugduna says:
    October 12, 2014 at 9:15 am

    Shockwaves helped me a lot even though they only did the trick together with the exercises described in the article..
    I have been injured with AT some 40 years ago (I am 57 now), and never really cured since (got it all from cortisone to plaster).
    I nevertheless had managed in the meantime to run 3 times a week for about 45 most of it uphill, fasted, at 5-6 AM and after some years of that regimen, my achilles tendons were more than sore again.
    The only thing that worked to start with were shockwaves, but it all came back, when I tried to take up my regimen as before. What now really got me back to running was 1) a (new) series of shockwaves (while no running, some light biking hardly tolerated, followed by 2) eccentric exercises as described, together with: a special bandage with small rubber plots (achillotrain pro), hoka one one shoes (giving much more resistance than asics nimbus, but still with extreme cushioning), warming my tendons over night with hot packs, icing after running.
    I hope I will be able to get rid of these aids one day, but as of today, thats what it took me to be able to run for about 1 hour, or something like 7 km without major pain.
    Good look to all of you

    Reply
  58. David Boorman says:
    October 25, 2014 at 2:21 pm

    I have been struggling for the past 3 months. I made a brief comeback and was quite confident I was fully recovered. Had done 3 small runs through the week but on my 4th a felt my Achilles twinge again just below my calf. I have totally rested for the last 3 weeks and it feels good when walking round work or even when i try a little jog (approx 20/30 yards or so. But sometimes usually when I am sitting down I feel an odd twinge below the calf. I am scared to try anything in case it goes again but I really want to be back running again. Any advice would be really really appreciated. Thanks

    Reply
  59. alex brinkert says:
    December 8, 2014 at 8:52 pm

    Ive been having jolts of pain every now and then at the bottom of my heel like a twissting and shocking pain. The pain is so bad that its bad enough to almost take me to the ground and i work in construction and want this to stop if there is anyone that can send me a link of some vids thatll be more specific on the exercises im nervous cuzz i torn my tendond on the side of my ankle and was out of work for 6 months and hearing something could go wrong with my achilies tendond scares me and i just turned 22

    Reply
    1. Coach Tina says:
      December 9, 2014 at 7:08 am

      Hi Alex, sorry to hear you are having trouble, but hopefully these articles will help https://runnersconnect.net/running-training-articles/how-to-strengthen-your-calves-and-achilles-to-prevent-injury/ and http://www.runnersworld.com/stretching/eccentric-calf-strengthening-achilles-tendinopathy-five-years-later

      Let us know how you get on, and look after that achillies

      Reply
  60. Mark Butler says:
    January 1, 2015 at 7:55 am

    If any of you guys are going through issues with achilles problems when training for a marathon then I feel your pain. I went through a terrible time when training for the paris marathon. You can read my tips and story here:

    http://achillesmarathonrecovery.com/

    My top tips are:

    1. Dont get injured
    2. Dont overdo it
    3. Invest in a pair of good trainers
    4. Stretch
    5. RICE
    6. Seek medical advice
    7. Stay positive
    8. Take some time off
    9. Come back slowly
    10. Stretch I cant stress how important this is!

    Reply
    1. Coach Tina says:
      January 2, 2015 at 8:15 am

      Thanks for your tips and thoughts Mark, seems we have a lot of the same points, and others can check out your site if they are looking for more information.

      Reply
  61. Sean Mulligan says:
    January 16, 2015 at 11:54 am

    I am only 5 weeks post-op after sustaining a total rupture of my right achilles tendon, so Im obviously not ready yet to begin these exercises. But have you any advise for how I can best prepare for eventually getting back out running? Time frames etcthe surgeon says Im probably looking at 12 months untill active running? I was hoping to make it back sooner than thatany advice you can give me would be much appreciated.
    Sean.

    Reply
    1. Coach Tina says:
      January 16, 2015 at 1:20 pm

      Hi Sean, this is probably not what you want to hear, but you are best listening to your physician. Each case is different, and they will see you and see how it is repairing to tell you when you are ready to start running. Hopefully this article will be helpful for you when you are ready to return, and it talks about returning after surgery also. https://runnersconnect.net/running-training-articles/return-to-running-after-an-injury/ Rest up!

      Reply
  62. Paul says:
    February 2, 2015 at 8:10 am

    Hey guys, does anyone know what to do for mid-point achilles tendnitis *AND* insertional achilles tendonitis?? I have so far not seen anything on the internet for an injury like this!! It seems that I have pain both at the heel (or just above) and sometimes at the mid-point as well. The insertional pain is much more acute, and the mid-point pain more like a deep muscle type pain. At first I tried the eccentric heel drops off a step but after only slight improvement and realising I had insertional achilles tendonitis as well I stopped and started flat eccentric heel drops. Now the pain is much better overall but I still have mid-point pain when I run sometimes. Now I have no idea what to do. Should I do BOTH exercises? maybe on alternating days? Do eccentric heel drops off a step *cancel out* flat eccentric heel drops?

    Any help at all will be much appreciated. I have had this for about 5/6 months, and everytime I try to return to a run I get pain after around 1 mile. Cheers!

    Reply
    1. Coach Tina says:
      February 2, 2015 at 1:49 pm

      It would probably be safest to just stick with the insertional exercises, as you will still hit the muscles needed for the mid point. Sorry to hear you are having such a rough time, but hopefully the exercises start to strengthen that achilles in the right way, so it can calm down a little. Best of luck, let us know how you get on. We would be interested to hear!

      Reply
      1. Paul says:
        February 2, 2015 at 3:34 pm

        Thanks for the speedy reply- much, much appreciated.

        I will ditch the eccentric heel drops off a step. I wonder if foam rolling the calf muscle instead would be a good way to combat the resulting stiffness without irritating the insertion point?

        Thanks again!

        Reply
        1. Coach Tina says:
          February 3, 2015 at 6:45 am

          Keeping your calves loose through foam rolling would be a good idea, just be careful to not overdo it!

          Reply
  63. Helen Irwin says:
    February 3, 2015 at 4:11 am

    For the past 3 years I have suffered daily with neuropathy. Well its been just 1 week and I just cannot put into words how brilliant my results have been. I have absolutely no more hyper sensitivity and no more agonizing burning pains.

    Reply
    1. Coach Tina says:
      February 3, 2015 at 6:46 am

      Thats great Helen, glad you found something that worked for you!

