Achille Tendonitis / Both Ankles (Help needed)

[tennisintheeighties]

Hi guys, I have had an issue with both Achilles tendons for a year.
I am 45 years old, ex 5.0, I suffer from tendons, the morning (very stiff since one year), a little better after a few minutes, but I almost completely stop playing tennis like i would like.
Running is no longer natural as it used to be. Doing some tennis footwork seems difficult now.

I have tried everything since january 2020. Pain started on this date.

. Recently 12 shockwave therapy sessions on my tendons (didn't work)
. Stretching, stanish, foam roller every day (not working)
. Sports clinic - july and december 2020 - Release of trigger points (didn't work)
. Ultrasound (october 2020 ) : Impression "Mild tendinosis of both the right and left achilles tendons. Mild Peritendinous fluid about the right achilles tendon as well as mild retrocalcaneal bursitis - the right and left plantar fascial attachment was normal"
. Self massage everyday (not working)
. Custom sole (by a Podiatrist) since july 2020 (not working)
. Blood test - october 2020 - everything is ok
. Ray-x (november 2020) shows nothing to the bones
. I have flat feet - starting exercices since a week. No improvement for now.
. Soaking in ice water 15x per day for 15 seconds ankles foot - Ice (didn't work)
. Heat (didn't work)
. Strasburg sock at night - (not working)
. No dental issues.

. Mental Health problems ?
Yes, It's starting to seriously affect me LMAO !

I don't want to stop playing tennis and competition. And I won't.
What do you advise me to do now ?

Thank you !

 

[socallefty]

Are you playing with old shoes that have become too soft where you tighten the laces very tightly to get a good fit? That can lead to Achilles tightness for me. If so, get a new pair of shoes. Also, make sure that the shoes you get are the right size and fit well without being too loose or too tight. If you have flat feet, you should try some insoles to raise your arch.

 

[tennisintheeighties]

Thank you.
I'm using a custom insole that raises my arch. Absolutely.
About the shoes, I have not been able to play with tennis shoes for 2 months.
They are too stiff, I feel pain almost immediately. I used several models, adidas solematch, court jam, and artengo ts990.

I play and walk with some adidas running shoes, extremely flexible, the only ones that don't hurt me. (with or without ankle brace, that's the same)

 

[yossarian]

Eccentric heel drops

 

[tennisintheeighties]

D

Eccentric heel drops

Doing eccentric heel drops since 6 months, and stretching.
Absolutely no results.

 

[travlerajm]

Don’t know if this will work but:

2.5 years ago, I started to suffer from Achilles tendinitis in both heels, at age 45.

One of them started to get particularly bad after I used a moonball strategy win a 2-1/2 hour league singles match.

After that, I tried playing twice a week, but it would get worse every time out. The injury started with a tweak down near the heel, then started zipping higher up my calf.

I took a month off to rest it, but then it was still there.
I was popping ibuprofen to get through matches.

A year later, I happened to get on a project in South America. It gave me a chance to play tennis 3 times a week on red clay. I was using soft adidas tennis shoes like you to protect my knees.

When I first started playing on the clay, my Achilles were always really sore the next day every time. But then a weird thing happened. The soreness started to go away. I think the key was that my tennis singles sessions were usually short (not longer than an hour, as I was usually paying a pro to play a match against me). And the temp was usually hot, in the 80s, which may have helped. But my frequent short sessions of clay singles somehow strengthened my Achilles and made me feel 10 years younger.

 

[tennisintheeighties]

Thank you. Could be the solution, yes !
Unfortunately, here in Vancouver, there’s 0 clay court, and the weather doesn’t match with arthrisis / tendonitis / etc etc !

 

[ollinger]

"How about a nice game of doubles"
----Joshua, from "WarGames"

 

[anarosevoli]

I had horrible achilles tendinitis for a year and nobody found out why, in MRT it was very much thicker than usual. Also made stretching and shockwave therapy but nothing helped. I used Novak Pro (= Barricade 7) shoes then, switched to Barricade 2017 which are a bit softer at the heel collar but it didn't help. I even cut the top of the heel collar off of the Barricades but still they touched my achilles and made the pain worse. Then I tried Gel Res 7 which are also stable in general but are very soft at the heel collar and not very high. After a few weeks it got better. Obviously my problems were not worsened by the other shoes but caused by them, something nobody told me is possible. So definitely worth a try to keep every physical stress away from the tendon. Now I have 25 pairs of Gel Res 7 in stock, never had a problem again, tendon thickness is completely normal again.

