injury recovery time?

[cward76]

About 2 ½ months ago I injured my right Achilles tendon running, or noticed the injury while running. When I first felt the pain it was a lot but not enough to knock me off my feet if you know what I mean. The next day the pain was still there but it was mild. The pain is in the back of my leg, it starts about half way in between my ankle and my calf and runs up into my calf. After a couple of days of no running the pain was almost non existent, which lead me to believe it was ok to run again. I tried and the pain came back so I stopped running immediately. I tried to run a week later with the same results. Keep in mind when I’m making these attempts, before hand my leg is virtually pain free. After the last attempt I decided to go see a doctor. Doctor said I had flat feet which led to pronation of my feet (the right foot is significantly worse than the left) and is causing my pain in the back of my leg. He sent me to a foot doctor who made custom orthotics which goes into my shoes. From the time I went to the doctor to the time I got the orthotics I did not run, which was 5 weeks. I would of thought that my injury would have heeled completely by this point. It didn’t, I tried running and the pain came right back. Keep in mind the doctor told me to run but to limit to two miles a session which I have been doing.

Questions
Should I wait until I have zero pain before I start running?
Has any one had any experience with this type of injury? If so what can I expect for recovery time? I lift weights three times a week, have a desk job, and I am 27 years old. In asking this question I realize that the injury probably occurred over a long period of time, so I really just looking for a ball park figure, 2 months, 6 months, a year?
Are there any exercises I can do to speed recovery?


Sorry for the long post, I wanted to provide as much detail as possible.

Any help that can be provided is greatly appreciated.

[Bill Hartman]

Have you had a running gait assessment?

If rest hasn't helped, I''m wondering if you're dealing with some form of mechanical issue in your gait pattern that overloads your calf region.

The orthotics will help some from the ground up but you may have something more proximal going on. See if there's a sports med clinic around that does the gait assessments. They may be able to zoom in on something.

Another thought, do you run on the roads? Always on the same side? This may alter your running mechanics as well.

Bill

[cward76]

Bill

No I have not had a running gait assement. I'm assuming that is were a professional looks at your running form? I will check into.
I will call around town to see if anybody does gives running gait assements. If that fails, I have a follow up appointment with the foot doctor in the 2nd week of July, I will ask him if knows of any body that gives gait assements.


I run on an ashpalt trail. It is pretty flat from left to right.

Thanks for the help.

[bryanc]

Either way, if you've developed an Achilles tendinopathy (the old tendinitis), then recovery time is on average about 8-12 weeks. The gait assessment might help in terms of avoiding future bouts, but rest and stretching will go a long way in getting you pain-free in the meantime.

[cward76]

Originally posted by bryanc:
Either way, if you've developed an Achilles tendinopathy (the old tendinitis), then recovery time is on average about 8-12 weeks. The gait assessment might help in terms of avoiding future bouts, but rest and stretching will go a long way in getting you pain-free in the meantime.

I was kind of afraid of that ie 8-12 weeks is long time not to run.
Thanks for the help.

[bryanc]

I know. It's crappy because it's summer too. What's your diagnosis? There's possibly a fairly aggressive program you can do for your Achilles if you've got "tendinitis".

[cward76]

Originally posted by bryanc:
I know. It's crappy because it's summer too. What's your diagnosis? There's possibly a fairly aggressive program you can do for your Achilles if you've got "tendinitis".

You know can't really remember what exactly he said the condition was. I think he said tendinitis. I know this sounds bad, but I have mainly thought about the correction. He talked about my feet being pronated and that it was causing a lot of stress on my achilles tendin thus causing the pain. I would very much be interested in checking into the programs for achilles tendinitis.

[cward76]

See this link, go to the forth paragraph. This is what my regular doctor and the foot doctor told me about my problem.

http://podiatrychannel.com/achillestendinitis/

Here is the two paragraphs that refer to my problem.

Sometimes an inborn trait causes Achilles tendonitis. Typically, this is due to abnormal pronation that causes the arch of the foot to flatten too much and the leg to twist more than normal. This, in turn, causes the lower leg muscles (the gastrocnemius and the soleus) to stretch more than normal. Like a rubber band, the further the muscles stretch, the tighter they become. The force on the Achilles tendon and the calcaneus increases, resulting in inflammation and pain.

Because the arch of the foot flattens over time, especially in athletes, someone may be problem-free for years and develop Achilles tendonitis later in life. The condition also is common in the "weekend warrior" who exercises infrequently, and those who are just starting to exercise. In these people, the muscles and tendon have little flexibility because of inactivity. Overdoing exercise in the beginning can cause tendonitis because the muscles are not flexible enough to withstand the new forces being placed upon them. It is especially important for people who are just starting to exercise to stretch properly, start slowly, and increase gradually

[bryanc]

Too bad you're in Kentucky. We've got an Achilles tendinopathy (the term tendinitis isn't used much around here anymore) study going on right now.

Anyways, here's the protocol. It's from Alfredson et al., 1998 American Journal of Sports Medicine Volume 26, number 3, page 360. It's called Heavy load eccentric calf muscle training. We just nicknamed it the heel drop program.

The bad news is that it's a 12 week program (see what I mean about the 12 weeks?).

This protocol should be done twice a day, 7 days a week for 12 weeks. During the 12 week program, running is allowed of it can be performed with only mild discomfort or no pain.

There are two eccentric exercises. 1) The calf muscle being eccentrically loaded with knees straight and 2) the calf being eccentrically loaded with the knees bent.

So for exercise 1: stand on a step on your tip toes with supports if possible. Lift up the non-painful leg so now you're on tip toe on the painful leg. Your knees should be straight. Now drop from tip toe to 'calf stretch' position (your heel should be below the level of the step). To return to the starting position, use your other leg and/or supports. Do not do a calf raise on the injured leg.

For exercise 2: the same as exercise 1, but your knee should be slightly bent to emphasize the soleus muscle.

The heel drops will probably be painful, but unless they're debilitating, you're to suck it up.

When you are able to perform the drops without any minor pain or discomfort, you should increase the load either with weights in a backpack or possibly using a calf raise machine (provided you are not doing single leg calf raises on the injured leg to get to starting position).

Each exercise is to be done during your twice-daily sessions and with a set/rep scheme of 3 sets of 15 reps. Muscle soreness is to be expected during that first one to two weeks of training.

[cward76]

Thanks for the routine, I will start this tomorrow. I'm going to check into the gait assement as well.