      Reply
  64. Chris says:
    February 19, 2015 at 4:44 pm

    Hi guys,

    Im running the London marathon in 10 weeks time, Its my first marathon, training is going well but as Ive increased the training im starting to feel a slight pain in my achilles tendon, I feel the pain for the first few miles then the pain goes away but feel it again the next morning, the pain isnt too bad at the moment but can imagine its gonna get worse! I dont really want to rest it for a few weeks as need to train, was wondering if you had any advise to get through it without resting? Thanks

    Reply
    1. Coach Tina says:
      February 19, 2015 at 4:57 pm

      Hi Chris, sorry to hear your achilles has been bothering you. Our best advice is in this post, and a lot of it you can attempt to see how it changes without taking time off. This article may also be of help to you https://runnersconnect.net/running-training-articles/how-to-strengthen-your-calves-and-achilles-to-prevent-injury/ Hope all goes well, and best of luck (I am actually racing London too!).

      Reply
      1. chris says:
        February 20, 2015 at 2:52 pm

        Hi Tina, thanks for the reply yeah I will try them out and see how I get on hopefully will do the trick, thanks for the advice and good luck in the marathon

        Reply
  65. Josh Tracy says:
    February 27, 2015 at 6:47 pm

    Hello, I have had what I guess would be midpoint achilles tendonosis for approximately 3 weeks. I have not run at all, since it seems to make it worse. However, I did not know what to do about it so I did nothing after the run. Can I run? If not, how do I know when I can start back up safely? How do I judge my progression? I currently have little to no pain while walking and most everything normal. I am trying to massage it rather than stretch it much. It is creaky. Thanks, Josh

    Reply
    1. Coach Tina says:
      March 1, 2015 at 12:11 pm

      Hi Josh, the suggestions we have made in this post are what we are able to offer for you. It would be impossible for us to make a specific suggestion for you as we do not know your body. Your best bet is probably to check with your physician, but make sure you incorporate the exercises we suggested into your daily routine at least twice a day right now. Massaging it is probably not a good idea as you may make it more irritated, but if you could get in to see a specialist, they may be able to help you get rid of some of the swelling. If it is creaking, it is probably going to need a little more time off. Make sure you add in the exercises for now! Hope this helps!

      Reply
  66. Linda Smith says:
    March 8, 2015 at 8:51 pm

    Dear All,
    having been diagnosed with AT and plantar fasciitis since 200, I had given up hope. I was extremely fit working out 5 times per week. I piled on weight ie 100 pounds. I was always in constant daily pain.
    I am now pain free it is a miracle let me tell you how.
    I just happened to buy scholl tri comfort orthotics, which I used with memory foam cushion heel support. Voila the results are amazing. I am pain free and the bump on my heel is reducing.
    Please try it as I was having talks about surgery.
    Please note I am only using the orthotic and the heel supports in trainers only.
    Good luck

    Reply
    1. Coach Tina says:
      March 9, 2015 at 9:12 am

      Hi Linda, thanks so much for sharing, and glad you are feeling so much better. Hopefully you are able to get back to working out very soon

      Reply
  67. Paul says:
    March 21, 2015 at 11:07 am

    Ive got midpoint tendonitis in my right leg that Im hoping to cure, but I was wondering if doing no calf exercises during the healing period is a good idea. If I do all the work to raise on my left leg, then wont my calves become lopsided? Having one weaker calf seems like it would create a situation where Im more likely to get injured. Should I do other exercises to maintain the calf muscle without damaging the tendon further?

    Reply
    1. Coach Tina says:
      March 23, 2015 at 5:05 pm

      Hi Paul, you would want to do exercises in both legs, as you can prevent it happening in the other leg also. You can still complete these during the healing phase, and some discomfort is okay, just make sure you are lifting up with both legs. Hope this helped!

      Reply
  68. Karl Lewis says:
    March 23, 2015 at 4:19 am

    Ive been running for 7 years, gradually building up speed and distance. Like off road/cross country and fell running. Did a off road race the weekend and damaged my achilles tendon, its difficult to walk on. swollen a few inches above the heal and feels a bit crunchy when walking. Would you recommend the eccentric heal drops right away?

    Reply
    1. Coach Tina says:
      March 23, 2015 at 5:13 pm

      Hi Karl, sorry to hear about your achilles, it would probably be best to give it a few days to calm down, but you can start them within a week, they can be a little painful as you lower down, but if it is extremely painful, back off and give it a few more days. Hope this helps!

      Reply
  69. sean says:
    March 25, 2015 at 3:30 pm

    my right Achilles tendon hurts really bad and I dont know if ive pulled it or tore it I cant bend my foot down or point my toes the only way I can bend my foot is upand even then It hurts but not as bad as it does when I try to bend it down

    Reply
    1. Coach Tina says:
      March 26, 2015 at 7:15 am

      Hi Sean, sorry to hear about your achilles pain. Your best bet would be to go see your doctor, and they can diagnose you, once they give you this information, you can come back to this post and determine where you should start. Sorry this is not what you are looking for, but we cannot diagnose you unfortunately.

      Reply
  70. suzy says:
    March 30, 2015 at 4:04 am

    i have had achilles tendinitis in both legs for months now. firstly, a huge thankyou for the modified exercises for those affected on both sides. secondly, my case is a little different as my doctors believe it was caused by a reaction to ciprofloxacin. as a result as well as the chronic bilateral tendinitis i am at increased risk of rupture. the problem is i cannot find a doctor/physio who understands cases caused by drug reactions or how to treat. it is so bad a potter around the supermarket leaves me in pain and it hurts a lot at night. does anyone know of a medical professional who knows how to treat this (neither anti inflammatories or steroids are an option as they can precipitate rupture). i am fairly desperrate at this point.

    Reply
    1. Coach Tina says:
      March 30, 2015 at 2:50 pm

      Hi Suzy, sorry to hear that. Hopefully someone will be able to help you out, but it may be difficult as our readers are from all over the world, and are not likely to be near you. Your best bet is to keep listening to your doctor, and hopefully it will improve.

      Reply
    2. John G. says:
      April 14, 2015 at 11:04 pm

      Hi, I posted this reply to another similar post above. Ive had similar issues, only in the left heel, from doing physical activity while taking Levaquin. Its been going on for five years. Doctors havent been much help. Someone clued me in to Hoka One One running shoes, which are about the softest shoes you can find, and even with them, I still add an orthotic on top of another orthotic, out of which Ive cut the heel and replaced it with gel pads, which I change every month, believe it or not. Im slowly working into these flat eccentric drops, but extremely slowly, and on both legs, not all weight on one. Reinjuring it is the worst thing you can do. Five years without being able to walk without a shoe, run, or jump. Where does yours hurt? Mine hurts right below the heel bone, where it meets the fatty part of the heel.

      Reply
  71. greg hudson says:
    April 1, 2015 at 12:46 pm

    Many people describing Hakan Alfredsons protocol mention performing the heel-drops and continuing through pain. I believe Alfedson himself said his patients would continue their heel-drops unless the pain became disabling, then once pain levels drop, add more weight.