 

[travlerajm]

Thank you. Could be the solution, yes !
Unfortunately, here in Vancouver, there’s 0 clay court, and the weather doesn’t match with arthrisis / tendonitis / etc etc !

I’m a fellow PNW guy, normally in Seattle (but current back in Southern Hemisphere).

You can’t get the red clay or the heat up there. But I do think the key might be doing exercises specific to the activity you are training for (so playing tennis), but being careful to never overextend too much.

As I learned in biomechanics class 25 years ago, tendons, ligaments, and bones need a certain level of stress within a fairly narrow range to promote strength augmentation - overexertion leads to scarring and tendinosis. Not enough regular stress leads to atrophy.

 

[tennisintheeighties]

I had horrible achilles tendinitis for a year and nobody found out why, in MRT it was very much thicker than usual. Also made stretching and shockwave therapy but nothing helped. I used Novak Pro (= Barricade 7) shoes then, switched to Barricade 2017 which are a bit softer at the heel collar but it didn't help. I even cut the top of the heel collar off of the Barricades but still they touched my achilles and made the pain worse. Then I tried Gel Res 7 which are also stable in general but are very soft at the heel collar and not very high. After a few weeks it got better. Obviously my problems were not worsened by the other shoes but caused by them, something nobody told me is possible. So definitely worth a try to keep every physical stress away from the tendon. Now I have 25 pairs of Gel Res 7 in stock, never had a problem again, tendon thickness is completely normal again.

I tried many shoes, Asics as well and recently NB LAV, really good and flexible, but this is not the roots of my problem

 

[tennisintheeighties]

I’m a fellow PNW guy, normally in Seattle (but current back in Southern Hemisphere).

You can’t get the red clay or the heat up there. But I do think the key might be doing exercises specific to the activity you are training for (so playing tennis), but being careful to never overextend too much.

As I learned in biomechanics class 25 years ago, tendons, ligaments, and bones need a certain level of stress within a fairly narrow range to promote strength augmentation - overexertion leads to scarring and tendinosis. Not enough regular stress leads to atrophy.

No tennis since one month unfortunately.
Only biking, and exercices, once every two days, but no improvement at all

 

[RogueFLIP]

Couple of thoughts FWIW:

You might want to consider that your issues might not be stemming from where your symptoms are. You might need to look further "up the chain" so to speak and see what's happening elsewhere in your body.

Suggest you find someone who can do a good postural evaluation and even a gait analysis. That might give some clues to where there might be other things going on that may be contributing to your continued symptoms.

For example (and I'm NOT saying this scenario applies to your situation) but tightness in your hip flexors could lead towards an anterior pelvic tilt. As your center of gravity now shifts forward from your normal center, your posterior chain (gluts, hamstrings, gastrocs) will now compensate and contract in order to keep you balanced. Under that constant tension, it's no wonder why your attempts at treating your achilles has not been successful. So correcting that tilt will take the pressure/compensation off the achilles and NOW whatever you do to the Achilles will be more effective.

Like your achilles is one end of the rope and you keep treating that one end, but the other end of the rope is constantly under tension and pulling on the Achilles end.

Related to your trigger point work and stretching, you might not be holding things enough to loosen such a tight complex. To really make some worthwhile changes in the system, you'd be better off holding your gentle stretching for at least 5 minutes at a minimum. 30 seconds, 1 minute isn't going to be long enough.
Same thing with the trigger point work, 30 seconds, 1 minute into a spot isn't going to be able to penetrate deep enough into the usually tight regions for anything to occur. Sure you might get 2 hours or 2 days of relief, but afterwards it'll just revert back to what it's used to.

Also regarding those therapies, are you doing it multiple times a day? If you're doing it just in the AM and or PM, then you'll loosen it up for a little, go about your day and tighten up and then the PM session you're just loosening up how tight you became throughout the day.

