One big part of my cycling endeavours is maintaining an injury free body. In this case I’d like to share a story with you regarding my Achilles tendon. Please be aware that this is not to be understood as medical advice. If you have similar issues please consult with your doctor. At best this could spark some insparation.
This picture is particularly nasty as it doesn’t just show the swollen area around the achilles tendon but also a really uncomfortable allergic reaction and on top of that there was still a lot of water in my legs at the time when this picture was taken.
During the Transcontinental Race No 9, after approximately 2’000km or rougly 6 days, my Achilles tendon was swollen and I basically rode the remaining 1’800km with a squeaky ligament, which was about two to three times its normal width, approximately 4cm above the heel. Tendonitis is quite painful, so I chose to start taking painkillers at that point in the race. This is the very last resort for me. I’d never take painkillers during training and I absolutely want to avoid taking them during races. It is my opinion that injuries should be taken very serious and they shouldn’t be suppressed to push on, as that increases the chances of making things significantly worse.
After the race had finished I had thrown in an entire week off the bike, which for me, is quite a long time. As a result, most of the issues I had developed were gone and even the tendonitis was at a point where I thought it wouldn’t come back.
Back at home I resumed my usual training which almost exclusively consists of base training. During the week I cycle 100km per day – commuting 50km on way -, resulting in 3 to 4 hours of cycling daily. At the weekends, I usually go for longer rides – 4 to 8 hours – aiming for 20 to 25h of cycling per week. Over the years I figured, this is a training load I can deal with well, while still being productive at work.
In the coming months, I never got rid of the tendonitis entirely, and I couldn’t figure out its root cause. I started a stretching and foam rolling routine, causing relief at first but it didn’t help in the long run. During one of the foam rolling sessions, I realized that the muscle on the outside of my right shin, where it connects to the foot, was as hard as a rock. Rolling it was extremely painful, but I soldiered through, since I wanted to find out if this has a positive effect. It helped a little again but didn’t resolve the issue.
Another evening foam rolling my calves and feet, I decided to feel out all the little muscles, where the calf muscle and the Achilles tendon overlap in the ankle region, realising there was another spot that was rock hard on the inside of my right ankle about three centimeters above the heel. At this point I felt like I’m on to something or that I’m at least closing in on the issue. The rock hard muscle was right at the place where the tendonitis had started. I started massaging that spot, and again, it helped but did not resolve the problem.
Alongside all the massaging I kept observing how everything felt on the bike. I adjusted the cleat position, saddle height, bar height, … It all seemed to help a little at first, but a few days down the road, it was back to “normal”.
The image on the left shows – in an exaggerated way – how my foot drops inwards and downwards, when there is no arch support and the cleat is too far forward. The picture to the right shows a healthier foot position.
During yet another commute I started experimenting what pedaling feels like, forcing the arch of my foot up. This provided instant relief. About a week after that, I came to the conclusion that changing the insoles of my cycling shoes to ones with arch support pads could be worth a try. I put on the cycling shoes, climbed on the bike, started pedaling and it instantly felt much better.
About two weeks later it had turned out, that supporting the arch in my right foot didn’t fully solve the problem and the soleus muscle, started to swell on the inside and get rock hard again on the outside of the foot. This then sparked more thinking and it had me changing the cleat position until a few days into this I started moving the foot closer to the cranks or in other words reducing the Q-factor, while also rotating the heel a tiny amount outwards. This was another measure that provided instant relief.
For now it seems like the root cause for my tendonitis was a lack of arch support in combination with too wide a Q-factor (distance between the crank to the foot). As a result my foot “collapsed” inwards, overloading the muscle behind the ankle, which then became rock hard, rubbing on the Achilles tendon, causing the tendonitis. Furthermore supporting the arch stopped my knee from tracking inwards – towards the top tube – resulting in a leg movement that is more “in plane”.
I’m well aware of the fact that I could go and consult a doctor and/or a physiotherapist concerning such issues, which is what I’d recommend anybody in such a case. But if it’s not absolutely necessary I like the challenge of figuring these issues out myself and maybe this presentation of my journey has helped you in some way.
Have you had to deal with similar issues during you cycling carreer or do you currently suffer from chronic pain that’s related to your cycling activities? Let me know in the comments I’d be curious about the experience you all had.