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Insertional achilles tendonitis

 Poster: A snowHead
Poster: A snowHead
Seeking "second opinion" here Very Happy

After multiple bouts of insertional achilles tendonitis and periods of PT and custom insoles - it flared up again just in time for ski season Sad

Saw my Dr. and he recommended another round of PT (which does make it marginally better) but it usually takes 2-3 months of twice weekly PT. My Dr. does not have answer about how skiing would affect my achilles pain. Trip is booked and my thinking is that because of the configuration of ski boot it would not put too much strain on achilles.

I will follow up doctors orders (but to be honest - slowly losing faith in his repeated recommendations of PT) but would just like to hear from skiers that had to battle similar problem.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
How are your calves ? It’s often the case, noting all I’ve got to go on is your description here, spend time getting your calves well massaged and stretch stretch stretch within your ranges. Don’t skimp on calf management as that often impacts this a lot. A boot will put you into a fixed stretch position which might aggravate it a bit, try not to ski on your toes, a small heel lift will help but not that will affect your boot fit and balance. I’d find a good podiatrist and see what is causing it - sometimes ankle flexion or previous injury does this, tight calves and/or upstream muscle imbalance. Hard to tell.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
I am sure you have tried lots of things but I find the following help. Heel pads in all my shoes and trainers. If I am on my feet for extended periods then Tulis heavy duty heel cups are a godsend I put them underneath my socks to keep them in place.
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@Cheapski, I suffer from serious inflamed achillees problems brought about by running as well as ski touring as the back of the boot can rub the already inflamed tendon.

Towards the end of the season in April 24 as I mixing trail running (climbing) and ski-touring it flared up again and I went to my doctor here in Serre Chevalier who is also a very good UMTB runner so quite sympathetic to my ills.

He then prescribed a course of physio and I went to an excellent one, and over 40 odd years I've been to many; and just as @orange, has mentioned she concentrated on the calves as well just as much as the Achilles.

I use one of these and I swear by them and use it on all parts of my body, unlike floor rollers this does not move all over the floor as its in a frame, and you can massage your achilles with the forward one whilst doing your calves with the other.

Just realised link below is amazon US but just read the reviews, obviously available on UK, it was featured on Dragons Den

https://www.amazon.com/BackBaller-Dual-Mounted-Roller-focused-muscle/dp/B01M1DYWT6?tag=amz07b-21
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
There is pretty good information and advice on management of tendon disorders on this podcast. Because it is golf it is focusing on elbow tendons but the general advice is good for most I think.
https://fitforgolf.blog/podcast/dr-keith-baar-golfers-tennis-elbow-tendon-rehab/
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I am going to go against all advice, but when I used to run a lot I suffered from Achilles Tendonitis for a few months, until I read a blog of a guy in the US who suffered badly for years. His medical plan wouldn't operate on him, unless he had a complete tendon rupture. So he started doing weighted calf raises on a step, despite the pain, tying his best to rupture the achilles. After a few weeks he didn't manage to rupture the achilles, but it did stop hurting and the tendonitis went away completely.
So I did exactly the same and was completely cured within a week. Anytime in the last decade that it's returned, a few days of calf raises and it goes away again.

In my experience the problem comes about because of changes in footwear, especially when running and more specifically a change in the shoes drop.
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
@doddsie, great stuff. How much weight approx?
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Doddsie - Not a massive surprise , what do calf raises do - strengthen the calf muscle which attaches to the achilles insertion. Stronger your calf, and most flexible/stretched, better your achilles function. I’d always recommend them but generally not with pain, so flat floor first on both feet then gradually move to heel drop then once you are pain free on single leg heel drops you can add some weight, don’t go full bore into that !
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
dynastar84 - If you do it on a staircase one legged, you can actually push down using the bannister to adjust the load. Orange is obviously giving the sensible approach to slowly build it up, but I've always found full bore to be quickly effective.
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 Ski the Net with snowHeads
Ski the Net with snowHeads
Such great info. This place is ace. Very Happy
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snowHeads are a friendly bunch.
Insertional achillies tendonitis needs proper assessment by a physio as lots of ifs, buts and maybe can be individual.

However, speaking broadly, tendons respond well to load, ski boot position shouldn’t inflame the ailment and for the love of God, don’t do any loading rehab without getting specifics from a professional.

Tendon management has changed a bit over the last few years and what was previously accepted practice isn’t quite the case anymore. In fact, it can be a hindrance.

After this bout, ensure you speak to a good biomechanics person and then try and find the real reason behind the tendonitis. It can be a number of different things. Do not go cookie cutter off the internet with this. It’s one of the worst injuries to do that with.
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