    Im curious about your description and definitions of this pain. What is a good pain vs bad pain. What type of pain should be expected as normal. For example, is a patient supposed to anticipate meeting the same pain that annoys them regularly during their tendonitis/tendonosis flare-ups, the midpoint tendon ache that occurs the morning after a bad run or run before fully recovered? Or is it a different type of pain akin to muscle-fatigue pain or stretching pain or something else?

    Reply
    1. Coach Tina says:
      April 2, 2015 at 2:59 pm

      Hi Greg, thanks for your question. When we talked about pain in this post, it was specifically during the motion of those exercises. It will probably be similar to those flare ups, but most people will not be running at the point where they are in pain for these exercises as they will be taking time off to recover. It will be a similar pain to that ache you feel during the flare ups. Hope this helps!

      Reply
      1. greg hudson says:
        April 10, 2015 at 12:06 pm

        Curious, is email a requirement of successful therapy via this eccentric exercise? I slowly built up to 35 lbs (straight legged only) and never felt any ache or pain. Could that mean I wasnt using enough weight?

        Reply
        1. greg hudson says:
          April 10, 2015 at 12:08 pm

          oops i meant pain, not email. Too much multi-tasking. Is inducing pain via the eccentric movement and critical component for success? thx!

          Reply
        2. Coach Tina says:
          April 10, 2015 at 5:50 pm

          When do you feel the tendon pain otherwise? If you never felt any pain, and you are sure you are doing the exercise correctly, then there may be something else going on.

          Reply
          1. greg hudson says:
            April 12, 2015 at 12:26 am

            I primarily only feel the pain during flare-ups which occur after some disagreeable exercise. But ill rest for a week or two and after the flare-up the pain is mostly gone.

          2. Coach Tina says:
            April 13, 2015 at 8:16 am

            Hi Greg, it sounds like you understand your body pretty well by now. Just listen to the pain, and stay away from exercises that bring it on.and bring them back in slowly so you can test if it still bothers it. Best of luck!

  72. Garry says:
    April 2, 2015 at 12:24 pm

    I have ruptured both of my Achilles tendons. The first one 35 years ago and the next 12 years later. I still run and compete in triathlon, having completed 2 Ironman and many ½ IM. I have been doing these exercises religiously for years. They work!

    Reply
    1. Coach Tina says:
      April 2, 2015 at 1:44 pm

      Thanks for sharing Garry! This will be a great affirmation for others to read! Hopefully it never happens again!

      Reply
  73. DaveG. says:
    April 10, 2015 at 2:48 pm

    So if you feel mild sporadic achilles pain coming on, you should start the eccentric heel drops right away, even though you have mild pain? Or should you wait awhile? Just want to make sure its OK to start doing the heel drops even though I have intermittent non-debilitating pain in the Achilles.

    Reply
    1. Coach Tina says:
      April 10, 2015 at 5:54 pm

      Hi Dave, it is probably safest to begin these exercises now, so that you can start building strength, and making sure the fibers are building in the right direction. Better to be safe than sorry Hope this helps!

      Reply
      1. DaveG says:
        April 10, 2015 at 11:15 pm

        Thank you Coach Tina. Your sites article on AT is one of the most informative I have read on this topic. Great research combined with real world experience from runners in easily understandable language.

        Reply
        1. Coach Tina says:
          April 11, 2015 at 4:21 pm

          Happy we could help Dave! Thanks so much for your kind feedback! Is there anything else we can help you with?

          Reply
          1. DaveG. says:
            April 11, 2015 at 7:27 pm

            Thanks Tina. Follow up: the mild sporadic pain is on the right side of the Achilles, right foot, lower down adjacent to the bony prominence (end of fibula?) that juts out. Could this be a case of mild insertional AT? Im not sure, but if it is, I guess straight leg flat ground heel drops are way to go? If so, am I damaging anything by doing flat ground heel drops if I have mid-point AT instead (and not insertional)? And I assume its still OK to run easy during this rehab protocol period if no pain.?

          2. Coach Tina says:
            April 13, 2015 at 8:12 am

            Hi Dave, thanks for going into a little more detail, helps us understand a bit better. I would say yes, use the flat heel drops, as they will not do you any harm even if it is mid point. If you have no pain, you are okay to run, run accordingly, but sounds like you are at a point where it is maybe in the healing phase, which makes these exercises especially important Let us know if we can help with anything else!

  74. Dave says:
    April 13, 2015 at 1:29 pm

    Thanks again Tina! Much appreciate your help and the resources on this site..Ill tell my running colleagues about it. Ill also follow the recovery advisor feature on my Garmin 620 with HRM.

    Reply
  75. Bruce says:
    April 13, 2015 at 2:19 pm

    Thanks for writing this article! It is quite helpful.

    Ive been doing the heel-drops for over 6 weeks and Im still experiencing some pain in my left achilles. They are tight/feel some pain in the morning when I do them. However at night, I dont feel much pain at all besides the first set. I still havent added weight to the drops yet.

    With that being said, I can crack my left ankle and left big toe at will. Not sure if that is related or not. Should I be worried as a 23 year old? Would you recommend I see a specialist?

    Reply
    1. Coach Tina says:
      April 13, 2015 at 8:01 pm

      Hi Bruce, sorry to hear about your achilles pain. We suggest you should try using the weighted backpack for a while first, and then if it does not improve, then check with your physician. However, if you are concerned, it would definitely not be a bad idea to see a specialist. It is impossible for us to know if there is a connection between your ankle/toe and achilles pain. Hope this helps!

      Reply
  76. DaveG. says:
    April 17, 2015 at 4:52 pm

    Hi Coach Tina,
    One more question: should the (insertional eccentric) heel drops be done after runs so as to not overly stress the tendon (if so, about how long after)? I read that it might not be a good idea to heel drops before runs as this might overly stress the tendon (and I assume on non-running days its OK to do the heel drops at any time?). Thanks for any input you can provide!

    Reply
    1. Coach Tina says:
      April 20, 2015 at 11:18 am

      Hi Dave, yes, probably best to do it after runs, although it does not really matter. Give it maybe an hour or so, but it shouldnt make too much of a difference! Hope this helps!

      Reply
  77. Angelica Allen says:
    May 11, 2015 at 10:27 am

    Hello,

    I was training for a 26+ mile hike/run race in August. I was already almost doing more than 20miles per week between running and going up down and stairs. No issues at all. I went to my first hiking/backpacking experience about a month ago. We walked with 30pund bags first day 9 miles, second day 12 miles. After that trip, the pain on my Achilles was really bad. I went to the Dr., who told me i have AT, wore a boot, and i just finished the physical therapy. They said, I can start training again, little by little. I know I will not be able to do all the 26+ race, I would like to still doing it until I am comfortable. Ive been walking with regular shoes about 3 miles, no pain at all. But every time I wear my running shoes, the pain come back. I need some help from you guys with what brand or shoes i should get. I will really appreciated any help on this. Thank you so much!!!!

