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Achilles update from July Dr visit

Totally forgot to give update after my visit. Kind of hard to put this in best order, but I hope there are some tidbits here that would useful to others with any injury.

Remember during my posts about fixing stuff and wanting to do it myself for, huh, thriftyness, but also distrust. Came up again.
Sports Podiatrists (according to their ads, so that means whole lower leg including achilles) first starts with x-rays before even talking. Upon saying "already", staff says "don't worry, insurance will take care of it". Huh no, HSA with big deductible, I will, but that's how they operate. Besides, x-rays are terrible for soft tissue injuries. Calling that first strike.

Dr comes in and asks of course what's going on and what I've been doing. I've got list of workouts leading up to time I first noticed issue and since, and what things seemed noteable to what was or was not involved, and what treatment stuff done when, ect. Referenced the eccentric heel drops in case it was achilles tendonitis. He asks what that is, I describe it, he says interesting, hadn't heard of that. Well, for a study protocol in last 5+ years that showed positive results compared to anything else non-surgical, that's not good. Strike two. Always like to go in semi-informed at least, to get an idea of where the Dr is in keeping up with recent stuff.

He does basically say it is early stages of tendonitis, earlier than they'd normally see, because usually someone would just work right through where I noticed it, and make it a whole lot worse, serious, and and easier definitive diagnoses, though longer recovery. So that's good, confirmed chiro/PT comments, I'm a wimp! Now of course the 2 strikes make me concerned about an honest diagnosis or him desiring to be quick as possible. So that may explain why it's such a specific spot of pain when pushed.

He didn't really want to figure out why it happened. To me, the why is half of the info to figure out, or how do I NOT do it again, since there didn't seem to be any singular incident. Or it's my troubleshooting nature, find root cause.

So he gave all the normal responses, ice (though accute stage was done already), heat to aid healing, naproxen 2 x daily, stretching, wear a boot at night ("don't worry, insurance will pay for one even though you have one"). Can't sleep with it though, so that's a bummer. Lay off using it (which was the case for 7 weeks no running and little improvement).

He did share some info that I think fits in with trying to figure it out. He pushed my forefoot back (dorsiflex) and said with this much pressure, he should be at about 15 degrees past 90 degree angle of foot/leg. He made it to only 90.

So I'm extremely tight in calves. But due to many twisted ankles as youth, they just don't bend much, so when I stretch, it's done quick, so neither side feels very tight at full stretch. And some attempts to stretch more have actually caused multi-day pain on side/front of ankle, so no good there either. So just need to stretch more often. Rolling isn't useful though, that's not stretching really, not same outcome. Already knew that. It can relieve tight spots to allow relaxing, but if maximal relaxed state is still really tight, it's ain't helping.

So the why did it happen? My first workout records comment on 3/20 bike ride didn't feel great. What was leadup?
Been running 1-2 x weekly since 10K race end of January, and backpacking trip well before with walking 13 miles x 3 days, so legs had the usage.
Did do that short notice 13 mile run on 2/28 after geting notice regarding job. But 5 days later did another 6 miler no issue, and another 6 a week later, so don't think that did it. Unless it merely added to too much stress.
Started lifting progressive heavy 4 x weekly upper/lower split routine on that 3/5 until 4/24, and hardly any running/biking. So 5 lower body workouts by that point of issue on 3/20. So I believe associated with that.

So I had noticed right before stopping the gym that it seemed my full depth squats caused me to shift to left side slightly. I figured due to right ankle breakage causing less movement, so I found raised heels solved that issue, on last day. But my left leg is also short, so I have heel lift in that shoe, and figured I needed it really on lifting heavy. So foot slanted forward, causing point of balance to be on forefoot more. And what do you have to engage to prevent tipping forward on calf, deads, SL DL, ect - calf. And that calf is already probably 1/2 - 1 inch smaller in size, so I'm guessing weaker. So heavy weight shifting left not on balance in middle of foot.
A week after noticing issue on 3/20, I also started farmer's walk with 160 lbs in same shoes with just heel lift, so now really stressful, so that probably didn't help.
I then started walking only instead of running through April. Then May with no heavy lifting, started the 10K training for that June race, and while some comments about tight achilles, never awful until after the race. Which was standing around waiting for storm to come or go, and not stretched out great.

So current program of stretching as much as I can remember, not sitting/sleeping with plantar flexed foot as best I can, and doing eccentric heel drops frequently, seems to be making the difference. Enough rest between running days seems to help too. And after the half-IM, I'm planning to back off to running 1 x weekly. Well, maybe 2 x short time. In case I can heal to train for marathon.
 
Lessons learned.
Go to Dr with some good knowledge to discern if they are keeping up with new things.
Attempts to do things right might not be thought out well enough, run through logic again.
Records of workouts useful to discern order of things leading up to and after injury may have occurred, examine early to have correct thinking rather than going off memory.
Any I missed that you see for application down the road? 
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