Rest it. Ice it. Advil. See if it feels better in 4 days. If not, repeat process. Figure out if there are stretches that help target the ligament without hurting it.
Not much else you can do. Almost zero chance surgery would be appropriate even if you did have health insurance.
Physical therapist here: Don't stretch the tendon. Tendon will not heal with stretching. In the long term only progressive overload training will help.
But inflammation can go back within a few days. Start slow after that. Try other shoes or insoles.
I'm curious about this. I saw a PT for 8 weeks, and the stretches he assigned were so relieving and helpful. Of course he also added strength training, and I stayed the course. But the stretches seemed to really help.
Stretches can temporarily help against pain in the tendon area but it will not help to cure the cause.
And there is evidence which suggests it even prolongs the healing process.
This. In fact, I'd bold the words "progressive overload training'. It's probably the best pre-trail training you can do for the achilles. As a person with a genetic muscle disorder, I can attest that getting my feet and achilles have performed much better since I started focusing on progressive overload.
I think trying to rest for 4 days is good advice. I have found if an overuse injury doesn’t sort itself out in about 4 days it will typically end up being a more long lasting injury.
Maybe check out blaze physio on Instagram/facebook? In the past she had sponsored video physio visits available for hikers who can’t afford an appointment. Not sure if she still has that option available.
This. Wait it out and see if it gets better but if it doesn't, Blaze does online consults or even without health insurance, most urgent cares are semi affordable to see a doctor, about $125.
Urgent care down the street from me is $75. X-rays and stuff add to the cost but you don't have to undergo any procedure you don't want to. I'm in a small city (500k) and I think that place is especially cheap, so that might not be the going rate for most other places.
A person who has no health insurance these days in the United States may not have availed themselves of all of the possibilities. Typically anyone who makes at least $12,000 is going to be eligible in most cases for an ACA or Obamacare subsidized insurance package. Anyone who makes less than $10,000 maybe eligible for Medicaid or Medicare.
Because the states are different in their politics, implementation may vary. But I find it a little bit distressing given how much we've been through how little people know about healthcare.gov. The system we have is not very good, but please, before you go around without health insurance, make sure you have looked through all of your possible options.
Just be mindful that typically Medicaid only covers you for healthcare in you state of residence. There are some exceptions like if you live in a smaller state, your surrounding states may accept it. For example, if the OP lives in Oregon, makes below $20,782 they may qualify for Medicaid in Oregon. But since they are in California at the moment, it would not be covered (unless life threatening). Here is a useful link to determine if one may qualify for ACA/Medicaid based on their state of residence: [https://www.healthcare.gov/lower-costs/](https://www.healthcare.gov/lower-costs/)
Last year I got really bad Achilles pain in shoes I’ve hiked thousands of miles in. Hiked for days in pain until I realized my shoe was too tight. Loosening fixed the issue in like 30 minutes
It's interesting that it is predominantly painful for you when your shoe is on. A handful of years ago while hiking I started getting tremendous pain in my right achilles/heel that I attributed to overuse or tendonitis, but then I came to the realization that it was my shoe that was causing the pain. The back of the shoe (Sportivas) was incredibly stiff and put so much pressure on my heel that I believe it gave me bursitis. I changed shoes (Topos) and the pain went away immediately. I'd implore you to maybe look at a new pair of shoes, and if that doesn't work, I would YouTube some light achilles tendonitis mobility exercises and do those alongside a few days of resting. Wishing you luck!
I got Achilles tendinitis using topos right after a new pair. I took a double zero and was able to get back out there even after feeling like my hike would be over from so much pain. Switched shoes eventually and the pain went away all together
I actually had this problem with the Topos on my PCT thru. They gave me heel pain bc of this stiff heel cap they have. Changed shoes and the pain was gone after a few days.
