# Achilles Tendon strain



## VP Not Free (May 25, 2006)

I see that there is a posting for Achilles Tendon rupture, but not a sprain. I strained it about two weeks ago out biking (I had tweaked it four weeks earlier, but got better in four day's). I was 8 miles out when I did it, so this didn't help. When I was on the bike there was no pain, until I got off the bike? I have rested it two weeks. The Internet says rest as long as possible, but my doctor said to stretch it out? It is stiff in the morning, & loosens up by night. There is a lot of conflicting info on how to treat this, so I would love so help. I did a search which did not come up with anything, so if there is any info already I would love the link. 
I really need to bike, but don't want to mess it up.


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## xcguy (Apr 18, 2004)

When I strained mine playing basketball (never had pain there before) the reading I did made it clear you don't want to mess with an achilles problem. I gave up hoops (one on one stuff) for now until I'm pain free for weeks, but that's not happened.

Gently stretching it daily is all I'm doing but I want to hear other's therapies as well.


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## VP Not Free (May 25, 2006)

xcguy said:


> When I strained mine playing basketball (never had pain there before) the reading I did made it clear you don't want to mess with an achilles problem. I gave up hoops (one on one stuff) for now until I'm pain free for weeks, but that's not happened.
> 
> Gently stretching it daily is all I'm doing but I want to hear other's therapies as well.


How long should you let it heal before stretching it out?


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## xcguy (Apr 18, 2004)

VP Not Free said:


> How long should you let it heal before stretching it out?


I never had mine checked out. Let's just say that before I roll out of bed I lay flat and move my feet back (like leaning against a wall but with hardly any pressure) first with my knees on the bed then with knees off the bed.

Then I get out and lean gently up against some furniture and do the same thing. And I'm talking very very gently. Hey, I just woke up. This is everyday stuff. Before I strained it I still stretched but probably more intensely. I did this right after my strain but completely gently. I increased the stretch very gradually for the next couple of months. You gotta take the long view with achilles injuries.

It still hurts but it seems "healed". Whenever I stretch it I just put steady pressure until I feel a pull then back off a bit. I may never be as limber doing that as I was before (like calf raisers with a ton of weight) but I'm trying to avoid any more strain, not get it "stronger".

If yours is still killing you you need a doc/physical therapist's opinion, not mine.


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## pwrtrainer (Oct 23, 2005)

See a PT. Pretty simple fix. Sustained stretch probably not the best, but eccentric exercises probably good. Depends on how severe the strain was. Nonetheless, see a PT...


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## twinkles (Oct 14, 2004)

Cho Pat makes an achilles strap that helped me a # of years ago. It is also helpful to move your cleats rearward on your shoes. There's a chance you are going to get plantar fascitis and have calf/soleus problems in the future. PT or a good massage therapist will help you get on the right track, pay attention to what they do and have them teach you to work on yourself. Work on spinning instead of pushing big gears. I found that self massage worked better than stretching. Be careful stretching cause that can tweak it and set you back. Be smart about it and realize it's going to take time to heal.


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## VP Not Free (May 25, 2006)

I own a ten's machine (electrical stimulus) can this be used? I am so low budget right now, what did the PT do for treatment? I have a $2,500.00 deductible, so insurance does not help.

Thanks


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## Burning Matches (Mar 14, 2011)

I suffered from tendonitis in my achilles last season (first on one side, then the other, which I attributed to increasing my mileage too quickly). It was very debilitating and frustrating. I did a ton of research on achilles injuries and saw an orthopaedic doc whose advice was "yes it will eventually heal, but the more you continue to use it, the longer the healing process takes." I never really laid off it completely but significantly cut back on riding time for a few weeks. I also tried the Cho Pat brace that twinkles mentioned but it was uncomfortable for me. 

What did help when I was riding was kensio tape. (Kenesio Tex Gold was what I used.) They have a specific technique for taping achilles tendons; if you Google it you can find some videos on how to use it.

Also I used a lot of heat and massage during the healing process, massaging the achilles with a massage cream a few nights a week until it was good and loose. That seemed to be the most effective at eliminating the pain.

Achilles injuries can be a major setback but is one injury you need to give sufficient time to heal, because they can get worse and cause more problems down the road.


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## Jlee197853 (Mar 15, 2004)

Agree with the cho pat brace. Also, don't wear any stiff soled shoes i.e. cleats or bike shoes that have stiff soles. I have had a rupture (complete) and tendonitis, and it sucks. Don't take any chances............


