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 Post subject: Achilles tendonitis bummer
PostPosted: Fri May 27, 2011 10:41 am 
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Joined: Thu Oct 14, 2010 10:24 pm
Posts: 75
Location: Seattle, Wa/Chamonix, France
Hey Everyone! Looks as though I've have had achilles tendonitis for 3 months and can't get rid of it! I've shredded once in the past 2 months (Baker attempt) I tried to give it a rest but it came back bigger and more painful than evar! The physical therapist says I need new boots. My boots are the K2 Affair, with the boa system that locks your heel into the back of the boot. I got these boots because they were the stiffest most aggressive women's boot I could find. Most snowboard boots I've worn pinch you in the achilles to make your heel stay secured in the boot. With all the touring I've done, that pinching sensation along with the rubbing from the up and down motion of touring has f*$ked my ankle. I'm sad.

Can anyone recommend a snowboard boot that doesn't pinch the back of your ankle? I was thinking about putting ski boot liners in my snowboard boots? Someone mentioned getting a AT boot, would they work with my splitboard? I started skiing in Cham because I couldn't snowboard and ski boots didn't hurt it at all. I really don't want to have to start skiing so please if you have any ideas or advice on boots or liners it would be much appreciated! I really want to shred some volcanoes in Wa before I go to Utah for the summer! Thanks guys! Ciao!

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Fri May 27, 2011 11:34 am 
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Joined: Tue Mar 15, 2005 5:06 pm
Posts: 167
Location: Mt Shasta
I switched to hard boots under similar circs: had the K2 T1's (sold them here) but couldn't eliminate the heel rub, which, though I didn't get a tendon issue from, constantly created blisters from the up down heel rub. The rub, I've come to conclude, is the result of insufficient ankle flex to allow the heel to stay put while hiking: softer flex boots allow your ankle to flex as it was designed to eliminating the up down reaction when stiff boots eliminate the hinge that is your ankle joint.

My thoughts about the ill effect of too little ankle flex was confirmed when (after 3 years in the same hard boots with no issues) I accidentally skinned myself into a nasty left heel blister. I was perplexed until I realized I'd forgot to check if the boots were in walk mode: the left boot was in ski mode and the right in walk mode (duh).

You might not like hardboots but its worth a try, if not a more forgiving soft boot might achieve the same result.

Good luck working this nasty problem out.


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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Fri May 27, 2011 9:18 pm 
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Joined: Wed Mar 23, 2005 10:05 am
Posts: 1519
Location: Colorado
Liz: I am very sorry to hear that your problem is on going, but I am glad to hear that at least you have not ended up rupturing your achilles. First, I would suggest a nice long rest to get your achilles fully healed and all the inflammation gone. I would consult at least a good physical therapist to help you with this. Then I would suggest making sure you have plenty of flexibility in the achilles, and then all the way up through your calves, hamstrings, glutes, and lower back. A physical therapist and massage therapists can help with this, or you can work on it yourself.
I suspect that splitboarding is hard on these areas, and tends to make them tighten up, lack of flexibility can lead to overuse injuries.
Once you are healed, fit, and flexible, revisit everything about your set up. I prefer a very soft AT boot and Dynafit toe pieces, and also feel that this set up is a little easier on the body (certainly rando skiers seem to get in plenty of vert without a lot of problems). If you want to stay with soft boots, I am sure you can get them to work well also-but either way, I would suggest that you work with the best bootfitter you can find, and make sure this bootfitter has a lot of experience working with backcountry skiers/snowboarders, as the needs of skinning are quite different from those of just riding lifts. A custom moldable liner and footbed, in the softboot outer of your choice, fitted by a skilled bootfitter, should alleviate your problems. In softboots, I would recommend checking out Deeluxe's top level boots, they come with quality moldable liners.
I am sure you know this already, but I'll mention it for anyone reading-always use your heelifters when climbing to reduce the strain on the achilles.
For specific advice on AT boots, see my posts on the Dynafit TLT5 in the boots forum, after reading that, if you have questions, please ask them in that thread. Do not believe the folks who say that hard boots do not ride well, they can be made (with mods) to ride anyway that you would like.

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Fri May 27, 2011 10:11 pm 
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Joined: Fri Oct 23, 2009 9:38 pm
Posts: 819
Location: The Belly of Ham baby!!
LizDee!

Bummer dude!

I have some ideas for you.

1) Is your PT familiar with ski/splitboard touring? Are you sure its to do with "pinching" of your achilles?

Tendonitis (aka a "tendonosis") is usually caused by excessive microtraumas that don't have time to heal. When we tour, we put our achilles in an excessive stretch for super long periods of time. I would recommend getting a dual heel riser that allows you to get more heel lift on on the up.