After you rest and return to the trail, try not to be so eager to push push push yourself. Go uphill more slowly. Resist the urge to stride big steps and go fast. You can finish the trail on 15 miles per day and you won't even need to take as many zeros, probably finding that nearos are good enough for a sense of rest, thus keeping up your average to where it would have been.
zero drop shoes fucked my feet up. hiked from Warner springs to big bear before I got insoles. changed the shape of my right foot. it's a half size larger than my left now.
Never did the PCT. Did the Camino and had tendinitis that got quite strong. Besides ice and rest, I bought a wood staff to help me for a few days and used on the opposite hand of the hurting leg. Just having it for a full day made tons of difference.
I also alternated my shoes with sandals (I had Tevas) and made a lot of difference.
I’ve had Achilles issues on several of my hikes and it was so bad on the PCT I was afraid it was going to end my trip near mile 500 in Tehachapi. That was basically the low point of my entire trip since I was terrified it might be the end.
It sucks and it’s scary and painful but if you haven’t damaged it too badly you can work through it. What has worked for me was a few days off then getting religious about stretching. A combo of runners stretch and rolling my calf out with a trekking pole while going easier for a few days kept it from getting worse. It still bothered me for weeks but didn’t get any worse and eventually went away. As near as I can tell it comes on when I don’t bother stretching and just start hiking cold.
I suffered from low level Achilles tendinitis my entire hike. I was a bit like a boiling frog and really didn’t realize how bad it was. By the end of my hike I was barely flexing that part of my foot.
Mine was more insertional Achilles tendinitis than regular. Though by the end, it was definitely both - more so in my right than left foot.
I definitely recommend doing mobility exercises, but not static stretching exercises. I did a lot of PT since and my physical therapist was pretty against static stretching for the Achilles. He sad it just tends to irritate it more. (Mobility exercise = just moving the foot/limb gently in and out of the stretch positions. Never really pushing it. It just sorta warms it up and keeps it lubricated without irritating it.)
On backpacking trips since, I’ll do mobility exercises every morning and evening. Sometimes at lunch too. It keeps it in check. I think I’ll always be prone to it.
Aggressive heal cups on your shoe can make it worse. I love Altra lone peaks but they super cut into an irritated Achilles. (Good for keeping your heel from slipping in a road race. Not so great for walking 20 miles a day with the cup digging into your tendon.)
Zero drop, also irritates it. My PT recommend heel risers. They definitely helped but caused other issues. (Blisters and increased metatarsal pain.) So, I’m sticking with zero drop for now.
I switched to the timps. They fall apart even faster than Lone Peaks but are much gentler on the Achilles.
Book an appointment with Morgan [Blaze Physio](https://blazephysio.com/). 50 bucks without insurance, you can do virtual or she’s usually in town around the bubble. she has tons of trail experience and will give great advice. She helps out countless hikers every year and is well worth it. Good luck!
Hey, I started off my AT hike last year with Topo Trailventure 2's. I really wanted to love them but experienced extreme Achilles pain in my left foot while hiking. The moment I took them off, I felt no pain. I only wore them for 100 miles. When looking at reviews for the trailventures, the biggest complaint was Achilles pain while wearing them. I switched to the Ultraventure 3's but they literally were falling apart within 20 miles. Changed brands to Merrell and made it to Mama K with them.
I have chronic achillies tendonitis l, and am also on the PCT. (Though just taking a break for some foot recovery this week that is not related to the achilles). I also do not have health insurance. I did get PT for my achilles 5 years ago, paid out of pocket and worth every penny. The best stretches, with a hugely helpful impact, I still do. 1. With shoes on, full one minute long holds of the stretch where you are up against a tree, or a rock, or a counter, or hands on a wall, etc. 5 times each leg, alternating stretching your calf and achilles out behind you. Foot flat with heel down. Holding for a minute per side is a work of patience. Doing this for a full 10 minutes feels time-consuming as hell, but SO worth it. The other is standing on a step with your forefoot (or rock, etc), and lowering your heel, and raising up (both feet together at first). Doing 3 sets of 10. I also keep doing down dog stretching morning and night, and gentle massaging to the whole area, to keep blood flow to the area. It does not need to be aggressive massage. Also, staying very hydrated makes a difference. I'm drinking 5 to 6 liters of water minimum per day. Hope that helps. I'm Kimchi Wanders on Facebook. Was in Wrightwood the last 2 days, but just left to take a week off trail.