I've got one of these at work and at home:

https://www.amazon.com/ProStretch-Blue-Double-Stretcher-Tendonitis/dp/B001HTFZZ8/ref=sr_1_8?dchild=1&keywords=pro+stretch&qid=1611607022&sr=8-8

Get on it whenever I get a chance. Also because it engages the great toe, it's a more effective stretch than just say the runner's stretch or hanging off a step.


You said you did some eccentric heel drops......but are you doing some concentric heel strengthening? I mean sometimes, if appropriate you just need to build up the strength of the area as pain can cause immobility which can lead to weakness/instability/stiffness.

Anyone ever test of mobility of the joints of your feet/ankles? Mid foot, rear foot, etc? A locked joint can def lead to symptoms......

Just some things to consider....

Good luck....

 

[Born_to_slice]

If you're not overweight, it's most likely the hard courts/playing too much. Consider taking a pause to heal and def don't give up on stretching and massage. I had a similar problem (also have flat feet) but it went away completely after losing weight. Tendons still hurt a bit after playing on HC once in a blue moon.

 

[mikeler]

I'm having some minor heal pain in one foot. I got 3 pairs of new shoes a few months ago. No issues at all. Then I bought the same brand to add a 4th pair and wore those a few weeks to try and equal out the wear and tear on all 4 pairs. That's when my issue started.

Every tennis player should have CBD cream (low THC so legal) in their bag. It's been a godsend for me.

 

[tennisintheeighties]

Couple of thoughts FWIW:

You might want to consider that your issues might not be stemming from where your symptoms are. You might need to look further "up the chain" so to speak and see what's happening elsewhere in your body.

Suggest you find someone who can do a good postural evaluation and even a gait analysis. That might give some clues to where there might be other things going on that may be contributing to your continued symptoms.

For example (and I'm NOT saying this scenario applies to your situation) but tightness in your hip flexors could lead towards an anterior pelvic tilt. As your center of gravity now shifts forward from your normal center, your posterior chain (gluts, hamstrings, gastrocs) will now compensate and contract in order to keep you balanced. Under that constant tension, it's no wonder why your attempts at treating your achilles has not been successful. So correcting that tilt will take the pressure/compensation off the achilles and NOW whatever you do to the Achilles will be more effective.

Like your achilles is one end of the rope and you keep treating that one end, but the other end of the rope is constantly under tension and pulling on the Achilles end.

Related to your trigger point work and stretching, you might not be holding things enough to loosen such a tight complex. To really make some worthwhile changes in the system, you'd be better off holding your gentle stretching for at least 5 minutes at a minimum. 30 seconds, 1 minute isn't going to be long enough.
Same thing with the trigger point work, 30 seconds, 1 minute into a spot isn't going to be able to penetrate deep enough into the usually tight regions for anything to occur. Sure you might get 2 hours or 2 days of relief, but afterwards it'll just revert back to what it's used to.

Also regarding those therapies, are you doing it multiple times a day? If you're doing it just in the AM and or PM, then you'll loosen it up for a little, go about your day and tighten up and then the PM session you're just loosening up how tight you became throughout the day.

I've got one of these at work and at home:

https://www.amazon.com/ProStretch-Blue-Double-Stretcher-Tendonitis/dp/B001HTFZZ8/ref=sr_1_8?dchild=1&keywords=pro+stretch&qid=1611607022&sr=8-8

Get on it whenever I get a chance. Also because it engages the great toe, it's a more effective stretch than just say the runner's stretch or hanging off a step.


You said you did some eccentric heel drops......but are you doing some concentric heel strengthening? I mean sometimes, if appropriate you just need to build up the strength of the area as pain can cause immobility which can lead to weakness/instability/stiffness.

Anyone ever test of mobility of the joints of your feet/ankles? Mid foot, rear foot, etc? A locked joint can def lead to symptoms......

Just some things to consider....

Good luck....

Thank you great post.
Absolutely you are right. It could be a possibility. I should consider to see a great chiroprator, in order to do a postural evaluation.
It could be that. Who knows ?

Yes, at the sport clinic, they tested already the position and mobility of my feet and ankles in july and then a month ago, and they noticed a great improvement in 6 months.
Thank you for the link, i'm gonna order it right now. It will be one more weapon in my big collection !