    Reply
    1. Coach Tina says:
      May 11, 2015 at 11:58 am

      Hi Angelica, thanks for reaching out. Unfortunately we do not make specific recommendations on brands as we like to be neutral to all brands, but if you follow our recommendations in this post, you should find that the pain begins to subside, in addition to continuing your exercises that your PT gave you. Hope this helps, sorry we could not give you more specific advice!

      Reply
  78. Ivan Thorn says:
    May 15, 2015 at 2:48 am

    Thanks for this. Can now see where Ive been going wrong. Once the initial pain has gone, Ive been abandoning and trying to go full pelt. I shall now be regimental in the heel drops and warming, cooling and give it time. (Mind you, in a race, Im still going to go for it, just cant help myself,).

    Reply
    1. Coach Tina says:
      May 15, 2015 at 7:15 am

      Hi Ivan, thanks for the comment, glad you enjoyed the article. Stick with those heel drops, and maybe stay away from races until you think it is healed enough to not aggravate it

      Reply
  79. Brandon says:
    May 15, 2015 at 3:32 pm

    Thanks for the great article!

    Do you have any insight on the FHL muscle/tendon? I dont feel pain when I do the heel drops and bent-knee drops. However, I do when I get on my toes or try to do any FHL stretch.

    Reply
    1. Coach Tina says:
      May 16, 2015 at 8:12 am

      Hi Brandon, glad you enjoyed it. You may enjoy this article, have you considered this? https://runnersconnect.net/running-injury-prevention/hallux-limitus-big-toe-running-injuries/

      Reply
  80. Kcotulla says:
    May 19, 2015 at 9:42 pm

    Hey all,

    I want to share my battles with Achilles pain and how Ive beaten it back with a committed, heavy-duty Stairmaster regimen.

    Im a 50 year-old male and have been an inconsistent runner and consistent soccer player for 30 years. I have always had seriously tight calves and Achilles tendons. Although Im generally a fast runner, Im not flexible at all. I envy those folks that can squat flat-footed without their heels pulling up off the ground. Ive dealt with heel pain all my life and have had bone spurs removed from both heels in the past with surgery along with the corresponding Achilles reattachment for that procedure.

    About two years ago, I took up a regular running program and had some great success getting healthy, dropping a lot of weight, and eventually increasing my mileage to about 45 miles a week. I had some improving half marathon times and was building for a marathon as I increased my mileage. I also was playing soccer in an adult league. I was feeling fit and healthy and confident and my foot problems seemed to finally be a thing of the past. But then the hammer fell on me and chronic Achilles pain erupted in short order on my right foot. For the next ten months I tried all sorts of programs to get back to running. I tried foam rolling, eccentric heel drops, stretching programs, and taking a month or two off. Each time I tried to start with some modest running, my heel pain immediately flared back up.

    The pain for me was insertional, right above where the Achilles attaches to the heel. I could press my thumb on the area and it would hurt. When I ran, the pain would crop up with each step very quickly. The worst part was that I was limping noticeably with simple walking each time I got up from a chair or out of my car. If I ran even two or three miles at a slow pace, I would be limping the next day.

    As I hit Thanksgiving last fall I was limping around, had lost my fitness from the year before, and was carrying extra weight again. I resigned myself to remedy this with surgery on my heel again after I had seen my doctor. However, I have a quality Stairmaster that Id bought on Craigslist about ten years ago. The stairclimber has always been a go-to method for me to get a great cardio workout. I have used this equipment off and on for spells at gyms and at home for many years, but mainly as an augmentation to running or soccer. So, before I followed up on the referral my doctor had given to me for an orthopedic visit, I committed to working out an hour a day on my Stairmaster. After about four or five weeks the results became noticeable that I was moving with a great deal less pain in my heel. At about ten weeks, the pain had virtually gone away, my legs were stronger, and I was not limping at all. My conditioning was back on track and I started playing full field soccer again with no heel pain. That was a big deal for me!

    Im now a little past four months on this 7-hour-a-week Stairmaster commitment. It is a lot of hard work, but the results have really been well beyond my best expectations. I know a stairclimber can be a grind at times like any cardio equipment, it can be BORING. But, I setup my iPad and listen to music, read, watch Netflix, watch videos, etc. Some days Im motivated and some days it is a real grind. If I cut a workout short one day then I make up the time the next day, so the numbers keep me motivated as well. Importantly, I also wear a heart rate monitor and keep my pulse at a challenging target level not usually over the top but consistent. My fitness has been clearly improving as Ive had to increase the levels on the machine to maintain the target heart rate zones. I dont use a StairMill, but a Freeclimber with independent foot pedals. This allows me to vary the step range from short and rapid to longer up and down strides. I also will work hands-free and not hold the rails to work on my balance and involve other leg muscles. As I work out, I also will vary my foot positioning on the pedals, hang my heels off the back, or work out for a spell up on the balls of my feet. I will keep things interesting by working in some tougher HIIT sessions once in a while. At times, Ill also work with some soft kettlebells for some light arm workout and this really pushes the hear rate up quickly.

    I have been a lifelong Achilles heel sufferer. This rigorous stairclimber regimen has made a great difference for me without surgery or physical therapy. I believe the Stairmaster offers a focused strengthening of the muscles in the calves, and also duplicates some of the benefits of eccentric heel drop therapy.

    The bottom line is that I feel great and can run without heel pain. Separately, Im in great cardio shape, my blood pressure is under control, and I am back playing soccer without feeling I had to give up the sport because of Achilles pain.

    I hope this helps someone else as well.

    Reply
    1. Coach Tina says:
      May 20, 2015 at 7:18 am

      Hi Kasey, thanks for sharing your story, and it is good to hear that you have found something that works for you. It is wonderful that you are able to play soccer again, and we hope you have continued joy in your sport. We have lots of posts for masters runners if you are interested in keeping up with the running. Just let us know if you need anything!

      Reply
    2. CherieF says:
      January 7, 2016 at 4:53 am

      Thanks for the post. I plan to try the stair master. Ive completed 22 marathons, started having IAT issues 5 years ago. First time, I ran through it. Dec of 2014 it got worse again, after 2 more marathons, I went to ortho doc in February 2015. She gave me a cortisone injection, boot for 2 weeks, and pt. I thought it was a miracle until July 2015. Pain came back worse than ever before. More pt, in sept, another injection. She did Mri and said surgery wouldnt help just no running until its pain free. Dec 2015, consulted podiatrist. He gave me a nerve block, which only lasted 2 weeks, now awaiting orthodics! Im thinking the injections have made things worse. Not running is killing my spirit! Again, thanks for the advise, it sounds like it may benefit my situation.