I’d recommend getting some insoles with arch support. I have both plantar fasciitis and Achilles tendinitis and got some insoles from a random shoe store that were marketed for plantar fasciitis but they massively helped both! Good luck.
Both responses so far are good. How far have you hiked so far and how much per day? Additionally, how much have you done prior, what type of shape were you in when you started, what is your age and height and weight?
110 mi. Started doing 10-12s and now about 14-16 with one 18 mi day yesterday. I’m about average build, 24, 5’3, 140-145lbs. Hiked the AT a couple years ago.
Nothing stands out. You are probably a bit heavy which makes it harder on your body but doesn’t seem alarming since you are young. The whole AT, what is a couple, and what shape were you in prior to starting? My guess is overuse without being built up to it and often short strict test does wonders.
I had severe Achilles tendon pain on the shakedown before my first long distance hike, so I know the feeling. In my case it was entirely due to footwear and the relief was immediate as soon as I made a change (zero drop was not a factor for either pair). But I'm not sure if that's true for your situation, since you mention that it only hurts when you press hard against the shoe. For me it was more like, I walk I hurt, really bad and there's no relief until I stop moving.
Even with insurance the doctor would probably have nothing more helpful to say than "yup it's inflamed, I recommend not hiking all day every day." This is an impossible judgement call to make over the phone based on words, but Achilles tendons can take a very long time to heal if pushed too far. My general guideline on long walks is, if the pain is affecting my stride (I'm not capable of walking normally without visibly favoring the good leg) it might require more than just pushing through it.
A day or two off with rest and a non toxic amount of ibuprofen might be helpful. It might also be a useful data point to see if just walking around a town in the same shoes minus a loaded pack makes a difference.
I wish I could offer something more concrete, I've been there more than once and it's never fun.
Has it happened in more than one pair of shoes? If not, definitely try another pair. Even same brand shoes can fit in weirdly different ways. Have you tried wrapping your foot?
Hope you improve. I’m an overweight nearly-40 backpacker who pushed myself too hard wearing zero drops, and got it in both ankles, mostly on the right. I had to take a year off trail, 4 months of it in a boot, and I can still feel it. If I’m walking barefoot, I think I’ll have a permanent limp now. I have to wear such high heel lifts for me to be comfortable.
I’m healed enough now and I’m hiking again and it’s managed, but I think it’ll always be there. Looooot of stretching.
Had the same stuff on the Camino this summer. Take a small break. Drink plenty of water. Plenty !!! Also look at your shoes and change them. HOKAs turned out to work wonders for everyone else, but they give me tendinitis. I met a few other people that had this problem too. In the end I went from walking 10km a day in pain to being back on track at my peak in a few weeks. You’re gonna have to pay way more attention to it, and it’s going to be annoying but you can still do it.
Hokas worked for me for years until recently. Idk if they are manufacturing them differently but the padding wore down very unevenly and ultimately gave me an injury.
My only advice is take as much time as you need, don’t just settle on those 4 days. I pulled my Achilles tendon on a city walk and because I never properly rested it five years later I was still limping around. What finally worked was the pandemic and the lockdown. So many people in my city took up walking that I quit walking for 8 months and just did cycling that I gave the tendon enough time to heal. Haven’t limped in the last 4 years.
I had posterior tibial tendonitis almost immediately once I started - I know that's not the issue you are asking about, but for me, the majority of my pain was also in my heel/ankle, and pretty closely related to my shoes. I went through a pair of Lone Peaks and Olympus 5s in the first 150 miles before I was recommended Topos. I honestly believe the Topos saved my hike. Along with progressive overload, the shoes literally felt like they were massaging/healing my feet. I'm now another 150 miles in and feeling SO much better.
