Achilles tendon pain - related to new shoes and/or cleat position?

Discussion in 'Health Nutrition and Supplements' started by kaian, Jan 10, 2006.

  1. kaian

    kaian New Member

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    I've been having achilles tendon soreness as well as calf tightness on my left leg for the past week. Every morning when I get out of bed, my AT is sore and tight. After I shower and go on with my day, it seems to go back to normal. When I ride, I don't feel any pain or discomfort and it was only yesterday that it felt sore after a 75 minute "easy" ride (no big gears). In general each week I bike 3 times a week and run 2 times a week (2.5 miles each time I run).

    I purchased new cycling shoes a month ago - Sidi Genius women's. I have extremely narrow feet so have been wearing thicker socks to compensate because my heel tends to slip in most shoes. I don't feel any major slipping at the moment. With the new shoes came having to reposition my cleats. My knees feel fine, so I figured the cleats were probably positioned correctly. I am also wearing my orthodics in the cycling shoes for arch support.

    One thing I notice when I am spinning is that my left foot feels different than my right foot. My right foot feels relaxed and comfortable while my left foot feels tensed up and uncomfortable. Does anyone have any suggestions as to what could be going on? I know there are a lot of factors involved, but are there certain cleat positions or foot positions that would cause strain to the achilles? I thought about trying a different insole - maybe Superfeet - instead of using the orthodics. The orthodics are on the new side and they may not be right for my feet.

    Any insight would be appreciated. Thanks.
     
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  2. atomicrc11

    atomicrc11 New Member

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    It may very well be your cleat position. I strained my achilles and calf last year. It kept me from riding for a good 4 months. Then I had to start slow. I started again in September. It was a fore/aft adjustment that did it for me. You will have to play around with that.
     
  3. kaian

    kaian New Member

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    It's so hard to get cleats dialed in correctly. Last August when I bought a new bike I got fitted. I am thinking about asking the fitter to take a look and help me if I am not able to get things positioned correctly. Thanks for your input.
     
  4. heyguy

    heyguy New Member

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    I am currently dealing with this issue and for me, it seems the problem was first caused by a calf strain a few weeks back. I didn't really let that heal properly and thusly have recruited other muscles to compenste. They have been overworked and something had to give...my achilles. I went to a chiropractor who is a cyclist and knows a lot about soft tissue work as well. He did some heavy work on my calf muscles which were very tight (I didn't even realize), did some ultrasound and finally adjusted my leg. I don't know physiology too well but I believe it was the fibula?? He said the fibula head wasn't moving at all and then showed after the adjustment that it was moving around.
    Basically, I think you will want to find out if you have other factors affecting the injury. I have had significant improvement after two days and hope to have caught the problem early for a full recovery. The day after the initial pain was felt, I could only ride 10 minutes. Today I rode for 3 hours without pain. This week I will continue treatment and keep riding to about 3hrs/day if no pain is noticed. Good luck to you....and to me:)
     
  5. Bullseye_blam

    Bullseye_blam New Member

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    Hmm... what is the best position then? at least, how did you know when it was right for you?
     
  6. tfstrum

    tfstrum New Member

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    I just tore an achilles and have read a bunch since. It could just be your new Sidi's and cleat movement, or it could be that you've also purchased new street shoes or you're using old street shoes and are going from old worn street shoes to new bike shoes.

    It sounds like you're sore enough to see a doctor or PT. Hopefully they can tell you if lall the parts that are supposed to e working together, are.

    http://www.ccptr.org/KDC/rehab_of_the_achillies_tendon.htm
     
  7. kaian

    kaian New Member

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    Update:

    I think the problem might be with my calf. It's pretty tight and sore, whereas my AT isn't so sore. My cleats are all the way back (as far back as they go) and the only other things I can think of is the new shoes or the orthodics. I bought the Sidi's a couple of months ago to replace a pair of Specialized Road Comps. I never had calf problems with the Road Comps, but had a problem with them digging into the side of my foot (thus my replacing them). I still have them - I wonder if I should switch my shoes back or try new ones.

    Anything else that would cause my calf to tighten up so much? Poor technique? Bad fore/af position? Saddle?
     