 

[tennisintheeighties]

If you're not overweight, it's most likely the hard courts/playing too much. Consider taking a pause to heal and def don't give up on stretching and massage. I had a similar problem (also have flat feet) but it went away completely after losing weight. Tendons still hurt a bit after playing on HC once in a blue moon.

Thank you. You are right.
I'm into fitness since many years, I consider myself fit and not overweight. 6"0 / 164 lbs

 

[tennisintheeighties]

I'm having some minor heal pain in one foot. I got 3 pairs of new shoes a few months ago. No issues at all. Then I bought the same brand to add a 4th pair and wore those a few weeks to try and equal out the wear and tear on all 4 pairs. That's when my issue started.

Every tennis player should have CBD cream (low THC so legal) in their bag. It's been a godsend for me.

CBD Cream is a good idea, but I need to know the roots of this issue

 

[mikeler]

CBD Cream is a good idea, but I need to know the roots of this issue

It is always shoe related for me. Have you tried seeing a podiatrist? They might recommend getting custom orthotics and could help with proper footwear.

 

[tennisintheeighties]

It is always shoe related for me. Have you tried seeing a podiatrist? They might recommend getting custom orthotics and could help with proper footwear.

Yes absolutely, i saw a podiatrist in july. I am wearing a custom insole since then.
But no improvement. It get worst. Just bought new running shoes (brooks ghost 13), and I removed the custom insole made by the podiatrist. Let's see what happen !

 

[mikeler]

Yes absolutely, i saw a podiatrist in july. I am wearing a custom insole since then.
But no improvement. It get worst. Just bought new running shoes (brooks ghost 13), and I removed the custom insole made by the podiatrist. Let's see what happen !

Are you using running shoes to play tennis?

 

[tennisintheeighties]

Are you using running shoes to play tennis?

I use Adidas tennis shoes principally like solematch and court jam ), but since one month i just can’t wear tennis shoe. The sole is too stiff and hurts my ankle in a second.
I just play one time in 2 months. And it was with running shoes ( only shoes i can wear for now, due to the high flexibility )


i got an appointment in 10 days with the best foot clinic in town

 

[S&V-not_dead_yet]

@tennisintheeighties

Have you tried walking barefoot in soft dirt or sand? That mildly stretches all sorts of stuff since the ground is slightly unstable and you have to compensate by engaging those elements.

As @RogueFLIP mentioned, maybe the root cause is elsewhere. For example, lower back pain can often stem from tight hamstrings and/or a weak core. Those two things act as shock absorbers and if they aren't doing their job well, a lot of that shock gets transferred elsewhere.

I'd want to get my entire body checked out by a PT and chiropractor. I prefer PTs and chiros with experience treating athletes.

 

[comeback]

Try googling SANEXAS therapy..it might help you

 

[Lex]

OP,

Have you had an MRI yet?

 

[tennisintheeighties]

@tennisintheeighties

Have you tried walking barefoot in soft dirt or sand? That mildly stretches all sorts of stuff since the ground is slightly unstable and you have to compensate by engaging those elements.

As @RogueFLIP mentioned, maybe the root cause is elsewhere. For example, lower back pain can often stem from tight hamstrings and/or a weak core. Those two things act as shock absorbers and if they aren't doing their job well, a lot of that shock gets transferred elsewhere.

I'd want to get my entire body checked out by a PT and chiropractor. I prefer PTs and chiros with experience treating athletes.

That’s totally correct. I’m currently looking for the best chiro in town

 

[tennisintheeighties]

OP,

Have you had an MRI yet?

Nope. They oriented me to do an ultrasound, in october and xray last month

 

[graycrait]

What kind of footwear do you wear when you are not playing tennis?

 

[tennisintheeighties]

What kind of footwear do you wear when you are not playing tennis?

I was using adidas solar glide, and now brooks ghost 13 with orthopedics insole (since july)
(no tennis shoes for now, and no tennis since 2 months)

 

[graycrait]

Does something to do with your job cause this?

 

[tennisintheeighties]

Does something to do with your job cause this?

I dont think so, i dont lift

 

[S&V-not_dead_yet]

I dont think so, i dont lift

It's not just lifting that could cause problems. Maybe you're just wearing dress shoes that are horrible for your body. Take a step back from the minutiae and try to view yourself holistically: things like posture, diet, sleep, stress, could be playing roles.

