Achilles Healed???

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vosadrian
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Re: Achilles Healed???

Postby vosadrian » Mon May 25, 2015 2:23 pm

Agree g-boaf. My S-works shoes are great, but I wore them way more than I normally would (10 hours a day for 6 days straight), and towards the end I noticed the pain. I would not blame the shoes on my issue, but I do think that they were digging into the sensitive area and making it worse. Any riding I have done since has been with my old ratty DMTs that are too big and were thrown in when I bought a bike second hand. They are much softer at the top of the back, and I added some adhesive foam at the base of the heel to push my foot forward in the show to move the top of the back away from my achilles. This works, but those shoes are falling apart (glued several times) and look crap and I only used them for commuting before. I prefer to find something that is a bit nicer and more suitable. I could try to add the foam to my S-works and see how that goes. Will be more difficult as they are the correct size so not as easy to push my feet forwards away from the heel cup. Ideally I could find anew shoe type that is looser/softer around the heel area, but I don't know how to go about finding a shoe that fits this requirement short of going window shopping in all the LBSs.

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greyhoundtom
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Re: Achilles Healed???

Postby greyhoundtom » Mon May 25, 2015 6:32 pm

If I was in your situation in regard to finding shoes that fitted softer on your heels if you were not already using them I would swap to SPD cleats and pedals. SPD shoes as a general rule are more like runners in construction and therefore are often easier on your feet in regard to fit.

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Tue May 26, 2015 9:00 am

That might be the only option, but prefer not to change pedals/cleats if possible (I am shortly getting some Vector pedals, so would prefer to play with them). Are there any road shoes that are designed for touring and long days in the shoes, so comfort higher priority than stiffness/power transfer?

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queequeg
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Re: Achilles Healed???

Postby queequeg » Wed May 27, 2015 2:42 pm

How about the Specialized Audax shoes

http://m.specialized.com/us/en/ftr/shoe ... hoes/audax" onclick="window.open(this.href);return false;
'11 Lynskey Cooper CX, '00 Hillbrick Steel Racing (Total Rebuild '10), '16 Cervelo R5, '18 Mason BokekTi

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Wed May 27, 2015 5:13 pm

Nice shoe, and probably fit the bill but would have to check one out to see. Unfortunately it is a little expensive for what I am looking for. Ideally a cheaper and probably heavier and more durable shoe that has lots of cushioning and would suit commuting and long ride duty. I still hope to use my S-Works shoes again in future for racing and weekend rides.

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g-boaf
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Re: Achilles Healed???

Postby g-boaf » Tue Jul 14, 2015 3:38 pm

Revisiting this, how about pedal technique?


https://www.stevehoggbikefitting.com/bi ... t-is-best/" onclick="window.open(this.href);return false;

Interesting post by Steve Hogg.

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Tue Jul 14, 2015 4:23 pm

In my case, I had my achilles issue after a 1000km in 6 days ride at about 150-180k per day. Some of the days had a lot of climbing (almost 4000m one day including reaching a peak at 1300m and long sections at 15+%), and I had recently been suggested by someone to try "ankling" (dropping the heel) as a means to promote different muscle use to get up long sustained climbs. I tried that. This was 2-3 days before I experienced any achilles symptoms. Not sure if it contributed. I suspect that it may have had some effect, but probably main effect was just more riding than ever before by a significant margin and I suspect my shoes were putting pressure on the tendon.

As an update. I stopped riding back in early March as I overdid it and it got quite painful. I figured that the only thing I had not tried was a prolonged rest. About 3 months into the rest, it had improved since the accute pain in March, but had not gotten better than prior to the accute pain in March. During this time I was doing Physio including stretching, heel drops, dryneedling, massage. So I decided to take it another step and saw a Sports Physician who gave me PRP therapy in 3 sessions with 2 weeks gap. It was pretty sore at times after the PRP sessions. Last one was 2.5 weeks ago, and I rested from physio during this time. There does seem to be some improvement. I am not in pain as such recently... just tightness. I have had episodes like this before that could quickly turn to pain again if I overdid it, so I am treading really carefully. I have just returned to the bike and only a couple of 10km rides so far at very slow pace. Also back to doing heel drops. Pain/tightness is no worse. I am hoping that gradual increase in load will relieve the tightness and the pain will not return. My heels are still really sensitive and easily irritated by hard heel cup shoes (work/dress shoes are no go at the moment). I feel like I have some way to go still before I can ride hard with confidence, and still quite concerned it could all go bad again quite quickly if I do something wrong.