      Reply
  81. Bianca says:
    May 27, 2015 at 12:56 pm

    Great exercises! Thank you. I have definitely been using some of these in my recovery. Ive found that exercises along with the BFST Achilles wrap have greatly improved my condition. I truly believe in the bodys ability to heal itself and did not want to have to resort to surgery. After suffering with this condition for so many years, and missing so many marathons because of it, I was almost ready to consider it. But after I started on a routine of exercise and BFST Ive noticed a huge change.

    Reply
    1. Ashley says:
      June 8, 2015 at 3:42 pm

      Bianca, I use the BFST wrap as well. I actually have links posted above to the products because I really believe in them as well. I have the achilles and the wrist wraps (pregnancy induced carpal tunnelwho knew!) and have recommended them to everyone! I agree. The body does have the ability to heal itself and it is best to avoid surgery.

      Reply
  82. Niall says:
    June 12, 2015 at 3:44 am

    Hi

    Just wanted to say a big thank you for this post as it seems to have finally cured my problems. I tore a calf muscle 5 years ago and ever since have had AT problems. Despite huge amounts of rest and stretching of the problem calf it always came back. Id nearly given up running distance altogether after the most recent occurance. I read your article and it made sense so I spent the last month resting and doing the exercises. I knew it was going to work for me when the day after I could barely walk due to the pain in my calf it was clearly a part of the muscle that was very very weak in me. That was a month ago. I ran yesterday and for the first time in 5 years felt nothing in my achilles at all, nor this morning. I will continue the exercises as I slowly up my mileage and fingers crossed it continues like yesterday.

    For the record I also think foam rolling just before running really helps too.

    Anyway, thanks so much for your article and good luck to those other sufferers out there.

    Niall

    Reply
    1. Coach Tina says:
      June 12, 2015 at 7:20 am

      Thanks for sharing Niall, and that is why we do what we do! Thank you for letting us know, and best of luck with the rest of your running.hopefully no achilles issues in your future

      Reply
      1. Niall says:
        October 21, 2015 at 4:19 am

        Just wanted to add one thing (which hopefully can be confirmed by one of the coaches). As I posted in June this nailed a long running Achilles problem I had. In hindsight I believe it was all down to a weak Soleus muscle which is why the The bent knee eccentric heel drop exercise worked so well for me. I would just add that this exercise is worth doing with foot straight, slightly pointing inwards and slightly pointing outwards. My natural strike when running is foot pointing slightly outwards and I had a few problems with the soleus/achilles despite doing the exercise (only with foot straight). By changing the foot position and doing the exercises I found it strengthened all of the soleus that I needed to run pain free. Hope that might help anyone with similar problems.

        Reply
        1. Coach Tina says:
          October 22, 2015 at 3:20 pm

          Hi Niall, thanks for checking in. Yes, that would make sense, and we are happy to hear that you found this exercise worked for you, especially with the slight modification you mentioned. Thanks for sharing, and this may help other runners. We appreciate it! Best of luck with your training!

          Reply
  83. unique says:
    July 9, 2015 at 8:47 am

    hello,

    I have IAT in my left foot , it has been there for around 5 months.I used to play football a lot and also used to run a lot when I wasnt playing football . I think thats how I injured my foot.

    I have tried a lot of things to treat my foot. First I tried to heal it by taking only rest clearly that didnt do any good. Then I went to a physiotherapist ,he advised me to treat it by putting the foot in a bucket of warm water with salt in it for 10-20 min daily . I did that for about 20-25 days but that also didnt work. Then I went to a orthopaedic he advised me to take tendocare tablets,3 tablets per day for 20 days and also that warm water treatment but that also didnt help. Can you tell me what is the use of these tablets as they are clearly not for treating IAT.

    Now for a month i have been taking complete rest , complete rest in the sense that previously i used to go for cycling almost every day, now I have stopped that also so that i dont put any pressure on my foot.

    I want to ask you if cycling has any affect on the injured part ? can I do cycling without putting any pressure on my foot?

    In the beginning when I started experiencing pain ,it was during running but when i stopped running ,it pained only when it was pressed.I didnt not have any pain while waking either.

    For a while i have been using the techniques that you have mentioned in this article and i think its working as i dont have any pain in my foot anymore even on pressing the injured part .

    I didnt feel any pain even when i started to do the heel drop exercise that you have mentioned , So does it mean that it is fine now or do i need to put more pressure on my foot during the exercise .

    I also wanted to know for whom this heel drop exercise is for, is it for the people who have problem even in walking due to IAT or for someone like me who has pain only while pressing the injured area.

    Reply
    1. Coach Tina says:
      July 9, 2015 at 11:16 am

      Hello, thanks for reaching out and sharing your story. The detail you gave helps us to understand a little more. If you do not feel pain in your achilles while cycling, it has probably not been doing any damage or making it any worse. If you feel pain during or after, then it may have prolonged recovery. AS for the exercises, we are happy to hear that you are feeling better with the exercises, and it would be a good idea for you to continue them as prevention. These exercises are great for preventing achilles injuries, which you may be at risk of again in the future. You are probably okay to start back running, but after a lot of time off, we would recommend using the advice in this post https://runnersconnect.net/running-injury-prevention/returning-from-running-injury/ Hope this helps! Good luck!

      Reply
  84. Corey says:
    July 27, 2015 at 1:52 pm

    Increased my running to prepare for a Rugged Maniacthis included hill running. Yesterday I was going to do a light run. 2 minutes into the run it felt like a rock hit my achiles. Yesterday it was sore I iced, wrapped and elevated throughout the day. Today theres little soreness but still very tender. I will continue my icing and wrappingbut, is it possible to do Rugged Maniac in 6 days. I definitely have a minor tear and dont want a full rupture. In a tough spot because the girl I like wants me to do race with her haha.

    Reply
    1. Coach Tina says:
      July 28, 2015 at 11:42 am

      Hi Corey, thanks for reaching out. Sorry to hear about your achilles pain. It is impossible for us to tell you as we cannot see it, but if you do have a tear and you do decide to do it, you could be putting yourself out for a very long time. It would probably be better to race (and go support the girl anyway!!), and then you can race again shortly. otherwise you may be unable to run for a long time if you do any serious damage to your achilles. Follow the advice in this guide, and hopefully this helps! Ultimately it is your choice!

      Reply
  85. Dave says:
    August 3, 2015 at 5:00 pm

    Hello Tina & RC: I have periodic flare ups of what appears to be insertional AT, and feel a little coming on again now, not bad currently, about a 1 or even .5 out of 10 on pain/soreness scale. To confirm, I assume I should start (or continue, but this time add weight when they become easy) the flat ground eccentric exercises now, even with mild soreness? And should I stick to 3 x 15 twice daily (90 per day total), or will even more help (as some other places say)? Finally, I assume, per the Gotebord group study, its OK for me to continue to run as long as the pain/soreness stays below 5 out of 10? Thanks!

