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Achilles Tendonitis Developing on Tour

Old 01-17-21, 09:05 AM
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mpalmer
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Achilles Tendonitis Developing on Tour

I'm currently touring from Florida - Alaska (pending Canadian border opening) and just finished my first 1000 miles. Early yesterday I began feeling some strain in my right achilles tendon but decided to push it through to the place I had lined up for the night. This morning it's still rather tight after some ice and elevation. I'm taking a rest day but am worried that this will be a chronic issue developing rather early in the tour.

Admittedly I was riding too many miles and have the time to dial it back even with a couple rest days but will this be enough treatment? Are there ways to mitigate this pain while still being able to ride or is this the end of the trip?

Last edited by mpalmer; 01-17-21 at 09:30 AM.
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Old 01-17-21, 01:39 PM
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Riding:
Don't ride with pain. You developed this for a reason - you're putting too much pressure on the ball of your foot. To fix, you'll have to reduce that. If you have toe clips, take them off, put the pedal midfoot.

If you have clipless, move your cleats all the way back. Pedal with your ankles relaxed and heel dropped. Push down on the pedals as little as possible. Instead, push forward at the top, pull back at the bottom, and unweight your leg on the way up. It takes a while and a lot of concentration to learn to do this.

If you are using flats, consider getting a good pair of MTB shoes and SPD pedals and doing the above.

Therapy:
Don't ride until the pain is gone. Absolutely do not. On the PCT, this is known as being "off the trail."
Making the pain go away: Try taking 600 mg. of ibuprofen every 6 hours for 3 days while you stay off the bike. If this doesn't make it go away, see a doctor! It's unclear if ice is helpful.
Stretch 3 X day, gently. Don't push it. Stretch only to the point of slight discomfort, never pain. You should have been doing this anyway. My stretches are here: https://www.bikeforums.net/road-cycl...l#post15372967

Riding after the pain is gone: Try taking a herbal anti-inflammatory every morning - turmeric-curcumin with bioperine, 1500mg/day for maybe the first week or two.

If you do all the above and the pain is gone, but returns on the bike after all this, you'll probably need to take a couple weeks off, resting, walking gently, stretching, etc. or whatever the doctor suggests.

I should mention that I've been regularly doing one-legged calf raises on a stair for decades. Maybe you can do that eventually, but IMO it's a preventative. I might also mention that I once ruptured an Achilles tendon and had it surgically repaired. I did it by missing a tall one-legged jump. Anyway, the best therapy for that was hiking rocky mountain trails because of the variety of stretching and strengthening inputs.
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Old 01-17-21, 02:30 PM
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All good to know! Thank you for the advice
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Old 01-17-21, 07:51 PM
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If your leg is almost fully extended at the bottom of you pedal stroke, you might try lowering your saddle a few mm. Also a gentle stretching of the achilles might help. If you are going to do toe stands as recommended above, do them on something (curb, stair step) that allows the heel to go lower than the ball of the foot. This will provide some stretch. Also stand leaning against a wall with both hands, with the injured foot stretched out behind you. Stretching should not cause pain.

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Old 01-17-21, 09:43 PM
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Sounds like you as admitted, are over doing it.
listen t to your body, but make sure bike fit is good.

I had this happen to me back on a trip in 94 I think, partly due to cold and probably overdoing it before warmed up.
Taking a few days off and not continuing with the pain was the wisest thing I did, kept it warm and the break was enough. Was careful with it when I started riding again and slowly it got better.

too many unknowns for us to comment why, new comer searching for help, but I hope you take care of yourself.
enjoy rest of trip, healthily.
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Old 01-17-21, 10:19 PM
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Ditto the advice about lowering the saddle. I had chronic Achilles tendonitis for years until I read that simple advice. Chronic groin pulls went away, too.

Some of the things we don't know about you are your age, lifestyle habits, and general health, and therefore how fast you might heal from this. Tendons have very little blood flow and damage takes longer to heal than with muscles.
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Old 01-17-21, 11:17 PM
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Originally Posted by Carbonfiberboy View Post
...Don't ride until the pain is gone. Absolutely do not...
An Achilles Tendon injury is not like a sore knee or a pulled muscle. Remember Tendons are things not bone, not muscle, not soft tissue. They are highly specialised devices and when torn or separated can take years to recover from.