 

[graycrait]

I dont think so, i dont lift

I had a job for several decades that required me to run daily and often carry a pack while wearing questionable designed government issued boots. Questionable because they were designed for mass production and durability by I suspect the lowest bidder. From age 18 to about 40 government boots worked fine. But in my 40's I started to get Achilles tendon inflammation doing the same work in those government boots. I had to cut out the back of the boots and have soft leather patches sewn in to alleviate the rubbing. Now in my later 60's I have not had Achilles issues since.

 

[tennisintheeighties]

I had a job for several decades that required me to run daily and often carry a pack while wearing questionable designed government issued boots. Questionable because they were designed for mass production and durability by I suspect the lowest bidder. From age 18 to about 40 government boots worked fine. But in my 40's I started to get Achilles tendon inflammation doing the same work in those government boots. I had to cut out the back of the boots and have soft leather patches sewn in to alleviate the rubbing. Now in my later 60's I have not had Achilles issues since.

Very interesting story. I never understood why it was always necessary to wear dress shoes at work (for those who work in a office). Terrible for confort, heel, and tendons.
I'm lucky, I always wear sneakers or running .

 

[graycrait]

I'm lucky, I always wear sneakers or running .

Good luck then and take care.

 

[FiddlerDog]

. Recently 12 shockwave therapy sessions on my tendons (didn't work)
. Stretching, stanish, foam roller every day (not working)
. Sports clinic - july and december 2020 - Release of trigger points (didn't work)
. Ultrasound (october 2020 ) : Impression "Mild tendinosis of both the right and left achilles tendons. Mild Peritendinous fluid about the right achilles tendon as well as mild retrocalcaneal bursitis - the right and left plantar fascial attachment was normal"
. Self massage everyday (not working)
. Custom sole (by a Podiatrist) since july 2020 (not working)
. Blood test - october 2020 - everything is ok
. Soaking in ice water 15x per day for 15 seconds ankles foot - Ice (didn't work)
. Heat (didn't work)
. Strasburg sock at night - (not working)
. No dental issues.

Lots of gimmicks but have you done the most obvious remedy?
The Alfredson Protocol for Achilles Tendonitis

 

[RogueFLIP]

Lots of gimmicks but have you done the most obvious remedy?
The Alfredson Protocol for Achilles Tendonitis

Post #4 & 5

 

[tennisintheeighties]

A great sport chiro found this :

following problems to work on:
R SI joint syndrome, decreased R ankle dorsiflexion, R tibialis posterior strain, bilateral fibularis longus strain, L achilles tendinosis

 

[datsveryinterestin]

im in my (late ) 40s and my achilles pain has been pretty bad but soaking it multiple times a day in HOT water (as hot as i can tolerate) for 15+ minutes has really helped.
normally the day after i play it takes me forever to carefully descend the stairs of my house using a sideways walk...like i am 90 years old.
I plan to ice after i play (it hasnt helped before but maybe it will calm any swelling?)
and definitely do hot water soaks AM and PM any time i feel discomfort.

i have bone spurs in my big toes, ankles and achilles... which has been diminishing the capability of good tennis,
(i play with some crazy guys with huge forehands and in doubles they really seem to enjoy pegging the giant statue at the net off 2nd serves... even when i know its coming.. i just cant move and adjust to volley it. my feet hurt too bad. its really become annoying.. that my feet are cemented to the ground and my volleys can't bail me out.
but the soaks have at least temporarily returned some elasticity and less pain to my tendons and joints.
i am taking some comfort in knowing i'm not alone in this achilles suffering and general foot pain while trying to play tennis..
but i also know how painful and frustrating these conditions are.. so hope we all can find something to make us better!

i know it didn't help the OP but in case others are suffering.. the hot soaks are great so far. maybe i should go for a SOAK now!

 

[Dartagnan64]

Thank you. Could be the solution, yes !
Unfortunately, here in Vancouver, there’s 0 clay court, and the weather doesn’t match with arthrisis / tendonitis / etc etc !

