Bulge is gone as is the creaking or squeaky feeling that I would feel in the tendon if I held onto it while raising and lowering my heel. I can also tell that the micro-tears in the tendon that I was able to feel are gone, it feels smooth like my other one.
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I have been meaning for some time to share how well some of the ideas in this thread this worked for me after severely aggravating my achilles during a severe TSS overload week in Mallorca on a rental bike.
I had gotten to the point of swelling and creakiness (crepitus) in the right tendon - something I had never experienced in a few years of cycling ~5k miles/year. The rental bike and workload I’m sure both contributed, but the problem persisted when I got back home.
In brief - the things that worked for me were:
- Cleats slightly back and seat slightly down - immediately reduced severity of pain/swelling following rides and I was able to get back to base riding. In recent months, I’ve taken seat back up a bit but will revisit cleats at next bike fit.
- KT tape - I was surprised how much this helped. One strip placed under tension from bottom of heel to about 1 foot up along back of leg, a second strip from ankle to ankle coming around the back - this got me riding again with really no issues at all - used it for about a month after the cleat/seat adjust.
- Eccentric heel drops as well documented in this thread - done on edge of stair - I progressed to 3x15 per side - only did these for a few weeks and they made a big difference in not even needing the tape anymore.
The internet is full of people telling you that trying to manage a problem like this yourself will result in catastrophic failure, broken tendons, a year off your bike, and maybe imminent death if you don’t see a specialist and PT. It doesn’t always have to be that complicated 
That being said, I would not have tried to manage this on my own if it was a sudden impact injury.
Great thread, Anthony!
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I’m late to this thread, but have a wealth of experience with Achilles issues…
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+100 on eccentric heel drops. They are the critical element in overcoming Achilles issues.
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When doing the drops, do not raise back up on the injured leg. Raise up on your good leg, place the injured leg down, pick up the good leg and lower on a 3-5 count. switch back to the good leg and raise back up. Start with body weight and then add weight. I used a back back with dumbbells tossed in. If you never add the extra weight, you are wasting your time.
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Put your cleats back as far as possible on your shoes. It will help minimize strain on the Achilles while riding. I have never moved mine back and this was over 10 years ago.
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Riding was alway therapeutic for me…as long as I stayed in the saddle. Standing is a big no-no when you have Achilles issues.
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Swimming was wonderfully therapeutic. I always felt great getting out of the pool. (Points 4&5 are possibly very individualistic…consult your doc)
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Don’t neglect your glutes in your strengthening routine. The root cause of Achilles issues can often be weak glutes.
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For me, finding the flattest possible shoes was a game changer. I had been doing heel lifts, shoes with substantial heel-to-toe drop, etc. Never helped…but once I started wearing completely flat shoes, I could walk better within a short time. My favorites were Sanuk canvas shoes. Barely any sole at all and 100% flat. This is likely to be very controversial as most will tell you the opposite. If you are stuck, consider it as an option, but be careful.
Good luck to any that are struggling with this injury…it sucks, but you can overcome it.
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Hey, thanks. Glad you found this beneficial. Being injured can be incredibly frustrating and depressing, especially if you have gone through the long (and expensive) traditional route of a diagnosis from a general practice doctor, referral to a specialist and then a physical therapist.
It can be a huge time and monetary investment only to find zero relief. I’ve done this before and it’s not fun.
My right achilles hasn’t flared up since I invested a good 12-14 weeks of the work I listed above. It will get a little “tight” from long/hard rides, but nothing a good calf roll session can’t help with. I love using a 32oz Nalgene bottle to roll out my tendons and calves. Helps A LOT to relieve tension.
Found this thread really useful. Just wanted to add the below in case anyone else comes across this thread as I did…
I was having Achilles issues running and cycling, and pain persisted for about 3 months. I did eccentric heel raises (2x per day in recommended sets) which definitely seemed to help. However, my physio also diagnosed pelvic misalignment, and having done the following exercise every day now for about 2 weeks I’ve had a dramatic improvement, to the point where I’m running and cycling distance without any pain or discomfort afterward. For me, at least, Achilles tendonitis was a referral from pelvis alignment issues, and keeping the pelvis stable and strengthened has made a world of difference.
Here’s the exercise: Natural Pelvis Reset - YouTube
Hope this helps someone else in their recovery!
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Does anybody have a reference for this study? I can find this quote in several places on the web, but not the source.
Maybe here:
If not let me know. I have too many bookmarks.
I know I’m late to the party, but I had this unexpectedly also. Turns out either me or my bike shifted a bit over time. Went and got a fitting done by a certified guy at my LBC and the problem went away almost immediately
This seems like a good paper to read, but it does not, as far as I can tell, discuss the cited study about the evaluation of tendon resiliency comparing different strengthening protocols. Sorry to but you about this, but this paper seems highly valuable to the discussion here.
I have been dealing with Achilles tendinitis for the past year now. I went through a very careful regiment of slowly ramping up my training since January and everything was going fine until a two-hour ride yesterday morning. It’s back–not bad–but clearly back. So what I was doing was kinda working, but not enough to get me fully recovered to the point that I can actually train hard. Most frustrating time as a hobby athlete by far. And now I am willing to read and try almost everything if it gets me back to being able to ride and run the way I would like to.