Personally I have had young healthy athletic friends pop thier Achilles without great strain. One was pushing a shopping cart. Another just making a basketball jump, and another missing a stair. The fact that you are receiving a warning ahead of time is fantastic. I am sure you have looked it up. As an athlete you must remember not to rush it. Tendons can take as long or longer than bones to heal. Let it rest and good luck.
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Old 01-18-21, 01:11 PM
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I should also have separated out the two different severities of Achilles tendon disorder: tendinitis and everything else. My ibuprofen recommendation could serve as a layman's diagnosis of tendinitis - a simple inflamed tendon sheath which has not progressed to tendon damage. If the pain goes away while using ibuprofen and then stays away after one quits it, it's tendonitis..

Everything else:
https://www.cedars-sinai.org/health-...-injuries.html
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Old 01-18-21, 03:57 PM
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Be very careful. I got this after 216km in a single day. I finished the ride in great pain. After having a rest from cycling for a week I tried to cycle again and pain was still there. It took me more than a month and a half to recover. I was cycling but slowly and really shorter distances in the city just to monitor my condition after that.
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Old 01-18-21, 09:26 PM
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Thank you all for the advice. I'm definitely approaching the issue with all this in mind and a little more care.

Some more information - I'm a 24 year old male who rode ~200 mile weeks before this tour. I also stayed active with rock climbing and eat a well balanced diet. On this tour I started out with a 350 mile week and bumped it up to 700 for the second week simply because I had all day to ride and had the energy to do so. I've been trying to eat from all food groups but the main portion of my diet has been protein and calorie dense foods as my primary goal is just to eat what I burn every day. I was riding flats with sandals (which is what I usually use at home). I'm guessing that the shoe pedal combo and sharp increase in milage are the main reasons for the pain.

I'm now on my second rest day and am going to take a couple more days to let the swelling recede before making the decision to see a doctor. I've also switched to mtb shoes with spd pedals if I do end up getting back on the bike. Also will be taking it easier if/when I do return to riding this tour.

I'm not sure if this changes anyone's advice but I wanted to provide the info to give the full picture. Thank you all again.
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Old 01-18-21, 10:23 PM
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There's really no way on the internets thing for any of us to properly evaluate bike position etc, but certainly riding loaded and big days has always shown up even small fit issues bike wise, or shoe fit, bike shorts fit etc.
hopefully you'll be ok and use common sense when you start again.
I recall post rest days when I started riding again, that I took it easy on that leg, and changed my pedalling slightly to reduce the strain and pull on the Achilles.

years later I hurt my achilles sledding with my kids, and that impact injury took a good while before it felt right.

really though, listen to your body and do what feels right. You want to take care of that body you got, so maybe in a hundred years you'll still be biking.
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Old 01-21-21, 07:29 PM
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A Physical Therapist once told me 'It's not no pain no gain, it's pain, no brain'
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Old 01-22-21, 06:43 AM
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About a decade ago I did a fully supported guided bike trip in Europe. Tour group provided the bikes, lodging, most of the food, was a great trip. There was a highly knowledgeable nurse practitioner on the trip too. And she pulled something in her knee on the first or second day. She described what she did with all of the medical and anatomy terms which of course none of us knew anything about. She could have sat in the van for the rest of the week but she wanted to ride.

She rode every day for the rest of the trip at a high cadence and low torque. At first on that trip, I had trouble keeping up with her, but after her injury she was quite slow as she nursed her knee back to health.

My point is that when you do start getting back to the ride, use your lower gears and stay with a low torque.

If you are new to SPD pedals, lots of people warned me that I would probably forget to unclip a few times and fall over until I learned to unclip BEFORE I stop. I have not fallen yet, but I tried to force myself to always unclip one of my feet about 20 to 30 feet short of where I stop. Set your pedal release really loose at first, later if you feel you want it tighter you can do that after you are healed. Cleat screws get looser over time. Every few weeks for a month, check tightness, then do that monthly for a year. I use a blue (removable) threadlocker on my cleat screws.

Have a great rest of trip.
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