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## BJL-1 (Apr 7, 2011)

I am a PT and see these on a regular basis. Unfortunately theres no quick fix. If its what i would consider a mild strain (mild pain with activity, tendon is not swollen--"thick" compared to the other one) and if you want to try to treat it at home I would recommend some time off the bike since the application of force through the front of the foot to the pedal is what applies stress to the achilles. I would massage the tendon for 5-10 minutes a couple times per day, followed by 3-5 reps of GENTLE stretching to the calf/achilles (sitting with leg out straight in front, use a belt or towel around the front of foot, pull foot toward you gently until you feel a mild stretch but no pain). Hold each stretch for 30 seconds. follow that with ice for 10-15 minutes (cold pack or massage the tendon with an ice cup or cube). Consider short term use of an over the counter anti inflammatory like advil (not tylenol or acetaminophen). If you are not sensitive or allergic to it, most people can tolerate 600 mg, 2-3 x/day. Other treatments that have been mentioned like cho-pat devices and tape are reportedly helpful. Would suggest trying one or more of those things in addition to the above program if you want--no one treatment plan is best. Most research i've seen seems to mention gentle stretching the most. These are just some of the things i do with people in my clinic. If you were to receive treatment from a PT they would likely do some combination of the above along with therapeutic agents like ultrasound or phonophoresis (ultrasound with an anti-inflammatory medicine) which has also been shown to be helpful.

No way for me to say how much rest to give or how long to treat. Condition can last weeks to months even if you treat it right. Surgery is almost never an option. It will go away eventually. When you do resume riding i would recommend flatter road rides with easy gears. If that doesnt cause pain, ramp up progressively. Hope this helps and good luck


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## VP Not Free (May 25, 2006)

Thanks for all the input. After 2.5 weeks of rest, my doctor said to start stretching it. She told me to stand on a phone book & drop my heel down, this did not feel right, so I stopped. I started walk around without limping, which slowly is stretching it out. In only three days it seems to be getting much better. Stiff in the morning, & loose at night.


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## nhodge (Jul 6, 2004)

BJL-1 said:


> I am a PT and see these on a regular basis. Unfortunately theres no quick fix. If its what i would consider a mild strain (mild pain with activity, tendon is not swollen--"thick" compared to the other one)*i've got a swollen tendon w/ fairly acute pain. i tore my other twice about ten years ago & i'm pretty sure i didn't tear mine this time. i can move my ankle in all directions, but w/ pain. any different suggestions?* and if you want to try to treat it at home I would recommend some time off the bike since the application of force through the front of the foot to the pedal is what applies stress to the achilles. I would massage the tendon for 5-10 minutes a couple times per day, followed by 3-5 reps of GENTLE stretching to the calf/achilles (sitting with leg out straight in front, use a belt or towel around the front of foot, pull foot toward you gently until you feel a mild stretch but no pain). Hold each stretch for 30 seconds. follow that with ice for 10-15 minutes (cold pack or massage the tendon with an ice cup or cube). Consider short term use of an over the counter anti inflammatory like advil (not tylenol or acetaminophen). If you are not sensitive or allergic to it, most people can tolerate 600 mg, 2-3 x/day. Other treatments that have been mentioned like cho-pat devices and tape are reportedly helpful. Would suggest trying one or more of those things in addition to the above program if you want--no one treatment plan is best. Most research i've seen seems to mention gentle stretching the most. These are just some of the things i do with people in my clinic. If you were to receive treatment from a PT they would likely do some combination of the above along with therapeutic agents like ultrasound or phonophoresis (ultrasound with an anti-inflammatory medicine) which has also been shown to be helpful.
> 
> No way for me to say how much rest to give or how long to treat. Condition can last weeks to months even if you treat it right. Surgery is almost never an option. It will go away eventually. When you do resume riding i would recommend flatter road rides with easy gears. If that doesnt cause pain, ramp up progressively. Hope this helps and good luck


=================================================================


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## BJL-1 (Apr 7, 2011)

nhodge---if the tendon is swollen with more acute pain and you have pain with any motion of the ankle thats a little more serious. If it occurred recently and the result of something traumatic (jumping, landing or during a fall) these usually require more rest than the milder ones. An orthopedic may even consider immobilizing it in a removable lower leg cast for a couple or few weeks to allow the thing some time to recover before starting to do some gentle stretching, etc. Consider seeing an ortho if you are limping significantly/cant weight bear on it much. Prompt treatment will minimize recovery time. :thumbsup:


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## nhodge (Jul 6, 2004)

BJL-1 said:


> nhodge---if the tendon is swollen with more acute pain and you have pain with any motion of the ankle thats a little more serious. If it occurred recently and the result of something traumatic (jumping, landing or during a fall) these usually require more rest than the milder ones. An orthopedic may even consider immobilizing it in a removable lower leg cast for a couple or few weeks to allow the thing some time to recover before starting to do some gentle stretching, etc. Consider seeing an ortho if you are limping significantly/cant weight bear on it much. Prompt treatment will minimize recovery time. :thumbsup:


hey, thanks for the return post.
i went to the surgeon today & got a diagnosis i was pretty happy to hear. no surgery! yeah!
tore it about 10% in an area that's not as crucial as it could have been. i just have to be careful not to aggravate it & do some stretching & easy resistant exercises shy of pain. sounds good to me. i'll wear a boot when i'm doing things that might be questionable w/o it & take it easy otherwise. he said it should be doing well in about a month to 6 weeks. i can deal w/ that no problem after going through 2 tears in 3 months & surgery w/ a year of rehab 10 years ago. 
thanks again for the answer


