How I Fixed My Achilles Tendinitis

First off, I was never actually diagnosed with achilles tendinitis. They hurt like hell though, and now, after a lot of work, they're better. I think my self-diagnosis was correct, but what do I know? Anyway, here's what happened and what I did:

I played Easterns in early June with no problems, but afterwards had some achilles pain in one ankle. Pickup over the subsequent weeks made it quite a bit worse, and it ended up in both ankles. Some days were worse than others. On a good day I was aware of my achilles but could play fine, and on a bad day my first step was very painful and I probably could only manage 75% of my top speed, if that. I stayed in denial for two to four weeks (can't remember), then decided I had to take steps. So I did what I always do, which is read a lot about the problem. If you don't feel like doing all the same reading, here's what I took away from it:

In most cases it's not an inflammation problem. Instead, the tendon fibers are being damaged, and the tendon is becoming less tendon-like. There were scary MRIs somewhere of healthy tendon vs. deteriorating, and they certainly helped spur me to action. Anyway, there was a study where one group did your typical anti-inflammatory treatments (ice, ibuprofen, cortizone) while another group did strengthening exercises. At the end of the 12 weeks, the whole (I think) anti-inflammatory group was still miserable, while the whole (I think) strengthening group was much improved or cured. Sounds great, right? Unfortunately, the strengthening protocol is a bit of a pain in the ass. You do the following twice per day (!), seven days a week (!) for twelve (!!) weeks:

  • 3 sets of 15 straight-leg, weighted, eccentric calf drops per leg (45/leg, 90 total).
  • 3 sets of 15 bent-leg, weighted, eccentric calf drops per leg (45/leg, 90 total).
  • (so that's 180 in the morning, then another 180 in the evening.)

An eccentric calf drop works like this: Stand with the balls of your feet on the edge of a step, and your heels hanging off the edge. With both feet, raise yourself up on your toes. Now stand on one foot and lower your heel as far as it will go. Put your other foot back down to raise yourself up again. The point is you are trying to NOT work the raise (concentric contraction of the calf), and are trying to super-work the lower (eccentric contraction).

The study said you should work your way up to decent extra weight. I started off with bodyweight just to try it, jumped up to 20 pounds almost immediately, and finished the 12 weeks at 60 pounds (attached to a dip belt). The study also said the participants generally pushed through pain, but what does that mean, really? Personally, I found my achilles might start off sore in a given session, but would usually improve over the course of the session. The study didn't say anything about whether you should lay off other activity, so I chose not too. Kept playing pickup twice a week (at times quite painful), doing other workouts, etc. Not sure if this was the right thing to do or not.

The other thing I did was borrow a night splint (I've never ordered from them before, so can't vouch for them) and wear it overnight on whichever achilles felt worse (wish I had two!). I feel like this helped, but it's hard to be sure. There is no doubt the splinted achilles was less stiff and sore first thing in the morning. Anyway, if I were buying new I'd probably try a couple of the sock-like variety (another vendor I've never tried) as the bulky ones are, well, bulky, and more expensive.

Finally, the last thing I did was work the calf stretch I described in my My Key Stretches as often as possible. I can now get my hips to the wall, which is a pretty big improvement from where I started 12 weeks ago.

Anyway, the bottom line is that in the first four weeks I wasn't sure if it was helping. I suspected it might be, but still had painful days. In the second four weeks I was sure it was helping, but I wasn't all better yet. By the third four weeks I was basically pain-free. At this point I'm all done with the program and the achilles don't affect my play at all. I'm doing maintenance sets every other day or so, and we'll see how that goes. I still get stiffness in the achilles from time to time, but so far no more pain. We'll see if maintenance workouts keep the problem in check.