Well not zero clay courts. It's just it'll cost you 30,000 to 50,000 to join Van Lawn or Hollyburn to access them.

Eccentric heel drops have been my solution combined with heel cup insoles that raise the heel slightly and provide lateral support. Good luck healing. Tendinopathies are a pain as I've suffered almost all of them lol (achilles, patellar, TE, GE)

 

[tennisintheeighties]

Well not zero clay courts. It's just it'll cost you 30,000 to 50,000 to join Van Lawn or Hollyburn to access them.

Eccentric heel drops have been my solution combined with heel cup insoles that raise the heel slightly and provide lateral support. Good luck healing. Tendinopathies are a pain as I've suffered almost all of them lol (achilles, patellar, TE, GE)

It seems that i’m going exactly to the same direction than you, before.( hope you get better.
My tendons are just weak, not feeling the same at 45 yrs old.

Van Lawn looks really good. And close to the mount pleasant.
Hopefully i can join the club before my 50th anniversary ;-)

 

[StringSnapper]

I recovered the Achilles tendonitis on my left heel which lasted about 2 years from religiously strapping a hot water bottle to it. I.e. if you can work from home, have it strapped to it as hot as you can stand and reheat it every 2 hours. Try to have it strapped there all day. I think in a few weeks itll clear up.

To prevent it reoccurring do dynamic stretching before playing

Basically tendons take forever to heal due to poor blood supply, and this should fix it. It works whenever I tweak a knee ligament too.

 

[tennisintheeighties]

I recovered the Achilles tendonitis on my left heel which lasted about 2 years from religiously strapping a hot water bottle to it. I.e. if you can work from home, have it strapped to it as hot as you can stand and reheat it every 2 hours. Try to have it strapped there all day. I think in a few weeks itll clear up.

To prevent it reoccurring do dynamic stretching before playing

Basically tendons take forever to heal due to poor blood supply, and this should fix it. It works whenever I tweak a knee ligament too.

Interesting technique, i can try it, thank you !

 

[tennisintheeighties]

Appointment today with a foot clinic.
I just stayed 5 minutes.
He touched my tendons L and R = Pain.
The Dr was very clear.

Result = It's a tendinopathy at the tendon insertion on both ankles
Next step = Prolotherapy

 

[yossarian]

Insertional tendonitis is a bit different. Probably why it didn’t respond well to typical treatment

 

[Folsom_Stringer_Musa]

I had horrible achilles tendinitis for a year and nobody found out why, in MRT it was very much thicker than usual. Also made stretching and shockwave therapy but nothing helped. I used Novak Pro (= Barricade 7) shoes then, switched to Barricade 2017 which are a bit softer at the heel collar but it didn't help. I even cut the top of the heel collar off of the Barricades but still they touched my achilles and made the pain worse. Then I tried Gel Res 7 which are also stable in general but are very soft at the heel collar and not very high. After a few weeks it got better. Obviously my problems were not worsened by the other shoes but caused by them, something nobody told me is possible. So definitely worth a try to keep every physical stress away from the tendon. Now I have 25 pairs of Gel Res 7 in stock, never had a problem again, tendon thickness is completely normal again.

25 Pairs alone in stock? No wonder why can't I find a pair.

 

[tennisintheeighties]

I found this video, and this simple exercice is about to work with me.
I spend so much time doing heel raise on stairs and it get worst and worst.
He explains this very well here :

 

[mikeler]

Years ago, I had someone with heel pain see a foot specialist. The guy told him it was likely plantar fasciitis which I always thought was pain at the bottom of the foot. My heel has been bothering me on and off for a few weeks lately, so I finally put these bad boys on today and it is already way better. It's a cheap solution to try out. Good luck:

https://www.walgreens.com/store/c/walgreens-plantar-fasciitis-arch-sleeves-one-size/ID=prod6189314-product

 

[Dartagnan64]

I found this video, and this simple exercice is about to work with me.
I spend so much time doing heel raise on stairs and it get worst and worst.
He explains this very well here :

I had insertional achilles tendionitis and heel drops worked fine for me. Everyone is probably different.

 

[yossarian]

I had insertional achilles tendionitis and heel drops worked fine for me. Everyone is probably different.

With insertional you may just want to forgo going past neutral, but eccentrics can still work