Achilles tendonitis

[Tim McNamara]

In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
right Achilles tendon. Hurt like a sumbitch and gave me new respect for soccer players and other
such sports where this kind of injury is relatively common. I've never had anything like this
before, in 35 years of riding bike a lot. But then I've never ridden 375 miles with 18,600 feel of
climbing in 24 saddle-hours before, either.

I generally ride relatively light gears and with a fairly quick cadence (80-90 rpm)- having started
riding when spinning was just becoming all the rage- but in retrospect I've been having left knee
problems this year and may have been overcompensating with my right leg. I suppose that could be a
factor as to why my left Achilles is fine.

I've taken a few days off to recuperate, am icing and using naprosyn as an anti-inflammatory and
doing a little gentle stretching. The acute pain is gone, there's still some swelling of my ankle
and a small tender lump about 3-4 cm above my ankle on the medial side (this is much reduced in size
and pain from Sunday). I notice a little discomfort when walking down stairs.

I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
from the old to new style Frog cleats.

I'm guessing others have had this and have dealt with it effectively. I want to get some curative
and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
ride the last 650 km with tendonitis...

 

[Wayne Pein]

Tim McNamara wrote:

> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon. Hurt like a sumbitch and gave me new respect for soccer players and other
> such sports where this kind of injury is relatively common. I've never had anything like this
> before, in 35 years of riding bike a lot. But then I've never ridden 375 miles with 18,600 feel of
> climbing in 24 saddle-hours before, either.
>
> I generally ride relatively light gears and with a fairly quick cadence (80-90 rpm)- having
> started riding when spinning was just becoming all the rage- but in retrospect I've been having
> left knee problems this year and may have been overcompensating with my right leg. I suppose that
> could be a factor as to why my left Achilles is fine.
>
> I've taken a few days off to recuperate, am icing and using naprosyn as an anti-inflammatory and
> doing a little gentle stretching. The acute pain is gone, there's still some swelling of my ankle
> and a small tender lump about 3-4 cm above my ankle on the medial side (this is much reduced in
> size and pain from Sunday). I notice a little discomfort when walking down stairs.
>
> I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
> It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
> from the old to new style Frog cleats.
>
> I'm guessing others have had this and have dealt with it effectively. I want to get some curative
> and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
> ride the last 650 km with tendonitis...

I've not had this problem to this extent, but when I've had various more minor afflictions what has
worked well for me is the use of "The Stick" or a real rolling pin. The Stick is basically a
glorified rolling pin with individual donuts, available from Performance, at the least. What is good
about such massage is that it lengthens structures too, like does dough when you hit it with a
rolling pin. But you don't get the possibility of micro tears like with conventional stretching.
I've often cured tendon pains by relaxing and lengthening the attached muscles which were tight and
thus unduly pulling on tendons.

Wayne

 

[S. Anderson]

"Tim McNamara" <[email protected]> wrote in message
news:[email protected]...
> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon. Hurt like a

<<snip..>>

> I'm guessing others have had this and have dealt with it effectively. I want to get some curative
> and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
> ride the last 650 km with tendonitis...

I've had achilles problems before and I can tell you that you should treat it seriously. It can be
one of those injuries, like a pulled hamstring, that just goes on and on. Properly stretching your
calf muscles is a good idea. Also, putting less strain on the achilles helps. Moving your cleats
will help as you've already suggested, as well as not lowering your heels while pedalling if you
have that style. Pay attention to proper warm-up methods and don't over do it when you're cold for
sure. Tendonitis is an overuse injury so if you start to have discomfort, pay heed and maybe lower
your mileage. I had a partial tear 5 or 6 years ago and every once in a while it flares up. I never
forget which heel had the problem!

Good luck,

Scott..

 

[Jay Beattie]

"Tim McNamara" <[email protected]> wrote in message
news:[email protected]...
> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon. Hurt like a sumbitch and gave me new respect for soccer players and other
> such sports where this kind of injury is relatively common. I've never had anything like this
> before, in 35 years of riding bike a lot. But then I've never ridden 375 miles with 18,600 feel of
> climbing in 24 saddle-hours before, either.
>
> I generally ride relatively light gears and with a fairly quick cadence (80-90 rpm)- having
> started riding when spinning was just becoming all the rage- but in retrospect I've been having
> left knee problems this year and may have been overcompensating with my right leg. I suppose that
> could be a factor as to why my left Achilles is fine.
>
> I've taken a few days off to recuperate, am icing and using naprosyn as an anti-inflammatory and
> doing a little gentle stretching. The acute pain is gone, there's still some swelling of my ankle
> and a small tender lump about 3-4 cm above my ankle on the medial side (this is much reduced in
> size and pain from Sunday). I notice a little discomfort when walking down stairs.
>
> I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
> It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
> from the old to new style Frog cleats.
>
> I'm guessing others have had this and have dealt with it effectively. I want to get some curative
> and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
> ride the last 650 km with tendonitis...

