Achilles tendonitis + eccentric heel drops = resolved

[Torres]

I'm really pleased with the results.

I developed some tendonitis (or should I say tendonosis) in my right achilles last summer which would periodically flare up as a sharp stinging pain in the back of the achilles when playing too much. It would often appear randomly during matches.

It seemed to come and go during the autumn, not enough to prevent me from playing - but enough to let me know that there was an issue.

So I started doing eccentric stretching/strengthening exercises of the achilles - basically heel drops off the edge of a step with the emphasis on the slow, lowering part of the movement. 15 times, 3 times a day is what the physio suggested.

I haven't even been that disciplined with the regime but the achilles has improved massively and the pain seems to have pretty much gone. And throughout all of that, I've still managed to keep playing 8-10 hours a week including a couple of tourneys etc.

Anyone with a similar injury or who wants to know about the exercises (which are really quite simple), I'd highly recommend this book:

http://www.amazon.com/Treat-Your-Own-Achilles-Tendinitis/dp/1457510928

 

[mikeler]

Those exercises work great for me whenever I get a flare up. I do them once a week but need to do them more since I'm feeling it sometimes a little bit in my left leg again.

 

[Bobby Jr]

Good stuff. This thread inspired me to not forget doing my heel drops after the holiday season.

 

[Champs990411]

How slow on the down? I used to set a timer and take ten seconds per. I've also seen Youtubes where the drop is literally two seconds. Thanks.

 

[Torres]

^ I don't it needs to be as slow as 10 seconds, just slow enough so that you feel the achilles working and your calf stretching. As long as its not rushed, you get actually get more resistance and strength when you start adding weight rather than time eg. dumbells in a backpack whist doing the exercises. What you can do is after the achilles part ie at the end of the motion is hang off the edge of the step with your body weight for a few reps - that stretches the calf muscle really nicely. Loose calf muscle puts less pressure on the achilles.

 

[Torres]

Found a good article below, if you like something detailed

http://www.runningwritings.com/2013/11/achilles-tendonitis-in-runners.html?m=1

 

[Stanimal]

Thanks man I tore my right one a while back and every once in a while have flare-ups

 

[mikeler]

My left one will get a little tender if I play back to back singles on it. It gets stiff on the car ride home after each match as well but nothing major.

 

[Fintft]

And change your shoes?

 

[Tmano]

And change your shoes?

yes, that worked for me. I was using the adidas barricade 6 and after the first pair i developed the achille's tendon issue although mild. I did exercises stretching but nothing really made the difference. Shoes was the answer....tossed the adidas for more confortable shoes with more heel shock absorbent. also now I m using some gel heel insert. also make sure your everyday shoes are confortable too.
That was it

 

[Attila_the_gorilla]

I also got this book a couple of months ago, and all his other books on treating your own injuries.

The heel drops are really working. I normally just drop as fast as natural, without resisting, must have missed the part about having to drop slowiy.

 

[Torres]

I also got this book a couple of months ago, and all his other books on treating your own injuries.

The heel drops are really working. I normally just drop as fast as natural, without resisting, must have missed the part about having to drop slowiy.

I think the point of doing it slowly is simply to make sure there's some resistance and the Achilles is put to work, as opposed to it dropping just through gravity. I'm sure its probably possible to do it faster, as long as you're working the Achilles during the dropping stage. It's just that when doing it slowly, you can't not work the Achilles, if you know what I mean.

 

[drak]

I unfortunately hurt my Achilles again last November, if felt like I got hit very hard there when pushing off hard, so it was more than chronic tendonosis and likely a significant tear but not a rupture. I rested for a month just biking and tried playing again but it was still sore, but I was going to Palm Springs for a month to play senior tourneys so I had to play. Unfortunately I pulled my hamstring badly the first day there and could not play at all, oh well.

so from the first week of Jan till the last week of Feb I did not play tennis or ski, just road stationary bike and did weights. During that time I was doing the eccentric heel drops which had worked before but after 5-6 weeks I had NO improvement, general walking bothered me constantly.

The KEY POINT I am making here is that for me, since I had a more serious "partial tear" I had to fully rest it by immobilizing it in a walking boot for 4 full weeks BEFORE starting the heel drops, that allowed healing and by weeks 4's end (last Sunday) I felt pretty good. Now I am very slowly introducing the eccentric heel drops and some concentric raises as well and slowly weaning myself off the boot and "listening" very closely to my achilles response - very good so far.

I think it very important to determine how severe your injury is to determine the best course of action and when to begin eccentrics. I think my case is more unique and severe than most and that is why eccentrics did not work initially.