    Reply
    1. Coach Tina says:
      August 17, 2015 at 4:40 pm

      Hi Dave, Sorry to hear about your achilles pain. Yes, you are correct, that should all allow your AT to calm down enough to continue running, as long as you continue to listen to your body and what it is telling you. Hope this helps!

      Reply
  86. Liza says:
    August 14, 2015 at 11:45 pm

    Hi, After 10 yrs on and off with chronic tendinopathy, and various treatments, some worked for a while. I decided to see a Specialist who has researched and developed model and framework on this condition. The most up to date treatment for achilles chronic tendinopathy is tailored to the individual. Eccentric exercises are good but its a one size fits all. If u have a chronic condition eccentric may work for a time but eventually come back. Isometric exercises are a vital component in the treatment. Talking from experience. Most with a chronic condition are complex. Its all about the kenetic chain, not purely isolating the gastroc or soleus with treatment. Glutes come into it. Muscle imbalance and muscle atropy. Check out the work of Professor Jill Cook and Craig Purdam. Im writing this because i know hoele frustrating it can be to be doing what we think to be the right thing for our tendon but only eccentric exercises wont do the trick if you have a chronic condition. All the best.

    Reply
    1. Coach Jeff says:
      August 15, 2015 at 9:37 am

      Totally agree, which is why we created this video: https://improverunningform.com/free-lesson-2-treating-cause-injuries/

      Reply
  87. Russell.FL says:
    September 11, 2015 at 3:46 pm

    Very informative article. My question is about the timing of performing the heel drop exercises. I usually run in the evenings, does it make sense to do one set before and one set after the run? I dont think Id want to do these exercises first thing in the morning. Thanks for your help!

    Russell

    Reply
    1. Coach Tina says:
      September 15, 2015 at 7:28 am

      Hi Russell, thanks for reaching out. These may be a little more painful in the morning, but as we mentioned in the post, it is okay to have some pain. If your achilles is particularly sore right now, by all means start with them just in the evening, and then add in another time during the day also. Hope that helps!

      Reply
  88. Tony says:
    September 27, 2015 at 4:36 am

    If my achilles feels stiff should I attempt the heal drop?

    Reply
    1. Coach Tina says:
      September 29, 2015 at 6:00 am

      Yes, that would be a good time to start, before you get any pain.

      Reply
  89. zz says:
    October 2, 2015 at 3:40 pm

    I injured my achilles in July 2014. After six months of pain I went to a local podiatrist who diagnosed me with insertional achilles tendonitis. He recommended the calf (achilles) stretching only. After three months of no progress doing these stretches I began researching online for other options. I read your article and immediately began the modified heel drops. I did them throughout the day and was still in intense pain most of the time and walked with a severe limp. I also did my regular morning exercises and continued very mild calf stretches when warming up, but did not tug as you say on my achilles. What you said made sense AND it has worked GREAT for me. Six months later I am back to full motion, no pain, and able to walk without the limp. Im in my mid-sixties and dont run much anymore but was really concerned that I may have had a life-long debilitating injury. I have added the modified heel drops to my regular exercises and continue to do them daily. Thank you so much for the in-depth article and giving me back my mobility. Best, zz

    Reply
    1. Coach Tina says:
      October 3, 2015 at 11:00 am

      Happy to help! Thanks for sharing! We really appreciate your feedback!

      Reply
  90. Amy C says:
    October 7, 2015 at 4:35 am

    Hi
    My doctor recently told me I had AT but he never specifically said which one. I am training for a marathon and I am 3 months into my training (the actual marathon is in march). I recently swapped from a normal Nike trainer to Nike Free Fly knit shoe.
    I didnt gradually break them into my routine because my previous shoes had quite bad wet damage, and a week and a bit into running in them the back of my foot was hurting and looked swollen. To me pressure hurt it and also it looked as though a bone had swollen not a tendon because the swelling was hard. But the doctor told me to stop running and do calf raises. Resting calmed it down but I think this is only because I am not doing the exercise that was irritating it. Ive changed my running form and quickened my cadence but some slight irritation is still there, threatening to come back.
    Does this sound like AT to you? I recognised a lot of what you were saying in the article and I really want to be able to finish this marathon! So I will start the exercises, what do you recommend I do about me shoes? I saw in the comments that the more people wore their minimalist shoes or barefoot the more it improved.

    Reply
    1. Coach Tina says:
      October 7, 2015 at 2:24 pm

      Hi Amy, sorry to hear about your pain. As you are still a good amount of time away from your marathon, it is important to get this taken care of now before you really get into the part where it could affect you (and put your training to a stop). The calf raises ill probably still help, but it would be impossible for us to diagnose what is going on, however, if you try the recommendations in this post, and notice it starts to feel better, then you are doing the right things. Otherwise it would be best to follow what your doctor is saying. As for shoes, you may have to try around with a few different types, to see which ones help to ease the irritation, sometimes runners find those minimal shoes actually make it worse as they have a lower heel to toe drop which makes the achilles work harder. Is there a reason you are in those flyknit? They may be a little too light for your every day training, it would be best to go to a running store and try a few pairs of running shoes on to see which ones feel most comfortable to you. Hope this helps! Sorry we cannot be more specific! Let us know if we can do anything else!

      Reply
  91. heather c says:
    October 20, 2015 at 11:02 pm

    Hi,

    I am a 62 year old female and have had Insertional AT in both heels for two years. I then formed bone spurs on the back of my left heal. Was then dignosed with Haglunds Syndrome and told by Orthopedic surgeon that I needed surgery to shave the bone spurs and lengthen the tendon. I had continued to play tennis 5 to 6 days a week throughout the 2 years but once the Haglunds was involved the pain escalated after play to the point that I could barely walk for a week or so after. I have stopped playing completely for almost 4 weeks now, and have been doing the IAT exercises along with the encumbant bike ( which does not exasperate the archillies because of foot position ). My husband is a massage therapist and has been doing deep massage on my calves, heels and under foot. I also use ice and heat on and off and roll my calves. Things have been improving slowly but still have soreness and stiffness in my left heel. I have read in blogs that some people have had good results by aggressively massaging their heels with vaseline nightly. I notice in a couple of replies here that massage was not recommended as it is thought to agrivate the situation. Now I am wondering if I should stop massage and just continue with exercises. Would love any thoughts regarding this. Also want to say thank you to everyone involved in these posts. It is so helpful to realize that I am not alone with this persistent and frustrating injury.

    Reply
    1. Coach Tina says:
      October 22, 2015 at 3:19 pm

      Hi Heather, sorry to hear about your AT, glad it is slowly getting better. The massaging technique is risky, especially for those who are not certified. We try to base our posts off the science and the evidence backed research studies. We would recommend you follow the treatment plan we have in this post, and see how you get on. Glad the discussion was able to help you, and hopefully provide you some comfort too! We know how frustrating this injury can be!

