Insertional Achilles tendinopathy protocol

Injury/Nutrition

2 hours ago 07/22/2024 9:13am EDT

I changed up my running routine by adding intensity and some plyos and ended up with a case of mild insertional Achilles tendinopathy. Over several weeks the pain went from 0-1 to 3-4, and I figure it's not going away unless I seriously address the issue.

After a few days rest the area is still slightly sore/tight, but the pain is generally 0-2 throughout the day. I only notice it going up and down stairs.

I've spoken with with PT. I was surprised that he recommended that I continue running with a lot less volume and little to no intensity for a few weeks (smooth even ground with no hills), while incorporating an isometric strength routine, basically everyday.

I always thought the rule of thumb with issues like tendinopathy was to rest until the area is no longer sore to touch when you press down, then start a rehab routine.

Curious about other's experience with insertional Achilles tendinopathy.

I don't want to unnecessarily prolong this thing by running easy junk miles and doing strength work that merely aggravates the injury.

Im in almost the exact same boat. Been doing PT once a week and it does help. They have me doing a variety of calf strengthening exercises with pretty heavy weights. Weight is equal to what i could do for ~15 reps. They have me doing 10-12 reps x3. Some hip mobility exercises too. I'm also running with a small heel lift on the impacted foot, although I'm not sure that is doing much. Running ~40 mpw through it and it has improved.

I run first thing in the morning, and I'm also doing some warmups (springing off my toes up, side to side, then forward back) that helps get the blood flowing as well.

2 hours ago 07/22/2024 9:28am EDT

re: boofermcgavin

I should have mentioned, my injury is NOT insertional. Mine is higher up on the achilles.

After being well into a "last gasp at a marathon PR" training block, I developed insertional
achilles tendinopathy. MRI and x-rays were unremarkable, but I did have that Haglund's bump at the insertional point.

I took 1-2 weeks easy and began doing doing heel drops everyday. The pain really didn't go away and I made the decision to just run through the injury. Trained full-blast for months, getting as high as 100mpw along with weekly workouts and long runs. The pain was always there, often intensely there, but a well-respected orthopedic physician told me that there was no risk for rupture, given the location of the injury (again, insertion). And the physical pain was much less "damaging" than the mental pain: giving up the fitness gains I had made and basically calling it a day as far as distance running goes.

Ended up running mid 2:20's with heel pain the whole time. I was happy with the result. 9 months since the onset of the injury, I'm still running and training and still have pretty noticeable pain at the same spot. I'm sure eventually I'll need surgery, but I've managed to just run though it.

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