Food for thought

Drak

 

[drak]

I unfortunately hurt my Achilles again last November, if felt like I got hit very hard there when pushing off hard, so it was more than chronic tendonosis and likely a significant tear but not a rupture. I rested for a month just biking and tried playing again but it was still sore, but I was going to Palm Springs for a month to play senior tourneys so I had to play. Unfortunately I pulled my hamstring badly the first day there and could not play at all, oh well.

so from the first week of Jan till the last week of Feb I did not play tennis or ski, just road stationary bike and did weights. During that time I was doing the eccentric heel drops which had worked before but after 5-6 weeks I had NO improvement, general walking bothered me constantly.

The KEY POINT I am making here is that for me, since I had a more serious "partial tear" I had to fully rest it by immobilizing it in a walking boot for 4 full weeks BEFORE starting the heel drops, that allowed healing and by weeks 4's end (last Sunday) I felt pretty good. Now I am very slowly introducing the eccentric heel drops and some concentric raises as well and slowly weaning myself off the boot and "listening" very closely to my achilles response - very good so far.

I think it very important to determine how severe your injury is to determine the best course of action and when to begin eccentrics. I think my case is more unique and severe than most and that is why eccentrics did not work initially.

Food for thought

Drak

so far so good as I have now been doing concentric raises and eccentric drops for 9 days after being in a walking boot for 4 1/2 weeks. Neither concentric raises or drops causes any pain as they did before (I did eccentrics only then). I took off 2 days in those nine days and have very slowly been building reps. My improvement in the past 9 days has been remarkable, so much so that I have to be careful and stick to my plan to take it easy for another 3-4 weeks at least.

Conclusion 1: I have healed as well from a worse achilles injury compared to last time when I had a PRP shot, so booting up and allowing healing seems to be the key.

Conclusion 2: For me given I very likely had a partial tear booting up for 4-5 weeks was the answer as the initial eccentrics did not allow healing in my case. Adding the concentrics and eccentrics after 4 1/2 weeks so far seems to be the real deal "for my achilles issue".

can't wait to get on the courts again but I am waiting to May 1 at a minimum

 

[mikeler]

I was getting heel bursitis from the $40 version of the New Balance tennis shoes. Went for the high end New Balance shoes from TW last week and now the issue is almost gone.

 

[drak]

My left one will get a little tender if I play back to back singles on it. It gets stiff on the car ride home after each match as well but nothing major.

Mikeler ,besides changing your shoes which I saw you did I would you recommend you begin a regular eccentric heel drop and possibly a concentric raise exercise regimen. What you are reporting is how my issues started and they gradually worsened over time. Nip it in the bud while you can is my suggestion

Drak

 

[GuyClinch]

Okay so flat or on stairs for heel pain? I wasn't quite sure what the wanted. Flat ones seem weird..you don't get any stretch that way...

 

[drak]

Okay so flat or on stairs for heel pain? I wasn't quite sure what the wanted. Flat ones seem weird..you don't get any stretch that way...

if your issue is "insertional" achilles which is lower and at the heel area you are only supposed to drop to a flat level, if you have the more common problem at the midpoint area of the achilles going below flat is what is needed

Drak

 

[drak]

so far so good as I have now been doing concentric raises and eccentric drops for 9 days after being in a walking boot for 4 1/2 weeks. Neither concentric raises or drops causes any pain as they did before (I did eccentrics only then). I took off 2 days in those nine days and have very slowly been building reps. My improvement in the past 9 days has been remarkable, so much so that I have to be careful and stick to my plan to take it easy for another 3-4 weeks at least.

Conclusion 1: I have healed as well from a worse achilles injury compared to last time when I had a PRP shot, so booting up and allowing healing seems to be the key.

Conclusion 2: For me given I very likely had a partial tear booting up for 4-5 weeks was the answer as the initial eccentrics did not allow healing in my case. Adding the concentrics and eccentrics after 4 1/2 weeks so far seems to be the real deal "for my achilles issue".

can't wait to get on the courts again but I am waiting to May 1 at a minimum

update: have stayed with and increased reps in concentric/eccentric regimen, also added some track work last week with a combo of very lite jogging and several different tennis oriented footwork drills and some explosive moves to build strength in the Achilles. Feeling better and better and a lot stronger, will hit the courts next week and then gradually build playing time. It's been a LONG haul but the rehab journey is about over. This time I will also continue a good portion of this rehab regimen the rest of my tennis playing life.

Drak

 

[drak]

update: have stayed with and increased reps in concentric/eccentric regimen, also added some track work last week with a combo of very lite jogging and several different tennis oriented footwork drills and some explosive moves to build strength in the Achilles. Feeling better and better and a lot stronger, will hit the courts next week and then gradually build playing time. It's been a LONG haul but the rehab journey is about over. This time I will also continue a good portion of this rehab regimen the rest of my tennis playing life.