      Reply
  92. Paul says:
    November 2, 2015 at 11:52 am

    This is a great summary of the problem with tendonitis and it offers the right exercises to come back from this injury. I have had this for about 7 months and it was really depressing. During this time I wasnt able to run and the pain got stronger or weaker without cause. Sometimes the achilles seemed almost ok and no pain occured. But then all of a sudden it hit back. So and forth I struggled with this ugly injury losing hope. The exercises presented here really helped me and after about 2 months of exercising, the pain left and the achilles seemed to get normal. Thanks for this valuable information. And keep patience guys ! It really heals very long !

    Reply
    1. Coach Tina says:
      November 6, 2015 at 9:46 am

      Hi Paul, thank you so much for the kind words. We really appreciate you letting us know how much it helped, that is exactly why we put so much time and energy into articles like this. If there is anything else we can help with in the future, please let us know! Now go enjoy your training.pain free of course

      Reply
  93. AJ says:
    November 2, 2015 at 8:50 pm

    Hello Coaches,

    Im hoping you can help me?

    Im a 28 yr old female who has been lucky enough to have developed tendonitis in various places of my body over the past 2 years. I definitely overused my arms, but for all the other areas I have no clue. Almost a year ago I developed what my doctor told me was achilles tendonitis (symptoms were worst standing on my toes and/or stairs) in my left leg (not which kind of AT though, I had no idea about that until my own research many months later). Doc sent me to a PT who told me she thought I had plantar facisits instead, but the treatment is the same, so it doesnt really matter. About a week into PT (a month after AT started in my left), I developed AT in my right as well. And surprise surprise I spent the next 1/2 year doing one ankle mobility exercise, rolling my foot out and stretching as prescribed (2 different stretches, 4 reps, 4x a day!) which seemed to help at first. Basically, I went from being able to stand for 5 minutes at a time without get me to a chair symptoms, to about 30 min or an hour. Oddly, once I stopped the crazy amounts of stretching my tendons started feeling better again. Not so sore and achey! I also started to suspect whether I had both types of AT and if thats even possible? Pain at the bottom of my heels at insertion and at midpoint

    My question involves not knowing how to proceed given certain painful symptoms. When this all started I had stabbing heel pain randomly while I was walking and always going upstairs, but then it became super sore tender spot on my midpoints. 6 months into this I started the insertional heel drops veery gradually until I was doing them twice a day, the recommended reps, they started feeling more tolerable to stand on or walk for longer periods at a time (about 2 months of this). By the end of this period my left glute became so unbearable tight I had to stop. I rested for a couple weeks before trying again and this time I modified how I did it and started stepping backwards down the steps (less glute having to pull myself back up the stair because its bilateral AT). I also started the midpoint kind because I really dont know if I actually have both types and thought Id give it a shot. I started very gradually again and not using full weight at first. The midpoint calf drops made my calfs and then my shins so sore, but I loved it! The soreness subsided and I had very little symptoms during and after the exercises (So excited!) until about a week into them. BAM! I started getting the super sharp pain in my heel like at the beginning of the year. Just the left side, the right side was fine and it occurred during the first 3 drops of the entire exercise and then for the rest of the day I would intermittently get the sharp heel pain going up stairs. The pain is directly on the inside of my heel near the bottom and sometimes on the outside of my heel. What could this be?

    Thoughts, suggestions, advice? After 3 days of trying to calf drop anyway, I stopped the exercises and the sharp pain no longer intermittently accompanies me up stairs or randomly while stepping on flat groundOn the last day of trying I did the exercises once in the morning and it reproduced the sharp pain. I didnt do the night time exercise and the next day I didnt have sharp heel pain. Been resting the past 5 days. Then, I stood on my toes for about 5 seconds yesterday and oddly enough the sharp pain came back for the rest of the day whenever I went upstairs. What is going on? Also, my left glute is still insanely tight. Correlation?

    Reply
    1. Coach Tina says:
      November 6, 2015 at 9:49 am

      Hi AJ, it is definitely possible to have AT in both areas, it sounds like you definitely have AT, and the stretching you talked about was making it worse. We would recommend using our guide to rehab you back to strength, it is unlikely that it will go away on its own. If not, it would probably be safest to go see a physician to see if something else is going on. It could be related somehow, we do have an article on how your hips can cause injuries, hopefully this helps https://runnersconnect.net/running-injury-prevention/the-relationship-between-hip-strength-and-running-injuries-the-latest-research/ If we can do anything else to help, let us know! Best of luck with your recovery!

      Reply
      1. AJ says:
        November 17, 2015 at 5:45 pm

        Coach Tina,

        Thank you so much for responding. I read the link on hip strength. I am more than willing to strengthen my hips, but earlier this year I was doing the bridges mentioned in the link you sent, in addition to physical therapist prescribed chair squats and a couple of other exercises for the supposed patellar tendonitis I developed several weeks after the achilles tendonisitis. The pateller tedonitis went away (yay!), not the AT and now I have an EXtremely tight left glute. Its actually the reason I stopped the bridge exercises and then all the others.

        Ive seen so many other physicians to find something systemic that may be wrong and have arrived at nothing. Still trying though.

        Would strengthening my hips possibly give relief to my tight left glute? Or would it cramp up more? Maybe my hips are the underlying cause of the patellar tenonidit and the achilles?

        Reply
        1. Coach Tina says:
          November 18, 2015 at 11:50 am

          Hi AJ, sorry to hear that the physicians have been less than helpful. I would recommend listening to this podcast episode with brad Beer, he talks about the frustration of not finding a specialist who can help, but everyone CAN run pain free, you just need to find the right person. It might provide you with some comfort. Here is the link https://runnersconnect.net/rc80 Strengthening your hips would almost definitely help, weak hips are the cause of many runner issues, and it would make sense that they are the source of your problems. Worth a try right? Good luck!

          Reply
          1. Angelica says:
            November 20, 2015 at 7:46 pm

            Definitely worth a try. Thank you so much for the advice.

          2. Coach Tina says:
            November 24, 2015 at 10:51 am

            Happy to help! Let us know if we can do anything else!

  94. Ritchie says:
    November 17, 2015 at 9:20 am

    Hi Guys, Ive had big problems with both achilles for a number of months now (mid-point). Both chronically inflamed, I just could not seem to get them better. After a visit to a specialist I ended up completing a course of ACP (autologous conditioned plasma) injections. This has successfully removed the constant pain which is great and I have now begun the 12-week stretching and strengthening program. I have now completed 1 week so early days.

