Achilles Tendonitis - How To Treat Painful Achilles Flare-ups
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- เผยแพร่เมื่อ 31 พ.ค. 2024
- It is quite normal to experience sporadic increases or flare-up in pain when you have Achilles tendonitis or tendinopathy. In this video, Maryke explains why this happens and how you can calm it down quickly so you can get on with your rehab.
👉 Maryke mentions heel-raising shoe inserts (remember to use them in both shoes) and applying ice as two ways of calming down the pain from an Achilles flare-up. Get it here:
- Heel-raising shoe inserts: geni.us/lA7G
- Re-usable ice bags: geni.us/tAaXMqV
🌟Need more help with your injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com
Other videos you may find useful
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Ice Treatment For Achilles Pain: • Ice Treatment for Achi...
Running Shoes For Achilles Pain: • Running Shoes for Achi...
How & Why Load Management Helps Achilles Pain: • How & Why Load Managem...
📚Chapters:
00:00:00 Introduction
00:00:55 What does pain mean?
00:07:11 What causes flare-ups?
00:09:39 Have I made my injury worse?
00:11:13 How to handle flare-ups
00:15:08 How we can help
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References:
Hanlon, S. L., et al. (2021). "Beyond the Diagnosis: Using Patient Characteristics and Domains of Tendon Health to Identify Latent Subgroups of Achilles Tendinopathy." J Orthop Sports Phys Ther 51(9): 440-448.
Rabusin CL, Menz HB, McClelland JA, et al. "Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial." British Journal of Sports Medicine 2021;55:486-492.
👉Some links here are to places where you can buy something relevant to this video. If you do, we may get a small commission at no extra cost to you.
👉 Maryke mentions heel-raising shoe inserts (remember to use them in both shoes) and applying ice as two ways of calming down the pain from an Achilles flare-up. Get it here:
- Heel-raising shoe inserts: geni.us/lA7G
- Re-usable ice bags: geni.us/tAaXMqV
If you buy anything via these links, we may get a small commission at no extra cost to you.
I worked very successfully on my left achillies tendon with your PT Aly last year. She got me from painful walking, back to running ultra marathons! I recently had a flare up - on my right plantar tendon. So I have backed off my runs and resumed my heel raises and kinetic chain strengthening.
Exactly what I would have advised!
That is the best channel about achilles problems I could ever found.Great job! Thank you very much ❤
Our pleasure!
Now I understand. Mareyke, you are the best, you are the achilles guru!
This is exactly what I need! I tried off-load, shoe insert, and some light workouts for a week, and already feel much better
Great to hear!
Thanks for the videom gives me real hope to get my flare ups better under control
Thank you! That was a great explanation! I am so relieved!
You're welcome!
Thanks for your video, your advice is beyond super helpful 🙏 this video was what I needed, my Achilles is insanely sensitive at the moment.
Glad it was helpful!
So educational... love it. You should be a lecturer for sure xxx
Glad you found it useful!
I can appreciate the point about feeling more pain if suffered longer than 3 months. I’ve suffered with AT in both legs for 4 years and i notice any small tingle or slight overloading. I think it has impacted me mentally over time and i’ve wondered if dealing with low level pain has created a greater stiffness in my lower body to compensate.
Yes, so one thing that may be useful in your case is to start thinking about what you feel differently. You mention in your comment that you feel any "slight overload". So ask yourself - is it truly overload or are those activities so gentle that it is actually normal load but your system creating pain too easily. If that is the case, then try not to call it "overload" - instead, when you feel that tingle, just remind yourself it is NOT caused by damage but just extra discomfort that has no place so you are safe to continue.