I have managed to stay reasonably fit by swimming with a pull buoy, but that is really upper body and cardio. Legs have done very little in many months... I think this is a good thing, as I won't be a able to ride hard for a while!! It was when my legs were almost back to normal that I overdid it last time.

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Xplora
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Re: Achilles Healed???

Postby Xplora » Wed Jul 15, 2015 12:03 am

Yeah just easing back can't be a bad thing. Considered a 32t ans compact to take the sting out of the climbs? You really are up against it with your streets to work.

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Wed Jul 15, 2015 9:15 am

Xplora wrote:Yeah just easing back can't be a bad thing. Considered a 32t ans compact to take the sting out of the climbs? You really are up against it with your streets to work.
I have considered using the MTB for commute for the low gearing.... but so far so good with the roadie with 36-28. There are a few points I have to do most of the work with my good leg to get up a pinch and protect the bad leg.

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g-boaf
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Re: Achilles Healed???

Postby g-boaf » Wed Jul 15, 2015 10:03 pm

I had a small flare up of this on Monday. I did my previous way of dealing with it (easing back a bit, and a few other things). It was somewhat tender today, yet after a couple of interval sessions tonight it feels fine again. I was not holding back at all, felt great. Very odd. Still wary though.

I think it may be dropping the heal that causes me that trouble. Certainly not hours or distance.

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Xplora
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Re: Achilles Healed???

Postby Xplora » Wed Jul 15, 2015 10:38 pm

I would guess that certain power levels would bring it on as well. You do a fair amount of tough intervals, and you might heel dip more for harder efforts

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Fri Jul 17, 2015 5:02 pm

Hey g-boaf,

My issue seems quite different to yours... Oh how I wish I could ease off for a day or two and be good to go again!! But my experience is that hopping on the bike and riding even quite hard will have mine feeling pretty good. I have never had to stop any activity due to excessive pain, and mostly the pain is quite low when working it. It is a few hours later when everything cools down and stiffens up that I regret it!! But you would have discovered that if it applied to you by the time you read this!! :-)

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Xplora
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Re: Achilles Healed???

Postby Xplora » Fri Jul 17, 2015 10:58 pm

That's weird mate. Must be related to the repair process. I know you have tried a bunch of stuff, have you hit the testosterone assistance like ZMA? Helps with Body repair. Multi vitamin?

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g-boaf
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Re: Achilles Healed???

Postby g-boaf » Sat Jul 18, 2015 1:43 pm

vosadrian wrote:Hey g-boaf,

My issue seems quite different to yours... Oh how I wish I could ease off for a day or two and be good to go again!! But my experience is that hopping on the bike and riding even quite hard will have mine feeling pretty good. I have never had to stop any activity due to excessive pain, and mostly the pain is quite low when working it. It is a few hours later when everything cools down and stiffens up that I regret it!! But you would have discovered that if it applied to you by the time you read this!! :-)
I noticed it a little bit today, when I was punching the power a bit (about 450w for a short while), the funny thing is that it settles down quickly and right now, it is fine. Today for an hour I absolutely gave it everything I had, got some power bests and feeling pretty good. If it weren't for the niggling heel, I might have snared 285-290w for the hour. Mystifying.

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Mon Jul 20, 2015 12:01 pm

No testosterone... I have tried some of the things recommended for tendons... MSM, Vitamin E to loosen the muscles pulling on it and a few other vitamin type things. I have never heard of testoserone being recommended for tendons. Mostly supplements aimed at enhancing collagen production are recommended for tendons. I have tried everything I know of, but I am sure that there is stuff I don't know of. I read with interest when Nibali mentioned Achilles issues over the last year hampering his Tour defence. I wonder what the pros do?

