Achilles tendons - thoughts?

[skywalkerbeth]

Hello

Well I have learned something new this week. I've perused the boards here and am wondering if my fitting Friday (seat slightly up and slightly back - maybe 1/4 inch for each) is why my achilles tendons hurt after my 41 mile ride (and did not hurt on previous rides incld the 35 miler). I learned about ankling but I cannot say for certain that is what I was doing. Maybe? I just don't know.

The fitting was a response to my back issues, which I am happy to say while not "gone", they are diminished from what they were previously.

What is weird is that the left foot hurt during cycling but seemed fine once I stopped. I took everyone's advice and iced it that day (probably a few hours after the ride ended).

My right foot didn't hurt during or after, BUT BOTH OF THEM hurt yesterday. Maybe "hurt" is a strong word. "Very aware of" each of them is better. As opposed to not being aware of them during a usual day, if that makes sense.

Today they are much better, in fact I would almost say they feel pretty normal. Once I start walking around (and not just to the tea kettle) I'll know but so far so good.

What next? How long would you avoid riding and how far would you go on the next one to test it out? My Saturday 20 miler, post fitting, was just fine. No achilles issues. The next day, Sunday, is when things started to break down and I'm just lucky the return ride on the W&OD was mostly downhill on the return. (Purcellville back to Wegmans).

Should I lower my seat again, maybe half way between what it is and what it was? He did put it slightly back as well as up, so as long as I know what I'm doing I won't be putting it forward, just slightly down. I don't want back issues but to be honest I think the achilles would be worse than the back!

I iced them big time last night, both of them.

[OakLeaf]

Here's what I'd do:

(1) If your fitter didn't give you a paper with all the measurements on it, take those now, so you have a reference point. If your seatpost and saddle rails have indicators on them, that makes it easy; otherwise measure the amount of seatpost exposed from seat tube to clamp, and the distance from the edge of your seatpost clamp to the zero mark on the rail - those are two of the easiest places to measure, and while they won't be any use to you if you get a different saddle, they'll let you get back to where things were with this one.

(2) Give the fitter a call and tell him what's going on.

(3) When you're riding, regardless of whether you tweak the fit or not, concentrate. Heels down, heels down, heels down, think about driving through your tibias all the way to your heels. If you like the boot-scraping visualization that a lot of people use, think about scraping the back part of your arches, getting all that horsepucky out of where it lodges immediately forward of the heel of the boot ;) - not scraping the balls of your feet. It took me at least a whole season to learn not to ankle.

(4) Whenever you're sitting and can slip your shoes off, roll your feet out with a spiky ball or ridged roller, concentrating on the area just forward of your heels, but getting the whole length of the plantar fascia.

(5) At least once a day, roll out your calves with a (non-spiky) Stick or rolling pin, and/or when you're sitting, you can cross your legs and dig at trigger points in each calf with the opposite knee.

(6) If it's really bad, you might try a night splint. But IME, those are expensive, uncomfortable, and only a Band-Aid solution. You want to address what's causing you to point your toes when you sleep, if you are doing that. (Which come to think of it, make sure you don't tuck your top sheet under the mattress ... that alone can force you to point your toes when you sleep.) But it's a good quick way to let everything rest and heal.


HTH. But I would definitely contact the fitter and get his input. It sounds kind of likely to me that raising the saddle might be causing you to point your toes ... but is that because you really can't reach the pedals, or because you're not accustomed to opening your knee joints as much as you ought to? Only someone who can see you on the bike will be able to answer that. Be sure to at least discuss crankarm length with the fitter too, if you didn't do that before. It's not an inexpensive swap unless you can find a used crankset in the size you need, but having 165s makes all the difference in the world to me.

I do think you're right that it was probably too big of a change all at once. Six millimeters in a single direction is a lot (see, doesn't that sound like more than a quarter of an inch? :p), and if he moved your saddle both up and back, then you've increased the distance from your hip joint to your pedal by even more than that. Going halfway back and working the change in stages is a good idea (or even more than halfway - sometimes 2 mm at a time is as much as I'll do). But I would still get the fitter's input.

[Sky King]

I have severe chronic achilles tendonitis in my left achilles. For 18 months I had both achilles flared up and was off the bike for a year... Mine came about from backpacking/hiking over the course of 3 years. Anyway, I digress.

Remember you achilles don't have strong blood flow, so while ice feels nice, they also need blood flow. The cold/hot/cold/hot helps.

I concur with Oakleaf on everything suggested.
Another helpful massage - get on your hands and knees, take one knee and place behind the other knee high on your calf and knead you calf with your knee, all the way to the ankle then switch legs. I find this super effective. I massage my achilles with my hands several times a day as I am sitting at my desk.
Consider ASTYM treatment if it isn't getting better. (a good PT certified in ASTYM) this is what finally got me back on the bike - as well as multiple stretching exercises.
Oh and I also own my very own ultrasound from mendmenow.com or mendmytendons.com when I am feeling especially tight I do a week of self ultrasound, it gets the blood moving.
Good Luck, I have had to learn to live with mine. Am not going to have a tendon replacement unless everything falls apart :)

[skywalkerbeth]

Thanks ladies. I actually feel a lot better today. I did not know this could turn chronic pretty easily though - wow.

