[Josh Gray]

So for the last few weeks I’ve been waking with considerable stiffness and low level soreness in one of my achilles tendons-my other achilles was repaired after a rupture 13 years ago and has never been a problem. I’ve been following the 24 week mountaineering program closely and haven’t really had any major jumps in training stress. A month ago tripped running downhill and tweaked that same achilles. It was quite sore for several days but subsided for a week or so but has now come back almost every morning. Once I’ve been up for a while and moving it mostly goes away but I do feel it occasionally on very steep slopes and after long or back to back days in the mountains. Just looking for recommendations on how to approach treating it. I’ve just started with some stretching/strengthening it and some massage and going to try taping. I’m 10 weeks out from my goal event/season and really worried about missing training time. Thanks.

• This topic was modified 1 year, 4 months ago by Josh Gray.

[Dr Andy Reed]

Hi Josh

Sorry to hear about your injury.

Typically lower limb tendons respond well to heavy, slow loading protocols.  This typically involves (for the achilles) a slow eccentric lowering of the heel off the edge of a step. You go up on tip toes, then slowly lower the heel down (over 3 or 4 seconds) for 10-12 reps. Normally I recommend 3-4 sets every second day. Pain during this is fairly normal.

As soon as these are feeling easy/tolerable, additional weight should be added (hold a kettle bell/heavy pack etc). A smith machine also works really well for these (https://youtu.be/1lKjFPrYqf0).

I also prescribe bent leg calf raises such as seated calf raises with additional weight – some gyms have a calf raise machine, or a Smith machine works well (https://youtu.be/Nd25-BniuGQ). The key is to introduce some heavy, slow eccentric loading as soon as possible, using both straight knee and bent knee variations.

I find most people are able to train through this injury, though if things get worse, I wouldn’t hesitate to see a physio or sport medicine doc. Hope that helps.

[Josh Gray]

Thank you Dr. Andy! I’ll start doing them today. Much appreciated

[Author]

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