I am sure you have something a bit different to me g-boaf. I rode to work this morning... turned up the effort a little bit more than a couple of prior easy rides. It is feeling a little bit tight now, but if it settles in 24 hours I will keep doing that. I think it needs some work to build up strength, but only enough that it can recover quickly.

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g-boaf
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Re: Achilles Healed???

Postby g-boaf » Wed Aug 05, 2015 8:47 pm

Possibly so. I never worked out what was going on, and it has settled down thank goodness, and not because of me easing off and resting it.

Your mention of those S-works shoes did prompt me to get a pair of them to replace my old SIDI ones. The difference is so huge, those S-works shoes are so much more comfortable.

vosadrian
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Re: Achilles Healed???

Postby vosadrian » Wed Sep 16, 2015 11:01 am

Just an update and request for any pearls of wisdom from those in the know.

In the last 6 months I took about 4 months of rest. I have not run at all in the last year or so, but but the 4 months of rest meant no cycling for 4 months and my only exercise was swimming with a pull buoy and not using my bad ankle at all for swimming (no wall push or kicking, but pointing toes for low drag). During this time it generally felt better than when I use it regularly but it did not heal. Over a few weeks it eased a little and then stabilised and stayed at that point. As soon as I used it for anything it would hurt more and take a couple days to resettle. During that time I tried a few things. A new physio with dry needling to calf area. PRP therapy to achilles area of pain (not guided). Went and saw a physio in Melbourne who was convinced it was facet joints in my back aggravating nerve roots that he could mobilise for instant relief but that did not happen. It should be said that I am having some lower back issues including facet arthritis, so I would not rule out a lumbar region back issue causing nerve impingement and pain in the legs which could contribute. Next was acupuncture which has focussed on yang deficiency and getting my blood flow better into legs so it can heel. This has not achieved any healing, but I have noticed by rest HR go up a bit and sleeping a little better so it may have done something to increase metabolism and blood flow?

I then saw a rhuematologist because a GP wanted me to look into subtalar synovitis that had shown up in a previous MRI. He did blood tests and physical examination and then a supervised ultrasound with what seemed to be a very good US operator. She had a good look around the area. Says the tendons look fine at midpoint and insertion. She actually said they looked beautiful and nothing wrong. She did say that there may have previously been something wrong that has healed. There was an effusion on the back of the subtalar joint consistant with the MRI synovitis. Could be some sort of posterior ankle impingement. Operator was thinking biomechanical issues. I use orthotics, but in some slip on shoes wince tight heeled shoes cause me pain due to this issue, and he thought that would not be helping. recommended seeing a podiatrist to get footwear and orthotic reviewed. Also gave me a referral for cortisone into the subtalar joint which I have had before after the MRI, but they seemed to put that cortisone into the front of the joint and the issue is at the back. Did not seem to make any difference the first time. Maybe putting into back of joint where effusion is will help more? Will do that in a few weeks when I return from a holiday shortly and then total rest for 2 weeks. Failing that not sure what the next plan would be.... maybe surgery and a cleaning of the area via arthroscopic surgery?

So not sure my issue really is achilles now. I must say that my constant level of pain has not been in line with symptoms I see others with achilles issue having where it is not painful with rest. My rest improved it a little, but I never experienced a moment where there was no pain that seems common with others with achilles issues. The best I had was back in summer when riding twice a week, it would feel a little bit better after ride recovery each week... until I overdid it, and it was back to square one which is when the 4 months of rest started.

I have recently started swimming without pull buoy and kicking gently. This seems to aggravate it as much as cycling or walking. I am wondering if swimming plantarflexed could be an indicator of the posterior impingment?

Oh, and I just got some Specialized expert road shoes. in a size larger than my S-Works to allow me to pad the heel a bit. Have not used them yet, but they are softer around the heel than the S-works and seem like a nice shoe until I can sorted so I can use my S-Works again.

Cheers,

Adrian

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