This video describes my current situation. I worked very successfully with your PT Damilola last spring -- I was dealing with a combination of achilles tendonosis and sinus tarsi syndrome. It took about 2-3 months of exercises before I was able to slowly return to running, which I achieved by starting with combination runs-walks (e.g., 4 minutes running, 1 minute walking x 6), until I was able to run without any walking breaks. Since that felt good, I started speeding up and doing longer (1 hour +) runs with more hills. And (predictably?) about 4 weeks ago, I experienced some sort of mild sprain to my foot (always the left, where the tendonosis had occurred originally). I took a break but continued to do all my exercises. I've returned to running, but only with the 1-minute walking breaks, and things seem okay (I also replaced my old shoes). But as you describe in the video, I'm super-focused on every little tingle I might experience, probably excessively. t's good to know that what I'm occasionally feeling is likely just an over-sensitivity in the previously injured area. The challenge is finding a good balance between my running -- which I'd do daily if I could but currently do about 3x per week -- and my strengthening exercises. (For example, I'll do my double heel raises with weight (25 lbs or so) but skip my single heel raises, or do them without any additional weight, or do the single-heel raises only a few times a week). At this point I think I have a good sense of when I've done enough, yet I do worry that if I don't do my strengthening exercises, I'll return to where I was when I got injured originally. I guess it's about finding that balance between maintenance of strength -- which is important, naturally -- and rest, which is essential to recovery. Thanks for another excellent video!
I should add that I'm 60 -- so I'm also trying to factor that into the equation.
Thanks for sharing your experience :) ✌️
Sounds as if you're doing a really good job with managing all the different aspects. Well done for sticking with it!
I started with a quarter size bump on my lower section of my Achilles from wearing new boots at work. I went back to my old boots immediately and have had a tough time walking along with pretty severe pain. Now it has developed into an elastic feeling in my right Achilles. When I move my foot up and down It feels like the tendon is tearing or cracking. I walk an average of 12,000 steps a day and work five twelve hour shifts a week, I’m on my feet for 11 of those hours. After watching many of your videos I’ve come to the conclusion that I may need to seek a doctor. Let’s hope I don’t need surgery. Thank you for all the information.
Thanks for sharing, and good luck with your recovery!
Hi, very good video. I have a question perhaps you can enlighten me. I have issues with different tendon muscles in all the joints and I’m wondering if my Achilles tendinitis is more of a systemic issue? I have gone to rheumatologist and they cannot see anything in the bloodwork. Is this fibromyalgia? Any recommendations are welcomed! I’ve had this condition for years and I’m very frustrated. 🙏
Hi Su, I'm not sure from your username if this is applicable so forgive me if I'm way off the mark, but can it be that you've entered perimenopause or menopause? Is so, then that may be the cause th-cam.com/video/nhsErPtAVz0/w-d-xo.html
So true.... The brain yet again 😬
You do such a great job of explaining this stuff. Thank you. I am working with one of the PTs at TMA. I've waited months and months to really deal with this because I had very little reduction of activity. But lately I am limping because of stiffness all throughout the day - not pain really. I don't know how to get back to ok general activity so I can live and get my exercises going. What about this stiffness?
Can massaging the calf muscle or the foot help?
The stiffness will reduce as your tendon starts to react to your treatment plan and it starts recovering.
Massage can bring temporary relief but it usually only lasts a day or so.
@@TreatMyAchilles Thanks for your quick reply. So even if the stiffness causes me to limp a bit, do you think I can start some gentle strengthening? And that will reduce rather than increase the stiffness? This tendon business is so confusing. I'd rather have a broken foot! ;-)
I have syptoms like needles and streched or ripped elastic on the tendon when walking.. what are they? Normal?
It sounds as if the little nerve in that area may also be irritated. Wearing shoes that has a heel on them (like running shoes) rather than flat shoes or heel lifting inserts may help: th-cam.com/video/crzrN0KseWg/w-d-xo.html
Here I explain about the nerve irritation: th-cam.com/video/eKc_5RoF2r0/w-d-xo.html
i have an insertional Achillies tendon issue and it started about 6-7 weeks ago. i cut back my mileage from 70-36ish and have been strength training it. i think the pain has gone from like a 3ish down to like a 1.5 over the 6 weeks. Is it normal for healing to take a very long time? I feel like after a workout/speed session it tends to get a little more sensitive to load but idk if I'd call it "pain". I just really want this to get better so i can increase load again with minimal fitness loss. it sounds like running can be part of rehab i just am getting discouraged at how long this is taking...