What has your rehab regimen been?
I took approximately two months off. Then started slowly with short walks, jogs, and limited biking. Over the course of 4 months I ever so slowly increased to about 3-4 rides a week with only a single longer ride of about 2 hours and 3 runs a week with only a single run >5 miles. In addition I did about 2x weekly leg-strength exercises with my TRX and daily stretches/mobility (including calf raises, single leg balance, …).
OK, so the big I don’t see from your regimen is eccentric calf drops. Not heel raises, but heel drops.
That is the single, most effective thing you can do for Achilles injuries. After a week of doing them (3x10 everyday, if not twice a day), add weight by putting dumbbells (or even plain old books) in a back pack. this is critical If you just use your body weight, you won’t progress. You need to overload the system, but in a controlled manner.
See the video below for correct method…but I would suggest raising up only on your good leg and then transferring over to your injured leg. This reduces the strain on your Achilles and saves it for the eccentric motion.
IN addition, get a balance pad (or just stand on a pillow) and do single leg squats and other exercises to strengthen your glutes and the whole kinetic chain in your leg.
Good luck…I managed to go form thinking I would never run again (even just playing with my kids) to completing two full IM and qualifying for 70.3 Worlds. Feel free to reach out with any questions!
ETA - also make sure you move your cleats as far back as possible on your cycling shoes. Avoid standing as much as possible, as well. This will help reduce the strain on your Achilles while riding.
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Agree - the cleats back plus the eccentric drops are huge benefit for this issue.
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Not sure if you mean two months off from strictly cycling or all types of exercise. If it’s the latter, that’s a big problem. As mentioned, tendons need resistance and weight to strengthen and recover. If not, they can degrade further.
I’ll try to dig it up, but I read a study about the effects of cycling on the achilles tendon with regard to tension based on force, and if I recall it’s not that much. It makes me wonder if your (our) Achilles injuries are a result of some other deficiency, like in your gastroc and soleus muscles, and not because of stress from pedaling.
This is why eccentric heel drops help so much. Not only are they loading the tendon, they are activating the key muscles of the lower leg and strengthening them, which takes stress off your tendon.
DO LOTS OF THEM and aggressively progress the weight. It will work.
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Everything in that post was spot-on, but really wanted to emphasize this…the leg is one long kinetic chain, adn where your symptoms surface may not be the source of the issue (for some injuries, it is in fact likely that it is not the area of the problem).
For me, almost all my lower leg injuries (Achilles, plantar fascitis, ITB, etc) were caused by weak glutes…and weak glutes are a huge problem with cyclists. We work in a very fore / aft manner, which is not great for overall glute strength.
Single leg squats, monster walks w/ bands, “running man” exercises, and a host of other exercises finally got me straightened out…but it literally took me years to figure it out.
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Dear @anthonylane and @Power13, thank you for your careful advice and suggestions. Just some comments from my end: I am a hobby triathlete and was working towards OCRs as well. So my workout includes bike, run, TRX, dumbbells, bodyweight HIIT, … and prior to COVID of course regular swimming, rowing, elliptical, … and other gym-related stuff. So I was trying to spread things relatively evenly, but in the end biking is still my ‘main love’. So it COULD be that other parts of my body are not sufficiently exercised, but I am not the standard scrawny biker with huge, overworked legs either.
I will take your advice and do plenty of heel-drops with increasing weight. I am a bit at a loss if cross friction massage is a thing to do or not. Some therapists swear by it while others tell you it AT BEST does nothing but likely will make things worse. So unclear what to do there.
In the meantime I will continue TRX, light runs, and other exercises that overall will make me (and the rest of my legs) stronger.
Thank you @Power13. I started a rigorous regimen of heel/calf drops and planning to increase weight as the weeks progress. Your story about recovering to the point of completing IMs is very heartening and aligns with my goals. After placing third in my age group in my first 70.3 I was aiming to train for a full IM, but injuries (in particular this Achilles issue) have stopped me from making any meaningful gains in the past year.
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Good luck…keep us updated on your progress!
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Quick update for all that weighed in: After 4 weeks of eccentric heel/calf drops I have been slowly ramping up running and biking. Last week I got up to 30 miles running (including a 10 mile run) and 100 miles (hard) biking all without any issues so far. That’s more than I have been able to do in over a year.
I will continue the exercises as I further (slowly) increase training intensity. Makes me really hopeful about finally being able to train at the intensity I would like–and maybe my final goal to complete a full Ironman is in reach again after all.
Thank you all!
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Just be aware that a realistic timeframe for rehabbing a chronic tendinopathy is 3-6 months, and the improvement ‘graph’ will not be a straight upward curve, so don’t be too alarmed if it takes a while longer and you have some setbacks. I have had a hamstring tendon issue since September, and it’s probably still only at c.75%. Be patient, and have a good physio to help you progress the rehab. I’m currently trying to transition to more explosive stuff, and it’s a tricky balance between loading it but not excessively irritating it.
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