  8. noonievut

    noonievut New Member

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    In the last couple of months I've noticed a pain on my left heel, mainly when I stretch my calf (pointing toe in air, or when I stretch my leg and my heel is on the ground). I'm not sure what can be the cause of this, so here is my 'foot situation':

    - I wear one of two pairs of dress shoes during the week, I've had these over a year, as there not as comfortable as running shoes, I sometimes notice the discomfort (not pain) when walking, but only sometimes
    - On my road bike throughout the summer I never noticed anything, so I can't see this related to my road bike, shoes or cleats
    - since November I've been riding my exercise bike, I use running shoes (they're old, but not worn often) and toe clips, I only ride the exercise bike 3 times a week for 30-45 minutes...I feel no pain or discomfort when riding, but my guess is I notice the pain the most after the ride and next day. My position on the exercise bike is very different from my road bike because of the fixed handlebars (I'm forced to sit back more)
    - I wear slippers in the house

    The pain isn't severe and there are days I don't notice anything. But right now if I stetch my calf I notice some minor pain and discomfort with my left heel (outside, back of heel, nothing on bottom of foot).

    Any ideas?
     
  9. tfstrum

    tfstrum New Member

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    A lot things I've read point to the shoes you wear and the difference from going to each type. Try some new dress shoes because they sound like they bring the pain on, the quickest.

    Ice up your achilles area when you do feel pain

    Back off on hard workouts and don't go out running, especially if you don't normally run. It won't help stretch it out...
     
  10. noonievut

    noonievut New Member

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    Thanks for the feedback. I've worn these dress shoes for over a year, but the running shoes I wear while riding the exercise bike are old, and I think the pain started while riding in the winter. I guess it could also be position on the bike...

    Can stretching help with this? The stretch where I feel the pain is when I grab the bottom of my foot and pull up to strech my calf muscle...the pain isn't serious but I'm thinking that if I stretch this more it may help.
     
  11. tfstrum

    tfstrum New Member

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    Stretching helps, cant hurt. The PTherapist has me using the square board in this kit to lean back on my heels to get the achilles and calf stretching (only a couple of minutes at a time). Something around the house should suffice.

    Some light yoga may help...

    http://www.barringtonequipment.com/store/index.asp?DEPARTMENT_ID=205
     
  12. noonievut

    noonievut New Member

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    I had a thought on stretching after I posted...I really only feel this pain when stretching my left calf muscle, I don't feel it on the bike, after the ride, and only at random any other time (hardly ever). So this makes me wonder if I shouldn't stretch this part at all? I do get a bit of a calf muscle stretch when I just keep my legs straight, bend over and touch the floor, and this causes me no pain.

    Thoughts?
     
  13. tfstrum

    tfstrum New Member

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    You should talk to a doctor or try dropping by a physical therapy place and see if they'll spend 5 minutes with you. Maybe they can recommend some exercises or they'll know the doctor for you to see....

    Good luck.
     
  14. noonievut

    noonievut New Member

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    Thanks.

    I spent some time last night searching similar threads on this forum (I should've started by doing this before posting :rolleyes: ) and there was a lot of information about achilles tendinitis (what I think I have based on what I read).

    Funny thing I found in a running/injury site was that runners were told that light cycling was a good alternative to running.

    I have an appointment with a foot doctor at a fitness clinic next week, but I have still been riding my exercise bike for 30 minutes at a time, not too hard, about 3 days a week. Maybe this is the wrong thing to do, but I feel no pain while riding, or even afterwards. I haven't rode since sunday morning and the pain is the same as it was (so I plan to go on the bike again tonight).

    Most of what I read on the forums pointed to some serious pain, swelling, etc., where as I have no pain unless I'm in a position where I'm naturally strecthing the calf (it does hurt if I try and stretch it, so I've stopped that). So I hope this light rides don't further hurt the achilles (I do find fitness benefits from these rides, so don't want to stop).

    I think I've pin-pointed the case...was fooling around with my pedal stroke a bit and with running shoes on my exercise bike was pushing through the stroke with my toes up, maybe in effect hurting the achilles. Was also first ride after being sick for a week, and when I stretched afterwards I noticed the pain (may have been there before, but only minor). I continued to stretch, thinking it would help, but probably made it worse.

    Between now and the appointment I may try taking Advil and icing the achilles for 15 minutes followed by compress, rest, etc. (things I've read on the forums).