Drak

Update 10/3: Because of moving this summer and doing a bunch of stuff I did not really start playing hardly any tennis until August, I did keep doing the concentric/eccentric exercises on a slant board 5-7 days a week, however I only do 2 sets of 15-20 reps once a day and seems to have done a great job for me, the 3 sets twice a day (what I often see recommended) at least for me appears overkill.

I have been playing 3-4 times a week now for the past 6-8 weeks, both singles and dubs, with no movement hesitation and absolutely no issues from my Achilles either during or after playing, feels just as good as the one that was not injured - YEAH!

I foam roll every day and do the 2 sets of the concentric/eccentric exercises.

Conclusion for healing and comeback:

1. Hardest and most important thing is to determine how serious the Achilles issue is. Is it more of the tendonitis/tendonosis variety or more significant and maybe a partial tear (likely what I had).

2. If more serious wearing a walking boot for several weeks should be considered, then start a concentric/eccentric program slowly and if it hurts back off. If less serious you may not need a boot and start the concentric/eccentric ASAP.

3. My opinion and that is all it is, is that concentric/eccentric exercises should not be done if painful, for me that just kept aggravating the injury area. A little "discomfort" is okay, but IMO that is all. Note that I am 58 years old so I don't heal like someone who is 25.

Please note I am only relating my experience and what has worked for me, it could be different for you and I am in no way a doctor or any kind of expert. This can be an extremely frustrating injury, good luck to anyone who has it.

Drak

 

[Champs990411]

Thank you. Happy to hear a success story. My right Achilles has not been fully healed since injuring it 6 years ago.

That's good to hear that two sets worked. Would you foam roll at the same time? Before or after? How long would you say the drop itself took? What worked best? Did you do the other leg, too? When during the day would you do them?

Many places do list that it should be a little painful. I was always uneasy about that advice. Thanks for sharing your experience.

 

[drak]

Thank you. Happy to hear a success story. My right Achilles has not been fully healed since injuring it 6 years ago.

That's good to hear that two sets worked. Would you foam roll at the same time? Before or after? How long would you say the drop itself took? What worked best? Did you do the other leg, too? When during the day would you do them?

Many places do list that it should be a little painful. I was always uneasy about that advice. Thanks for sharing your experience.

I usually do the concentric/eccentric combo at my club after a workout, either cardio or tennis and when my muscles are warm. I do them using a slant board (so I don't drop to far) on the "modest" slant setting (second lowest). On the concentrics I rise up using both feet equally, then remove one foot and slowly drop, usually trying for a 5-6 second drop. On the rise I do the concentric using what was by bad achilles only about half the time, the other half I'd raise with the good side. I mix up the foam rolling, I also stand on the roller and slowly roll the bottom of my foot, (plantar facia area and make sure you have something solid to hold onto!), for me it feels good - always start something new very gently. I now roll my achilles-calf-hamstrings-quads and back daily.

Drak

 

[mikeler]

A cheaper option for a foot massage is to stand on a tennis ball and let it roll around.

 

[drak]

A cheaper option for a foot massage is to stand on a tennis ball and let it roll around.

lol, since I already have 2 foam rollers for other body parts, it costs me nada to roll bottom of my feet - the hard black one with the big nubs (rumble roller) really gets in there good!

 

[mikeler]

lol, since I already have 2 foam rollers for other body parts, it costs me nada to roll bottom of my feet - the hard black one with the big nubs (rumble roller) really gets in there good!

You are assuming a sunk cost. Just trying to help the others out there.

 

[drak]

You are assuming a sunk cost. Just trying to help the others out there.

imo rollers are something all athletic types especially should own, great benefits in many areas and for a low cost

 

[drak]

Update 10/3: Because of moving this summer and doing a bunch of stuff I did not really start playing hardly any tennis until August, I did keep doing the concentric/eccentric exercises on a slant board 5-7 days a week, however I only do 2 sets of 15-20 reps once a day and seems to have done a great job for me, the 3 sets twice a day (what I often see recommended) at least for me appears overkill.

I have been playing 3-4 times a week now for the past 6-8 weeks, both singles and dubs, with no movement hesitation and absolutely no issues from my Achilles either during or after playing, feels just as good as the one that was not injured - YEAH!

I foam roll every day and do the 2 sets of the concentric/eccentric exercises.

Conclusion for healing and comeback:

1. Hardest and most important thing is to determine how serious the Achilles issue is. Is it more of the tendonitis/tendonosis variety or more significant and maybe a partial tear (likely what I had).