It sounds as if you are actually managing it very well at this point. The shortest time it takes to recover is usually 12 weeks but it is normal to take 6 months or longer. Try not to get impatient because rushing it can be a big mistake. My colleague Steph has just written a blog post about her own experience when hers flared up which you may find useful: www.treatmyachilles.com/post/i-treated-hundreds-of-patients-for-a-painful-achilles-and-then-it-happened-to-me
Does it mean that once you have the first flare-up (of any tendon) it would not go away completely for your entire life?
I can't get rid of the symptoms in my achilles and triceps tendons for more than 10 years. Sometimes it's better, sometimes it's worse but I still have symptoms after exercise.
I tried heavy slow resistance, isometrics, light weight load, heavy weight load. Usually I don't have symptoms during exercise but next day (or 2-3) after.
Sitting in the office and feel how my tendons are starting to flare up, and I realise that I exercised 2 days before that day.
Is there any method to reduce the sensitivity to zero like it was before the overloading (or acute overloading) of the tendon?
It is really about getting your rehab and load right - most of our patients get back to being pain free like when before they got injured. The only time it may then flare back up is if they don't really exercise for a long time (so the tendon loses a bit of strength and becomes deconditioned) and go back to exercising too quickly (so it doesn't get a chance to strengthen back up). But if they build it up slowly and keep consistent, they are usually pain free.
how do i know i can remove heal lift from my shoes? i have insertional..
We usually get our patients to slowly get used to walking without the heel lift once:
- they are 100% pain free while using it
- and can tolerate some strength training exercises while using the heel lift.
@@TreatMyAchilles many tnx for answering:) you videos are the single most helpful thing that i found. Im so glad i found them:))
I went to the doctor and he gave me stretches and voltaren:/. Never did any of it, because i know it would made me worse.
Instead first did bodyweight and now i do strength exercises in the gym, every other day, from floor level. If im not at the gym I do single leg heel lifts of the floor with 2kg 3x10 and then sitting single leg heel lifts with 5kg weight on my knee 3x10. Slowly im getting better and im trying to gauge when and how to get rid of heel lifts:)
this will be my first victory, bacause i was used to barefoot shoes, wore them for a year.
And hurt my achilles doing a mtb tour that was too long after having a flu:/
Im tenis coach and I also playing tennis matches . I struggle with achhilles mamy year I tried everything with I faund on the internet. Every time when Im back to play pain is back in both legs. Sometimes I feel more pain in left sometimes in right. Its very frustraiting. Anyway I can handel this pain I only scare that some day it will retured
Perhaps this video can be of use - Steph shares some tennis specific info: th-cam.com/video/XOHrcPAF3P8/w-d-xo.html
What we can do if achilles irritates easily but the pain is gone after 5-10 hours? Should we continue to strenght training or we should wait for few days before start training again?
The rule with rehab and exercise is usually that it is OK to do as long as:
1. It only causes a slight discomfort while doing it, AND
2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours
If it is a significant increase in pain, I would see if you can reduce the strength training or adapt it to cause less pain e.g. less weight, or fewer reps, or if you think doing over step is the issue, then I would test doing it to floor level only.
FYI - you should in any case be leaving 1 or 2 recovery days between strength training sessions.
@@TreatMyAchilles Thanks for the answer.
Are there some people who do years of (adequate) rehab exercises and are never able to do 100% of the daily activities they wanna do because of the hypersensitivity of the tendons?
Yes, there are some. One of the runners I treated always had to cut his running shoes at the back because his heel would not tolerate the pressure. But he still was able to run and compete at a high level for his age group. Scans + strength tests showed that he had a strong tendon so he was safe to run - the pain was disproportionate.
@@TreatMyAchilles thx for answering. But that worries me about my golfer's elbow lol (I can easily reinjure it or make it much more sensitive and it loses its load tolerance for months if I just cross the threshold of '' too much '' or '' too hard for one day '')
Golfer's and tennis elbow are my pet hates when it comes to tendons - your experience is not unique - it often reacts like that. They do eventually go but it requires a good mix of not overdoing normal daily tasks e.g. habits of holding phones etc. and strength training can work but I have seen better results in some patients if they take up sports like swimming that moves and works the whole arm rather than laser focus on the muscles in the forearm.
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