2) What kind of exercises/therapies are you doing for it? Is your PT doing ultrasound? Eccentric loading?

I wrote a review last year on this stuff. There's a lot of evidence that inactivity is no good for tendonitis. Eccentric loading of the musculotendinous junction seems to be the key statisical predictor for proper remodeling of those tissues. At the same time, you wanna be super careful not to reverse healing once you've seen progress.

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Thu Jun 02, 2011 7:40 am 
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Joined: Mon Oct 19, 2009 9:18 pm
Posts: 590
Location: reno
Boot stiffness is proportional to your size. Weighing in at around 135-140 with narrow feet, I don't require a boot quite as stiff as the people I tour with. I switched from the stiffer Salomon F24's to a pair of kickass RFL's (upgraded liner I think. Russman knows which ones) and all my foot problems went away, not to mention they are really effing light! :lol: However, with all this pow, they have not been really tested in spring conditions ie pointing it yet.

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 Post subject: Re: Achilles tendonitis bummer - try Spark R&D Deeluxe boots???
PostPosted: Fri Jun 03, 2011 1:27 pm 
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Joined: Tue May 03, 2011 2:16 am
Posts: 108
Location: New Zealand
Hi, sorry to hear your archillies is not good, look after it well for a good recovery! Hey just a thought have a look a the soon to be released Spark R&D / Deeluxe Splitboarding boot. My understanding is these are sub 1100g per boot, so very very light compared with any other snowboard or AT boot, they are reasonably stiff (not ultra but a good ride) oh yeah thats right they are a purpose built Splitboard boot too!!!!! The sole is a beautiful Vibram boot sole - proper sole for climbing and walking in the mountains and snow, the outer is beefed up a bit to take some grief, and they have a moisture membrane to let them breathe a bit but not let the water in. The sole takes a mountaineering crampon just fine too! They kick steps very well apparantly.

Check the pics these are going to rock! Perfect. Photo's are on the Spark R&D Facebook page http://www.facebook.com/pages/Spark-RD/171487301612 and also keep an eye on the Spark R&D website http://www.sparkrandd.com/ as products come online.

These boots will be out for the Northern Hemisphere upcoming season and I have ordered a pile of them down into New Zealand for this 2011 winter.

Good luck with you heel, hope it gets better soon.

Cheers
Rich

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Fri Jun 03, 2011 2:59 pm 
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Joined: Tue Feb 21, 2006 1:57 am
Posts: 1110
Location: Santa Barbara, CA/Ashland, OR
bummer Liz. :banghead:

I got nothing to offer that your PT and these other nerds couldn't. I'll just tell you that using anti-inflamatories as AIs and not as Analgesics (merely for the pain) was key to solving the tendonitis problems I've had. Taking the AIs only when you're in pain is only getting part (the least therapeutic part) of their intended effect(s).

Best of luck to you. Stretch, rehab, think positive. I know lots of splitters dealing with injury at this point in the season, so you're in good company.

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Mon Jun 06, 2011 1:00 am 
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Joined: Fri Nov 19, 2004 8:41 pm
Posts: 1622
Location: Santa Cruz, CA
Well that sucks. But, you made a really important discovery which is that it doesn't hurt in ski boots! Seems pretty clear then that *something* about your current boots is what is causing the problem, not necessarily a core issue with your achilles. Obviously something in the boot is irritating it when you use your snowboard boots. If you don't use the snowboard boot but do the same thing (i.e. skinning), it doesn't hurt. I assume when you said you went skiing that you were doing bc skiing and actually skinning; if that's not the case then this may not apply.

So, figure out what part of the boot is causing the problem. Could be that a different liner could help. Are these new boots, or did you use them a long time before they ever caused a problem? If the latter, check and make sure the inner BOA cable isn't somehow misaligned. Storn had something happen where one of the cables got moved slightly from where it was supposed to be and it started causing all sorts of pain. Also, some boots have those removable "J-bars" that help lock the ankle down, if yours has those you could try removing them.

I've had achilles issues on a couple occasions. Both times it was due to the shell of the boot breaking down and developing a slight kink behind my achilles, right at the base of the calf (2-3 inches up from the heel). I think in both cases they were Burton Ions, and in both cases getting new boots solved it.


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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Fri Jun 10, 2011 11:49 pm 
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Joined: Thu Nov 04, 2010 10:13 pm
Posts: 208
This is going to be controversial, but here it goes:

Start running barefoot. If you have to - walk barefoot first, on level asphalt. 1 mile, and then build up - gradually.