2. If more serious wearing a walking boot for several weeks should be considered, then start a concentric/eccentric program slowly and if it hurts back off. If less serious you may not need a boot and start the concentric/eccentric ASAP.

3. My opinion and that is all it is, is that concentric/eccentric exercises should not be done if painful, for me that just kept aggravating the injury area. A little "discomfort" is okay, but IMO that is all. Note that I am 58 years old so I don't heal like someone who is 25.

Please note I am only relating my experience and what has worked for me, it could be different for you and I am in no way a doctor or any kind of expert. This can be an extremely frustrating injury, good luck to anyone who has it.

Drak

Update Jan 24, 2015

Achilles feeling better than ever as I continue to do the raises/eccentric heel drops at least 4-5 times a week along with foam rolling. I am playing a LOT of tennis with no achilles issues at all. This will be a lifetime maintenance exercise for me given how many Achilles issues I have had the past 3-4 years and my age (59).

 

[elias_ch]

Update Jan 24, 2015

Achilles feeling better than ever as I continue to do the raises/eccentric heel drops at least 4-5 times a week along with foam rolling. I am playing a LOT of tennis with no achilles issues at all. This will be a lifetime maintenance exercise for me given how many Achilles issues I have had the past 3-4 years and my age (59).

I hurt my Achilles tendonitis playing soccer and it was sore for 3 days.
I resumed playing tennis & feel little pain after finishing than 2 weeks later i couldn't run anymore.

It took me 4 weeks of daily eccentric heel drops + Ice and now i can play tennis again. I will give it few more weeks to go back into soccer.

I am still doing the eccentric heel drop after playing but are you doing any kind of stretch/warm up for the Achilles before you start playing?

 

[mikeler]

The only thing that will completely take away my heal pain is below. If I don't wear these all day and on the court, it comes back a little bit:

 

[GregSV]

A cheaper option for a foot massage is to stand on a tennis ball and let it roll around.

Even better, keep one under your desk at work, and do your daily massages there while working.

 

[GregSV]

I fixed my own mild case of heel spur doing heel drops like you describe. A nice side effect was that my foot work became much much better: moving on the balls of my feet became a natural thing. I still do them 3, 4 times a week.

It’s amazing what you can do yourself if you’re willing to; and also how conservative physicians can be – at least over here in NL. There was this guy at my club suffering from heel spur. The only thing his physician prescribed was rest and these soles. No exercises whatsoever. I haven’t seen the guy in months.

 

[drak]

I hurt my Achilles tendonitis playing soccer and it was sore for 3 days.
I resumed playing tennis & feel little pain after finishing than 2 weeks later i couldn't run anymore.

It took me 4 weeks of daily eccentric heel drops + Ice and now i can play tennis again. I will give it few more weeks to go back into soccer.

I am still doing the eccentric heel drop after playing but are you doing any kind of stretch/warm up for the Achilles before you start playing?

just make sure my muscles/body is warmed up, try to ride a stationary bike during the indoor season before I play

 

[janky]

Revisiting an older thread here. Been having recurring achilles tendonitis (the laymen name for the condition) the last 6 years. Goes away during ski season when I'm not playing and then flares up around August every year around playoff time. I decided enough was enough so did some research and found this thread. I used to do both eccentric and concentric heal drops/raises but changed all that about a month ago. For the last month I've been 100% on eccentric heal drops just like the YT video below. I've gone with no added weight to using a backpack loaded with 20 pounds. I added 10 pounds after 2 weeks and another 10 pounds after weeks 3 and 4. I'm going to continue to do these 7 days a week for 3 months (that's what the "Treat Your Own Achilles Tendonitis" says). Few questions for folks that have done the same (i.e. Drak, Torres, etc):

1. How much weight did you end up using in a backpack after the first 3 months? Did you use weight in a backpack at all?

2. Now that your achilles tendons are healed, how often do you do the heal drops? I imagine this is something you have to keep up or the tendonitis comes back. I'm thinking at least 4-5 times a week for the rest of my life at this point (if I want to continue to play tennis).

3. At what point did the pain go away completely when you pinched your achilles? After I do the heal drops I have slight pain in the achilles if I pinch but the next morning the achilles feels great.

4. How much tennis did you play while you were doing the heal drops? I've only hit say 4 times in the last month, trying to figure out when I can start going aggressive again.