    Anyway, just sharing this in case what I'm saying sparks any other thoughts someone may want to share.
     
  15. noonievut

    noonievut New Member

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    WOW.

    Went to the doctor today (foot doctor at a sports clinic) and went over my condition, which he confirmed was achilles tendinitis. Spent very little time there are the recommendation was heel pad raises in all shoes and 'shockwave therapy', 3 sessions. No stretching, open back shoes (for work), and ice/heat won't make a difference.

    I'm currently having difficulities with my insurance trying to get this covered, so I phoned a physiotherapy/rehab clinic to get a 2nd opinion, the person was very friendly and seemed to know that he was talking about. However, they contradicted just about everything the 1st guy said :( , inlcluding suggestion to stretch and use heat treatment; and eventually see them about further treatment.

    Even though the phsio place didn't see me, the 1st guy didn't spend too much time with me either, and I actually gave a lot more info to the physio place.

    Not sure what to do next, but I don't think you can say 'go see a doctor, they'll solve your problem', as I'm hearing 2 different solutions (complete contradictions in fact).
     
  16. tfstrum

    tfstrum New Member

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    He didn't prescribe much so go for it. The pads are @ 8.00 and insurance should make the sonic therapy reasonable. While at the physical therapy office for the sonic therapy ask them about other doctors that people really like. If you don't get better through what this prescribed, try another doctor the therapist mentioned.

    I was seeing another doctor for frozen shoulder that's in the same office as the guy I used for my achilles repair. Total night and day. This new guy is awesome. He talks to me, asks me more questions, called me at home early in the process. He makes the whole process better. I can't imagine having used the other guy. Lady at physical therapy also mentioned that the first guy doesn't get rave reviews for his interaction from other customers...
     
  17. noonievut

    noonievut New Member

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    Sounds like the same doctor :p

    I've already bought the pads and put them in my dress shoes (at work), he did recommend getting an open-heel shoe for work, but it's a little tough to find a nice pair with dress pants.

    So is 'shockwave therapy' the same as sonic therapy? The physio place I called didn't know about shockwave...actually laughed about it.

    I'm going to try this as I can get about 50% coverage, it's only 3 appointments over 3 weeks so I'll no soon if it's working/worked. Then I'll re-asses from there.

    Thanks.
     
  18. tfstrum

    tfstrum New Member

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    Never heard of shockwave, but where I'm going there's Ultrasound and electronic stimulation (4 pads with wires attached). Not sure which one your doc suggested though. Sounds like the PT will have to call the doc...

    Good luck
     
  19. heyguy

    heyguy New Member

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    A guy I know who does acupuncture recommends no stretching during the onset of the injury. It needs to heal. Maybe after a week, some light stretching is okay. I can see his point. Something is torn, not tight, so stretching could cause further tearing. Whenever you first feel pain or tearing, do not stretch. You're just doing more damage. If the calf is tight, I would think you'd be better off using your thumb to dig in with some deep massage as you wouldn't be putting your whole body weight into a stretch that pulls on the achilles. I did this for mine, and while it was a little sore the next day, the calf was much looser afterwards. Moving the ball of your foot just over the pedal axle will help prevent heel drop so keep that in mind as well. Ice after riding for sure. Treatments like ultrasound or Moxa from an acupuncturist help draw blood to the area. You want to bring warmth to the area before riding and during treatment but you want to ice afterwards and after riding to reduce inflamation. Orthotics and heel lifts help prevent heel drop while the achilles heals so I think that's a good idea as well. I put my orthotics in my slippers when I'm at home. I also bought a simple 8.00 ankle brace at RiteAid to prevent my ankle for rolling inward. The onset of my pain was on the inside not directly behind. You could also try taping.
     
  20. noonievut

    noonievut New Member

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    I've had this for 3 weeks and I wish I had known this sooner, because the day after it happened I stretched a lot, and I think made it much worse than it would've been. After that disaster day I read something here and decided not to stretch for a while. I've now been stretching a bit (week 3), and yesterday used heat before the stretch...felt good. This morning was very stiff though, but after walking a bit if feels better. I still have my dress shoes on because I can't find one's without the heel...I hope this doesn't hurt it more.

    Thanks.
     
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