Many people and doctors will tell you that this will worsen your issues. Speaking from personal experience, it may actually help. But you have to do it gradually. Of course, this opinion is worth what you pay for it :)

You need to start slow / low mileage

Best
Ivo


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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Sat Jun 11, 2011 7:57 am 
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Joined: Wed Mar 23, 2005 10:05 am
Posts: 1519
Location: Colorado
Ivo: Yeah, that advice does sound controversial! I do not want to discount your experience though. I wonder if the low heel inherent in snowboard boots contributes to Liz's problem. Ski boots, AT boots, and mountaineering boots all feature a raised heel, and it has been my impression that a raised heel puts less stress on the achilles tendon. Certainly barefoot running would be contrary to the raised heel theory.
Ivo: do you actually have personal experience of barefoot running solving achilles tendonitis problems?
I also think if you are going to recommend trying barefoot running, some advice on technique would be appreciated-for example, I am assuming that the barefoot runner lands the ball of the foot rahter than the heel? I am curious to hear more about your experience.

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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Sat Jun 11, 2011 4:13 pm 
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Joined: Thu Nov 04, 2010 10:13 pm
Posts: 208
Hi Barrows -

first, thanks for the tip to talk to Bola, I just heard from him, he has ordered my boots :)

On to the barefoot topic: my post was intended to present the possibility, then the person should research on her own and make a decision to try or not. My statement that this is just an opinion, and a free one was meant to be a disclaimer of sorts.

The answers:
I was never 'officially' diagnosed. When my running mileage increased (years ago) I experienced what I thought was AT, and also sharp pain in knees. I try to avoid doctors and researched on my own. My problems were solved by gradual barefoot walking and running. To give an idea of my 'investment' and experience - my longest was a barefoot half marathon on asphalt, so not too much, compared to people who do barefoot marathons routinely. I have stopped running regularly since then, but still do the occasional 5k barefoot or in Luna huaraches (very minimal, less than 1cm plain leather and Vibram level sole) without any issues (just reminding myself that I need to run more and get n better shape).

In general, AT seems to be caused by a weak calf that cannot do its job, and barefoot walking and running works to develop and strengthen the calves in new ways that shoes prevent. The 'evolution' explanation: we were optimized to walk and run barefoot, we did this for a very long time before shoes, and now our shoes change the way we walk and run in ways that are not matched to our bodies. E.g. the calves do not stretch as intended and are artificially weakened.

Being barefoot, even in your room, does stretch the calves and Achilles tendon, so should be done very gradually. Some recommend a 10 min walk on grass or asphalt as a start, but I personally would try to do more - like 20-30 min, if you can.

Technique is really important - and yes, you do land on the ball vs. heel. Heck, you can't run any meaningful distance and land on the heel even if you wanted - the pain would make you stop pretty quickly. But if a person has serious AT, she would not be able to run - that's why I said walking. Other parts of technique are the 'falling forward' dynamic balance and not over-extending but using shorter steps and higher cadence. The key is to be relaxed and light on your feet. These points are not too easy to explain, but there are internet groups (runningbarefoot yahoo group) and now even a book, from what I hear.

Bottom line is that I suggest this approach from my personal experience, but I'm a dude on the internetz, and every one of us has the responsibility to research and make a choice / decision.

Best!
Ivo


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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Sat Jun 11, 2011 4:25 pm 
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Joined: Wed Mar 23, 2005 10:05 am
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Location: Colorado
Thanks Ivo! It is always interesting to hear new perspectives on things.

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Quiver Killer inserts

http://protectourwinters.org/
http://14ersnowboardproject.homestead.com/


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 Post subject: Re: Achilles tendonitis bummer
PostPosted: Sun Jun 12, 2011 6:55 am 
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Joined: Sun Aug 23, 2009 5:56 am
Posts: 42
Location: Melbourne, Australia
Liz,
I would suggest having a look at Earth shoes. I have prescribed them for many patients with feet/tendon complaints and they have worked very well in slowly stretching the tendon over time whilst addressing arch issues that commonly complicate tendon issues.

K2's liner design/injection mould was a bit of an issue when i had some K2 proofs years ago. The actual liner achilles area had a visual kink in it which bowed and aggravated the tendon whilst hiking. The fit around the achilles was too tight as well. Not a good design. Heel lock felt great in the shop.
Maybe not tested on people that hike for lines.
3 weeks of hell and anti inflam whilst in Gulmarg.

Traumeel cream and traumeel/zeel injections work very well.
You would have to see someone who practices biomesotherapy/biopuncture to get the injections.

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