 

[drak]

Revisiting an older thread here. Been having recurring achilles tendonitis (the laymen name for the condition) the last 6 years. Goes away during ski season when I'm not playing and then flares up around August every year around playoff time. I decided enough was enough so did some research and found this thread. I used to do both eccentric and concentric heal drops/raises but changed all that about a month ago. For the last month I've been 100% on eccentric heal drops just like the YT video below. I've gone with no added weight to using a backpack loaded with 20 pounds. I added 10 pounds after 2 weeks and another 10 pounds after weeks 3 and 4. I'm going to continue to do these 7 days a week for 3 months (that's what the "Treat Your Own Achilles Tendonitis" says). Few questions for folks that have done the same (i.e. Drak, Torres, etc):

1. How much weight did you end up using in a backpack after the first 3 months? Did you use weight in a backpack at all?

2. Now that your achilles tendons are healed, how often do you do the heal drops? I imagine this is something you have to keep up or the tendonitis comes back. I'm thinking at least 4-5 times a week for the rest of my life at this point (if I want to continue to play tennis).

3. At what point did the pain go away completely when you pinched your achilles? After I do the heal drops I have slight pain in the achilles if I pinch but the next morning the achilles feels great.

4. How much tennis did you play while you were doing the heal drops? I've only hit say 4 times in the last month, trying to figure out when I can start going aggressive again.

Answers s best I can:

1. I never added weight for the heel drops, did not feel the need. I do use a slant board when I do the drops and now use the two most "slanted" positions (I started off on the least slanted), the most slanted really loads and stretches the achilles - I worked up to that VERY, VERY gradually

2. Probably averages 3-5 days a week of heel drops (2 sets of 15 on each side), seems to be a good maintenance program, usually do it at the end of my workout or after tennis

3. Never really did the "pinch" test

4. Once my Achilles felt good and strong I had no problems playing 3-5 days a week. Note that is mostly doubles or drill sessions. Frankly at 61 and still in good shape playing 3-4 times a week is plenty for me, if I do too much more I get a lot of other aches but not from my Achilles!

Regards

Drak

 

[janky]

Thanks Drak for the reply! Happy New Year. Interesting you never added weight in a backpack. Do you have a visual of what the slant boards look like? I've just been doing the drops on steps around my house or in the garage. Yeah, thinking I need to keep doing the drops almost forever. Ideally 3-5 times a week like you. I've been in Tahoe the last 2 weeks skiing and achilles feels amazing since I haven't been on the court and still doing the heal drops here.

 

[drak]

Keep in mind doing eccentrics and dropping below "flat" is good for mid portion achilles issues but not "insertional" which is where it connects to the heel bone area. So if you have midportion a slant board works well, here is similar to what I bought

http://www.fitaboo.com/slant-board-benefits/

 

[janky]

Thanks for the info on the slant board. I've been looking for a slanted stretch board I can buy and the Power Series one I use at the gym is about the same price but isn't as adjustable and well, it's very metal like. I might just get this one instead as it's nicer looking too. Where did you get the info to use a slant board instead? I don't have insertional achilles issues so I should be good.

 

[janky]

Updating this thread with my current status: As of April 14, 2017, the achilles feels absolutely amazing. After almost 7 years of battling it being sore after any tennis match I'm happy to say it doesn't get sore at all. I've been doing eccentric heal drops *every day* to maintain the strength. Occasionally I'll forget a day but I try to do the heal drops almost every day. I started in October of 2016 and after 6 months I can play multiple times a week with zero pain. Loving life!

 

[drak]

Updating this thread with my current status: As of April 14, 2017, the achilles feels absolutely amazing. After almost 7 years of battling it being sore after any tennis match I'm happy to say it doesn't get sore at all. I've been doing eccentric heal drops *every day* to maintain the strength. Occasionally I'll forget a day but I try to do the heal drops almost every day. I started in October of 2016 and after 6 months I can play multiple times a week with zero pain. Loving life!

Great to hear! just got back from the gym after a bike workout, resistance band stuff and foam rolling and of course the eccentric drops. Like you my Achilles remain awesome, amazing something so easy and simple can do so much good for a body part that can cause a lot of problems.

 

[janky]

Nice! I have such a renewed outlook on tennis that I started taking lessons again. My game is improving and I'm doing it injury free, woo. Thanks again. I'm passing it forward now too. Guy on my team last year is struggling with his achilles. I've given him all the info

 

[Champs990411]

Awesome. How exactly do you do them? And how much time does each session take?


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[TnsGuru]

ProStretch Calf Stretcher helps with Calf/Achilles tendon stiffness but helps Plantar Fasciitis also. I say this device has helped me over the years to keep flexible in the lower leg area.

 

[janky]

Read through the previous replies. Find my posts. I posted a YouTube video of the eccentric heal drop.

Awesome. How exactly do you do them? And how much time does each session take?


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