I had the same problem after a relatively flat double century (a walk in the park for you). It
probably was caused by pedal-mashing with limber shoes and dropping my heel at the bottom of the
stroke. The tendonitis resolved quickly and never came back on similarly long rides -- I think in
part because I switched to stiffer shoes with a slightly more aft cleat position and got orthotics.
As for preventative approaches, you probably are stretching and training enough. Don't over train
and take some Naprosyn to Paris. -- Jay Beattie.

 

[Ryan Cousineau]

In article <[email protected]>, Tim McNamara
<[email protected]> wrote:

> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon.

Ouch!

> I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
> It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
> from the old to new style Frog cleats.

I had a similar event near the end of my first 100 km ride, which was earlier this year. Rest, Ice,
etc., and if fast recovery is necessary, see a sports-minded physiotherapist. Also, you may benefit
from a very small seat drop, though that will aggravate your knee problems, if any. I have had very
good results by moving my cleats ludicrously rearward, with no apparent ill effects, though it still
feels a little odd sometimes (the cleat position, not my tendon).

> I'm guessing others have had this and have dealt with it effectively. I want to get some curative
> and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
> ride the last 650 km with tendonitis...

No indeed. You need rest now, and it will heal. But don't mess it up. My tendonitis was so bad I
ended up off work for a few days while I healed. I could barely walk.

--
Ryan Cousineau, [email protected] http://www.sfu.ca/~rcousine President, Fabrizio Mazzoleni Fan Club

 

[Peter Cole]

"Tim McNamara" <[email protected]> wrote in message
news:[email protected]...
> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon.
>
> I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
> It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
> from the old to new style Frog cleats.
>
> I'm guessing others have had this and have dealt with it effectively.

From what I've read, tendonitis in the achilles can be caused by too much foot travel. This can be
provoked by deliberate "ankling", having the saddle a little too high & "reaching" with the toes,
or attempting to offload the upper leg extensors when fatigued and putting more effort into the
foot extensors. Moving cleats back takes a lot of "toe" out of the stroke and lowers the load on
the achilles.

The inflammation can be in the sheath that surrounds the tendon, and can lead to scarring, which can
predispose to additional bouts of tendonitis. If you're really concerned about recovery and return
to full performance before PBP, you might want to go to a good sports doc for a checkout & rehab
program, chances are it'll just be a "RICE" treatment variant; it might seem like overkill, but
you've got a lot at stake... It might be good to get a professional opinion on how long you should
lay off, whether stretching is helpful or harmful, & stuff like that.

I DNF'ed on a 400K because I tweaked the toe-in a bit on one of my cleats the night before the ride.
I was trying to eliminate a hot spot on my little toe that developed around 200 mile mark. I wound
up with a very sore knee at the 200 mile mark (my toe was fine!). Moral of the story: never change
*anything* before a long ride. Now is not the time to be experimenting with anything radical, I
think moving cleats back & adjusting saddle height if necessary (down, if you're a toe-down pedaler)
would be safe.

 

[Nick Payne]

This happened to me about a dozen years ago on a 1000km brevet towards the end of the second day of
riding. After having it recurring on and off for several months, I dropped my saddle height about
6mm or so and the problem vanished. So I surmise that in my case it was caused by "reaching" with my
foot a bit at the bottom of each pedal stroke.

Nick

"Tim McNamara" <[email protected]> wrote in message
news:[email protected]...
> In the final 35 miles or so of a very hilly 600K brevet last weekend, I developed tendonitis in my
> right Achilles tendon. Hurt like a sumbitch and gave me new respect for soccer players and other
> such sports where this kind of injury is relatively common. I've never had anything like this
> before, in 35 years of riding bike a lot. But then I've never ridden 375 miles with 18,600 feel of
> climbing in 24 saddle-hours before, either.
>
> I generally ride relatively light gears and with a fairly quick cadence (80-90 rpm)- having
> started riding when spinning was just becoming all the rage- but in retrospect I've been having
> left knee problems this year and may have been overcompensating with my right leg. I suppose that
> could be a factor as to why my left Achilles is fine.
>
> I've taken a few days off to recuperate, am icing and using naprosyn as an anti-inflammatory and
> doing a little gentle stretching. The acute pain is gone, there's still some swelling of my ankle
> and a small tender lump about 3-4 cm above my ankle on the medial side (this is much reduced in
> size and pain from Sunday). I notice a little discomfort when walking down stairs.
>
> I moved my cleats rearward a couple of mm to see if that would reduce the tension on my Achilles.
> It's possible they were a bit far forward to begin with as I had replaced the cleats and switched
> from the old to new style Frog cleats.
>
> I'm guessing others have had this and have dealt with it effectively. I want to get some curative
> and preventive approaches nailed down as I am planning on doing PBP in August, and don't want to
> ride the last 650 km with tendonitis...

