I haven’t been training for a week now and used to do about five days of training normally, so to put it gently it is frustrating, but also really necessary.
A pain developed in my achilles tendon between the heel and the bottom of the calf muscle. It was subtle first but then grew more and more and started to affect my everyday walks and later continued onto the foot and the plantar fascia tendon in particular. This increased so much so that I felt like walking on razors when I made a step on my left foot and my right foot’s achilles tendon wasn’t doing much better.
I know that the issues with these tendons are notoriously difficult to work with (because Andra had them too) and the main thing one needs to do is rest – blah, boring! Also
I have been reading and here are a few notes that match both my symptoms and make me even more likely to develop these problems.
- Achilles tendinitis occurs most commonly in men.
- A naturally flat arch in your foot can put more strain on the Achilles tendon and tight calf muscles also can increase tendon strain.
- People who have psoriasis are at higher risk of developing Achilles tendinitis. are at higher risk of developing Achilles tendinitis.
- Activities that place a lot of stress on your heel and attached tissue — such as long-distance running — can contribute to an earlier onset of plantar fasciitis. (I’ll come back to this)
- Being flat-footed can affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.
Prevention of achilles tendonitis:
- Increase your activity level gradually. If you’re just beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training.
- Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest.
- Choose your shoes carefully. The shoes you wear while exercising should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don’t support your feet, try arch supports in both shoes.
- Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis.
- Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to better handle the stresses they encounter with activity and exercise.
Stretches to help prevent achilles tendonitis and plantar fasciitis
- Stand an arm’s length from a wall.
- Place your right foot behind your left.
- Slowly and gently bend your left leg forward.
- Keep your right knee straight and your right heel on the ground.
- Hold the stretch for 15 to 30 seconds and release. Repeat three times.
- Reverse the position of your legs, and repeat.
- It’s important not to hold the stretches for too long.
- While seated, roll your foot back and forth over a frozen water bottle, ice-cold can, or foam roller. Do this for one minute and then switch to the other foot.
- Cross one leg over the other for the big toe stretch. Grab your big toe, pull it gently toward you, and hold for 15 to 30 seconds. Do this three times, then reverse and do the same with the other foot.
- Fold a towel lengthwise to make an exercise strap. Sit down, and place the folded towel under the arches of both feet. Grab the ends of the towel with both hands, and gently pull the tops of your feet toward you. Hold for 15 to 30 seconds, and repeat three times.
- I am a man,
- I have been having some problems with psoriasis for a while,
- my foot arch is so flat it can be used as a ruler,
- and I just realised I’ve been putting extra stress on my heel.
In particular, since I’m new to cycling, I didn’t realise by my shoes are very soft and have little support. Second, I don’t wear my prescribed insoles while cycling and third, I really drop my heel when I push hard up the hills. This last one is probably partly due to the shoes, partly due to my technique.
I used to have the SPD cleats very much under the foot right after the toes and under the little “pillow there”. That made my heel drop even more exaggerated and on long distances I had extremely intense pain in my achilles to the point of not being able to walk. After a bike fitting session, the specialist pushed the cleats much further back, which helped a bit and the pain was much less on longer trips, but I suspect the lack of rigidity in the shoes and the lack of support didn’t help.
Finally, I am very flexible just naturally, which is a good thing in most cases but I think it might have relaxed me when it came to stretching my calfs in particular. So I might have not given them as much love as it was needed. I normally focus more on my hamstrings, quads, etc.
As you can see, many little factors, now that I look back, have affected and lead to this situation. Factors that could have been prevented or minimised in terms of impact, but due to ignorance or lack of knowledge – weren’t. The fact that I also ramped up my training in preparation for the TCR didn’t help either.
I am scheduled to see a physiotherapist tomorrow, who also does bike fitting and as such would no doubt recognise all of the above. I am hoping to a) get some exercises from him to strengthen, alleviate and prevent future issues and b) tell me what the damage really is and when I can start training again.
Regardless of that my prevention and further attending to these problems will include:
- Religious daily stretching of the hamstrings, calf, achilles and feet
- Religious daily foam rolling of the calf muscles
- Introducing slowly calf raises initially once and later twice a week into my training routine
- Buying rigid cycling shoes that fit properly and provide space for my feet to expand on longer rides and also do not squeeze the heel too much as that can irritate the tendon there
- Always cycle with insoles that support my flat feet
I will update this once I get the information from the physiotherapist tomorrow and I hope this will help others that might suffer from similar problems.
Update after the physiotherapist (25/03/2019)
The physiotherapist was very good and patient. I explained to him past issues, current training and the problem at hand. He asked me to do a few tests, i.e. ankle flexibility, hamstring flexibility and unsurprisingly my left leg is a bit less flexible than the right, but they are both a little above average, so flexibility is not the problem.
Then he told me to do maximum repetitions of one leg calf raises on each leg. Unsurprisingly again, the left leg was much weaker than the right. 18 repetitions on the left and 23 on the right. I could have squeezed maybe a few more but not with good form. He told me that I have high mobility but low strength in that area, which causes me to abuse the flexibility when the pushing gets hard and strength is supposed to kick in.
This is spot on even based on my observations. The therapist gave me some calf raise exercises to do, to strengthen each leg, specifically with static holds at the top, middle and bottom of the movement. That would constitute one repetition and I would have to build up to doing three sets of fifteen of these on each leg.
He also said to go back to training, slow and observing how the achilles feels, always taking a day off after each training and observing how it feels then too. Finally the calf exercises are twice a week, but I am planning to slowly build them to three times a week eventually.
This has given me a lot of hopes and now I am glad knowing what the problem is and how to work on it. Stretching is still important, but not my weak link. I need strength and this just proves how important is to not only sit on the bike and pedal all day, but to work on your weaknesses before they become problematic.
As a result, there will be a lot more strength workouts in my training now, for the core, calfs, feet, quads, hamstrings, core and neck. As Ross Edgley says in The World’s Fittest Book, there always must be first a base level of conditioning before you get into a specialised level of conditioning for a specific task/exercise (i.e. cycling).