Sky King, sorry to hear about that. I can't imagine dealing with the discomfort every single day.

The fitter didn't have much to offer other than "bring it in again".

In talking to some people I am really thinking the change must have either caused it or wasn't helpful.

Backwards - more reach - and up - more reach. I'm stretching more than I was used to do, before this...

[skywalkerbeth]

I have a stupid question.

Isn't pointing your toes kind of like wearing heels? I'm trying to figure out "which prolonged position is making it worse".

Heels DOWN means I'm constantly giving the achilles a stretch - right? Are you saying that doing it heels down is better because I'm stretching it all the time.. and pointed toes down (similar to the position when you are wearing heels) is bad.. why? That is not stretching the achilles... it's the opposite of stretching.. right?

Just trying to visualize and understand.

I was at the gym just now, on the treadmill. When I inclined the treadmill I felt a little better. Not great, better.

I dinged my achilles BUT GOOD earlier today. As in, hopping around and cursing. I backed into a deck post barefoot... a good hard one because I was trying to pull a deck glider into place that had moved overnight.

Sky King, when you massage with your hands - how hard? More of a rolling motion?

ps. in massaging my left leg... there is a definite knot about 4 inches up from the heel. I think I dinged it a lot lower than that... not sure what the knot is.

[OakLeaf]

It's not about stretching, it's about not overworking the calf muscles.

[skywalkerbeth]

It's not about stretching, it's about not overworking the calf muscles.

Ok, that makes sense.

[Sky King]

I massage my achilles anyway i can. circular and up and down the sides. I have a giant lump of inflammation and scar tissue so how much pressure and motion depends on day and how sore it might be. Today my left is pretty sore, we rode 40 miles yesterday and even though I concentrate on spinning it still gets cranky.
Keep massaging the calf muscle. Having access to a gym, is there a decent trainer that can show you some good calf strenghtening exercises. I too can walk an up hill all day long but the down is a killer so biking is better as I can climb and coast on the downhill :)
Am not going to get into the heel down or heel up. As I pedal, I for the most part try to keep my feet level and think about a striding out as if I were walking, so I work my quads and my hams and at the moment I work my right leg more than my left.
Going into the cast with no weight on the leg for six weeks did zippo for me but some say it helped them but it just weakened my calf muscle
okay enough about me, but consider riding the spinning bike at the gym as the impact on the tendon is less than running and walking



I


Sky King, when you massage with your hands - how hard? More of a rolling motion?

ps. in massaging my left leg... there is a definite knot about 4 inches up from the heel. I think I dinged it a lot lower than that... not sure what the knot is.

[jelee1311]

I have had cronic tendonosis from overtraining and last year had to be in a cast for four months. Nothing helped so I had a PRP(platelet rich plasma injection) done it worked for me. My achillies isn't perfect because its super thinand my joints are hypermobile but its waaaaay better. I still do PT exercise and some Rolfing but I've been back to riding for a year. The PRP has few risks it either works or it doesn't but it is expensive and I had to pay out of pocket

[OakLeaf]

The other thing that's getting a lot of attention for tendon problems these days, is eccentric strength training. So you can do calf lowers - skip most of the concentric phase of the exercise by stepping up onto your tiptoes and slowly lowering your heel to the floor. Keep a hand on a wall or bar for balance if you need it. Doing them barefoot (or at least without rigid shoes) will help strengthen your feet, too - which as I'm learning, weak feet can really be a culprit in Achilles problems.

Or you can do them seated on the floor with a strong Thera-Band around the balls of your feet - that really lets you do only the eccentric phase since you can let go of the tension on the band while you point your toes to get ready for the next rep.

[Sky King]

Oh glad to hear that helped. That is the next step for me but as you say it is expensive!

I have had cronic tendonosis from overtraining and last year had to be in a cast for four months. Nothing helped so I had a PRP(platelet rich plasma injection) done it worked for me. My achillies isn't perfect because its super thinand my joints are hypermobile but its waaaaay better. I still do PT exercise and some Rolfing but I've been back to riding for a year. The PRP has few risks it either works or it doesn't but it is expensive and I had to pay out of pocket

[jelee1311]

I- hope if you are a good candidate you can get it done. It was a good investment in me. One year later I'm riding 4 -5 times a week and not in constant pain. That seemed like a better deal than surgery, recovery,and lots of PT and still no guarantees. I also have found that the achilles pain was all relative I have tight hammies, glutes,lower back and if I treat this sytemically I can prevent further injury.