A question from a member cyclist in my riding club
Matt,
Achilles tendonitis…got it during a hilly ride. After a couple weeks of ice for swelling and a disgusting grinding, creaking sound it’s getting better. Have not been back on bike yet though. I was told I may need to change location of my cleat. Thoughts?
The Cypress challenge is approaching and we’ll see a few of these Achilles flare ups in the clinic over the next several months as training ramps up.
In cycling, this condition usually comes as a result of too much force through the pedal in hill climbing. Some riders also overuse the ankle, having an exaggerated toe down position which overloads the Achilles. Onset can be over several rides or, as in this case, can come on after a single tough ride.
First aid means first and foremost rest. Regular icing, NSAID’s like Advil and a temporary heel lift will all help speed the settling down.
From a Physio perspective, length needs to be restored in the calf complex. Stretches, massage and rolling the muscles all help, as can IMS (Intramuscular Stimulation) therapy. An eccentric exercise protocol is usually needed to restore full tendon flexibility.
The question specifically asks about cleat placement. From a Bike Fit perspective, moving the cleats back on the shoes will shorten the cleat to Achilles distance and reduce the load on the Achilles. I’d also be checking saddle height. Too high can force the aforementioned “ankling” or toe point and that would invite a whole new episode as training ramps up again. In addition, a better insole might be needed to help control the foot position inside the shoe, relieving the lateral side to side whipsaw strain on the tendon.
See you all out on the road and keep the rubber side down.
Matt Powell
Matt Powell and Jen Macpherson are physiotherapists, bike fitters and club riders.
You can find us at West 4th Physiotherapy Clinic in Kitsilano.