    Your article mentions the possibility of pain during the exercises; can I assume you refer to mid-point achilles pain in my case? I get sore calf muscles during the stretching but no pain in the achilles itself. I am however noticing slight pain in both achilles first thing in the morning, which disappears once I am warmed up. This is how my chronic inflammation started so I am naturally worried that things are not off to a good start. Any thoughts? Does the absence of achilles pain during the exercises mean I should add some weight already?

    Also, I have limited ankle flexibility in my right foot which is hindering me from getting a good stretch in. I can only go very slightly below horizontal before I get pain and restriction in the ankle joint and surrounding ligaments. Will this range of movement be sufficient to address the achilles? Any other suggestions here?

    Many thanks for your response!

    Reply
    1. Coach Tina says:
      November 18, 2015 at 11:48 am

      Hi Ritche, thanks for reaching out. Sorry to hear about your problems with AT. What you are describing sounds pretty typical of AT, both insertional and midpoint. It would be a good idea to add the weight if the drops feel okay without it right away. It might be a good idea to try to see a chiropractor or specialist to see if there is some kind of tightness elsewhere that could be causing your problems. Hope this helps, and the recommendations in this post should help the symptoms continue to decrease!

      Reply
  95. Ahmed says:
    December 4, 2015 at 4:30 am

    I have had non-insertional AT for over 2 years now. I only got better after getting 2 PRP injections. I , then, started to do the heal-drop exercises more regularly and to wear soft (silicone-made) arch supports. I can not pinpoint which of these measures caused the improvement but I would like to point out that PRP injections are a treatment option.

    Reply
    1. Coach Tina says:
      December 4, 2015 at 5:58 am

      Thanks for sharing Ahmed, we appreciate your feedback!

      Reply
  96. betsy says:
    December 15, 2015 at 3:56 pm

    Stated feeling pain about 5 weeks ago. I am recovering from some hip/piriformis issues and was only running on a treadmill when Achilles started hurting only on left side. Stopped running and tried stationary bike though that hurt too. Now I can only swim and aqua jog (which is driving me crazy). PT has me doing eccentric exercises, ART, nitro patch, ultrasound, ice but still when I try to run (just short distance on treadmill) my Achilles gets inflamed again. I feel like Im doing everything right but cannot beat it. I thought I had caught this quickly as I stopped running as soon as I felt any pain. How do I get back to running ASAP??

    Reply
  97. Mike H says:
    December 23, 2015 at 12:03 am

    Ive been struggling with what I believe is retrocalcaneal bursitis. Having a really hard time makimg improvement. I believe it is related to tightness in my upper leg. Ive been stretching, using a foam roller, icing, contrast baths, but no lasting change. At times it seems it is on the mend then gets sore agian. Any suggestios?

    Reply
  98. says:
    June 24, 2016 at 11:52 am

    Ive battled Achilles Tendonitis, plus plantar fasciitis, fibroma, then insertional Achilles tendonosis. Its been on going for more than 6 years. I put off surgery and tried everything under the sun. Stretching. Steroid Injection. RICE, prolotherapy, ESWT, accupuncture with electrodes, pills, etc. everything worked temporally. Yesterday I finally decided to do Umbilical Stem Cell Therapy. This is day one after the procedure. I have no pain at all in my left foot where it all started and minimal pain in my right foot at the insertion point. I used crutches the day of the procedure and will continue to use them at home. I dont want to make the mistake Ive made in the past by over doing it causing reinjury. The procedure wasnt cheap but if it keeps me from having to do traditional surgery with 6 months to a year recovery then Im all in.

    Reply
  99. says:
    June 26, 2016 at 10:24 am

    Day three after stem cell therapy for IAT both feet. The pain in my left foot completely vanished and I have zero to mild pain in my right Achilles insertion point. I have not left the house since the procedure so not to aggreviate my feet. I bought crutches but only used them the day of the injections. Im going to venture out the house tomorrow. I plan to go to the gym but will not lift heavy weight and will only train my upper body. Im hoping for the best. Surgery is my only option after this.

    Reply
  100. says:
    August 14, 2016 at 8:18 pm

    I have achillis injury around 1 year ago and tried several aproaches but there is little improvement. I found this review very valuable to me and I think, it will help me to be on the correct path in a short time.
    Thank you.

    Reply
  101. says:
    August 22, 2016 at 7:05 am

    I like to know if going downstairs (not up stairs) is similar to the flat-ground eccentric heel drop. I am planning to use the elevator to go to high floor level at my building (15th floor) and then going downstairs. Will this has the same value of the flat-ground eccentric heel drop.
    Thank you.

    Reply
  102. says:
    March 5, 2017 at 6:58 pm

    I have played lot of cricket as a student. Now I am in middle age with sever calf muscle stiffness if is difficult to me to run even 200mts at a stretch. I found this article quit useful and I will practice the remedies mentioned and come back soon.

    Dr.C.V.S..Siva Prasad

    Reply
  103. says:
    April 20, 2017 at 10:02 pm

    For the past week. I have been doing this slightly different. Upon raising up, I put equal wait on both the injured side and strong side. Did I do damage?

    Reply
  104. says:
    October 22, 2017 at 1:51 pm

    Thank you for this article. Ive had a bad achilles for a few years, and nothing else seemed to help. Im about 11 weeks into this program, and Im finally running again, instead of just slowly limping around every day. Ran 10 miles yesterday, and another 10 today, pain free. I can also walk normally throughout the day. THANK YOU!

    Reply
    1. Tony Pallotta says:
      October 23, 2017 at 8:47 am

      Awesome to hear. Achilles injuries can be tough to overcome because the cause of the pain / injury can be so many things. Glad youre back safely on the roads. Enjoy!

      Reply
  105. says:
    March 18, 2018 at 7:36 am

    Great to read this all these comments. I have spent a lot of limited use money on physio and a private surgeon over the last 2 years eventually I went back to the NHS and a surgeon recommended Achillo Train by Baurfiend. Been wearing this on my left leg at night on and off for 4 months and it has really solved the issue. I cannot wear it whilst training / cycling as it gets too tight as my feet swell. It has done such a good job in terms of aligning and strengthening the filaments / no scar tissue / no knots that I have now ordered one for my right leg as well.
    As I do between 15-20 hours of exercise a week and am 48 yrs young, I would highly recommend both rolling and stretching each day, would half heartily recommend essentric loading, as I get enough of this via cycling but think the real game changer was the Achillo Train: ie I do not wake up each morning with loads of scar tissue in the Achilles anymore.

    Reply
  106. says:
    August 3, 2018 at 5:27 am

    I love running. Because of frequent running so i often have problems with my feet, especially achilles tendonitis. Thanks to your article. I chose a pair of shoes to fit with my feet. Now i can run regulary without worry about foot problems.
    Thank you very much!

    Reply
  107. says:
    August 3, 2018 at 6:58 am

    It is good!

    Reply

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