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## VP Not Free (May 25, 2006)

nhodge said:


> hey, thanks for the return post.
> i went to the surgeon today & got a diagnosis i was pretty happy to hear. no surgery! yeah!
> tore it about 10% in an area that's not as crucial as it could have been. i just have to be careful not to aggravate it & do some stretching & easy resistant exercises shy of pain. sounds good to me. i'll wear a boot when i'm doing things that might be questionable w/o it & take it easy otherwise. he said it should be doing well in about a month to 6 weeks. i can deal w/ that no problem after going through 2 tears in 3 months & surgery w/ a year of rehab 10 years ago.
> thanks again for the answer


How did you know it was torn 10%, xray, MRI?


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## nhodge (Jul 6, 2004)

VP Not Free said:


> How did you know it was torn 10%, xray, MRI?


that was my surgeons opinion just based his hands on observations of the torn area, movement i had, the degree of swelling, lack of pain, etc. xrays don't cut it for tendons, MRI would be the definative test, but he didn't feel it was a close call for surgery, so it wasn't called for.


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## BJL-1 (Apr 7, 2011)

nhodge said:


> hey, thanks for the return post.
> i went to the surgeon today & got a diagnosis i was pretty happy to hear. no surgery! yeah!
> tore it about 10% in an area that's not as crucial as it could have been. i just have to be careful not to aggravate it & do some stretching & easy resistant exercises shy of pain. sounds good to me. i'll wear a boot when i'm doing things that might be questionable w/o it & take it easy otherwise. he said it should be doing well in about a month to 6 weeks. i can deal w/ that no problem after going through 2 tears in 3 months & surgery w/ a year of rehab 10 years ago.
> thanks again for the answer


Glad to hear its not that serious!. Hope you recover quickly...


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## nhodge (Jul 6, 2004)

*see ya*

in about a month


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## Boreit (Jan 1, 2009)

tendonitis can be a real PIA. struggled with bicep femoris tendonitis for some time. The only treatment that has provided tangible improvement for me was plasma injections to the affected area which were accurately identifed by mri. my experience is some gp like to dance around the subject & hope you wont ride your bike for 12months & it will go away. they suggest massage, acupuncture, tens/ ultrasound, stay off the bike & then you get the dodo's that want to use cortisone, no thought of what actually is causing the problem or continues to aggravate. if the problem persists, find a good sports physician who does plasma injections & go see what they have to say.... & get your bike fit done by a physio that specialises in cycling injury rather than the LBS. hope your back on the bike soon buddy.


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## VP Not Free (May 25, 2006)

OK, if I work my Achilles, biking, walking up steps, ect., it stays loose, as soon as I rest it, tightens up. Does this mean I need to work it more?


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## ric426 (Jul 13, 2007)

Went through the same thing a few years back and didn't rest it enough initially. I wound up in a removable walking cast for 12 weeks then 3 months of PT during the winter. I did some research on supportive taping techniques and conferred with my therapist and tape that foot ankle before *every* ride. I also moved my cleats all the wayback on my shoes and learned to use a higher pedaling cadence to minimize the strain. Now I buy athletic tape by the case, but I haven't had any more problems with it. 
Good luck. I know it's a drag, but you have to give it whatever time it needs to heal.


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## VP Not Free (May 25, 2006)

ric426 said:


> Went through the same thing a few years back and didn't rest it enough initially. I wound up in a removable walking cast for 12 weeks then 3 months of PT during the winter. I did some research on supportive taping techniques and conferred with my therapist and tape that foot ankle before *every* ride. I also moved my cleats all the wayback on my shoes and learned to use a higher pedaling cadence to minimize the strain. Now I buy athletic tape by the case, but I haven't had any more problems with it.
> Good luck. I know it's a drag, but you have to give it whatever time it needs to heal.


My initial rest was about 2.5 weeks, My doctor said start stretching it. It is all over the place, good, bad, real bad, heeled? Should I work it, or rest it?


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## ric426 (Jul 13, 2007)

You have judge it according to how your particular case feels. If you caught it early and got it checked out your recovery will be quicker. If you're stupid about it like me, it'll take a lot longer to get it under control. I tried to ignore it for too long, then when I did finally get help I overdid the stretching and set myself back even further. The "if a little is good, more must be better" mentality doesn't apply here.
If you're cautious and conservative and follow the doctor's instructions, you'll be riding again quicker than if you do it like I did. Once you're riding again you'll need to pay attention to preventative measures like cautious stretching, taping, etc. From what I was told, once you have a tendinitis tyhpe problem, you're more prone to more flare ups.


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