 

[Jay Beattie]

"Nick Payne" <[email protected]> wrote in message
news:[email protected]...
> This happened to me about a dozen years ago on a 1000km brevet towards
the
> end of the second day of riding. After having it recurring on and off
for
> several months, I dropped my saddle height about 6mm or so and the
problem
> vanished. So I surmise that in my case it was caused by "reaching"
with my
> foot a bit at the bottom of each pedal stroke.

I had a very similar problem while riding a 10,000km brevet around Death Valley in summer on
deflated tubulars which I finished in one day. I bought some ice at Furnace Creek, but it turned to
steam immediately after leaving the store, so I had to resort to the native remedy of chewing peyote
which worked quite well for the last 300km climb from Bad Water to the top of Mt. Whitney. I could
not lower the saddle which I had worn out and discarded, but I did lower the post by about
one-quarter inch -- which also helped, especially during seated climbing. This all will be in my
upcoming book "To Hell and Back in the Big Ring." -- Jay Beattie.

 

[Tim McNamara]

Thanks for the ideas. I tried to go for a spin today but found that my Achilles was mildy painful
within a few blocks of my house, so I called the ride off. Obviously not quite ready yet. Bummer, it
was a beautiful evening for a bike ride here in Minnesota.

 

[Shayana Kadidal]

I've had tendonitis, always on my (stronger) right side, on and off over the last four years. I've
noticed it happens a lot more on days when I've worn dress shoes to work, with their one-inch heel.
Stretching the calf after hard rides seems to prevent it from happening.

I'm sure the heel thing sounds weird, but it's been a very consistent phenomenon--even though the
tendonitis problem has largely gone away and I don't stretch so much these days, on the rare days
when I wear a suit to work I often notice a bit of tendonitis on the next day's ride. Even now it
surprises me, which makes me think it isn't all in my head... --Shayana Kadidal

 

[Tim McNamara]

In article <[email protected]>, [email protected] (Shayana
Kadidal) wrote:

> I've had tendonitis, always on my (stronger) right side, on and off over the last four years. I've
> noticed it happens a lot more on days when I've worn dress shoes to work, with their one-inch
> heel. Stretching the calf after hard rides seems to prevent it from happening.
>
> I'm sure the heel thing sounds weird, but it's been a very consistent phenomenon--even though the
> tendonitis problem has largely gone away and I don't stretch so much these days, on the rare days
> when I wear a suit to work I often notice a bit of tendonitis on the next day's ride. Even now it
> surprises me, which makes me think it isn't all in my head... --Shayana Kadidal

Actually, there's reference to an increased risk of tendonitis in people who regularly wear heels 1"
or taller, who then switch to flatter shoes for athletic endeavors, in several of the Web sites I
read (including some that actually seemed written by someone who wasn't a flake; there are also some
flake-o-matic Web sites about this stuff).

 

[Shayana Kadidal]

Ah. Thanks for the post! So I am neither crazy nor unique. Reassuring/disappointing.

Here are some cites:

http://www.coachr.org/achilles.htm http://www.mydr.com.au/default.asp?article=2369
http://www.spinalhealth.net/inj-ach.html

Runners seem to have this problem well-researched.--Shayana Kadidal

> > I've had tendonitis, always on my (stronger) right side, on and off over the last four years.
> > I've noticed it happens a lot more on days when I've worn dress shoes to work, with their
> > one-inch heel. Stretching the calf after hard rides seems to prevent it from happening.
> >
> > I'm sure the heel thing sounds weird, but it's been a very consistent phenomenon--even though
> > the tendonitis problem has largely gone away and I don't stretch so much these days, on the rare
> > days when I wear a suit to work I often notice a bit of tendonitis on the next day's ride. Even
> > now it surprises me, which makes me think it isn't all in my head... --Shayana Kadidal
>
> Actually, there's reference to an increased risk of tendonitis in people who regularly wear heels
> 1" or taller, who then switch to flatter shoes for athletic endeavors, in several of the Web sites
> I read (including some that actually seemed written by someone who wasn't a flake; there are also
> some flake-o-matic Web sites about this stuff).

 

[Tim McNamara]

In article <[email protected]>, [email protected] (Shayana
Kadidal) wrote:

> Runners seem to have this problem well-researched.--Shayana Kadidal

Yes, although the recommendation seems to be to take up swimming or bicycling as alternative
activities, at least until the problem is resolved. Maybe I should take up running, since cycling is
what caused my problem?

On the up side I was able to get out for a 23 mile spin last night with no flare-up of the pain.
I'll try a little longer ride today. The advice I've received about moving the cleats a little to
the rear seems to have been helpful. I haven't tried lowering the saddle yet, thought I'd do one
thing at a time.