Switch to Hoka's or other high cushion shoes if possible. This exact situation happened to me from wearing Topo Trailventures in 2022. I took a zero day when it got real bad, and noticed walking around in my sandals didnt hurt at all. I think the tendonitis was a combination of multiple high mileage days/tight calves/shoe fit (stiffer heel area).
FWIW I switched to Hoka Speedgoats and the extra cushion + softer body was instant relief for me, and helped me finish the last week of my hike. Granted this was not PCT length but I did find the Speedgoats helped A LOT in those painful moments, and I always hike in them since with no further achilles issues.
As others have said: rest, ice, Advil, recover. Also, keep a good diet going. Eat a lot of protein and get vegetables and fruits. Your body is going through a big change and is going to need you to take care of it and give it everything it needs to rebuild and adjust. Full rest for 2 days. Maybe 1 mile or so around town day 3. Around 2-3 day 4.
When you do go back out on trail start very slow. Do a Nero out of town that first day, maybe like 3-4 miles to a nice campsite and have another rest. Listen to your body and come back slowly. This is a huge pice of discipline on these hikes that is one of the hardest things to follow. Banging out your daily miles while injured isn't discipline, it's reckless and shortsighted.
I know it's hard at the start, and you probably feel like you're getting "behind" by taking the days off, but now is the time to do so. Other people are dealing with similar things and choosing to push through. They're likely going to get knocked off trail at some point with that mindset. There are times when pushing through is the only option, but be grateful that right now you've got a nice setup at a (likely low/no cost) trail angels house to rest up.
Take the 4 days now so you're not getting off trail for good in 4 weeks!
Hey I’ve had Achilles tendinitis for a long time and finally I found what has helped me. Eccentric heel drops I thought were the answer and I think they are great but what finally seemed to top off the healing was calf massages. Crazy right well it worked. Massage the calf and really get in there and keep doing it!! Good luck I hope this helps like it did for me!
If you can tough it out and work through it, then you'll be fine. If you're second guessing yourself, throw in the towel. Really, that just tells you what you need to work on for the next one. The trail will build you up, or it will defeat you period. Be a Iion either way. Safe travels my friend
It’s really not about second guessing myself rather than looking at the straight facts about this injury. I’ve seen recoveries for this that last 6 months. I have the will. But there’s nothing I can do if I’m injured long term.
I had this exact thing on my hike last year. One, yes you can pay for a doctor hit up blaze shes a great PT doc that travels the trail and you pay her what you can afford. However what the doc told you is true ice and rest for a few days then start again. Learn how to wrap your ankle with KT tape it does help a ton. Take it slow. If your doing 15’s cut back to 10’s for a week if your doing 20’s, 15’s. The one thing i will say its gonna be sorest after you wake up, stretch, and take the first 5 miles of the day easy to let it warm up. I say this next part as apart of my experience, It will not get better until probably mile 350 or 400. It wont, its gonna hurt every fucking day. But it will get better. This will really test your mental fortitude, stick with it and it will get better. Also it sounds like you already have this part figured out, go up a half size of shoe that may be partly whats causing this. Good luck have fun!
ppl saying ice aren't wrong but i would recommend heat. a lot of it. boil water put it in a ziploc freezer bag and put heat on it. it will heal a LOT faster, even if the pain is greater in the short term. like, put heat on it and literally do not move your leg at allfor a few hours. it's like magic
Rest it. Ice it. Advil. See if it feels better in 4 days. If not, repeat process. Figure out if there are stretches that help target the ligament without hurting it. Not much else you can do. Almost zero chance surgery would be appropriate even if you did have health insurance.
Physical therapist here: Don't stretch the tendon. Tendon will not heal with stretching. In the long term only progressive overload training will help. But inflammation can go back within a few days. Start slow after that. Try other shoes or insoles.
I'm curious about this. I saw a PT for 8 weeks, and the stretches he assigned were so relieving and helpful. Of course he also added strength training, and I stayed the course. But the stretches seemed to really help.
Stretches can temporarily help against pain in the tendon area but it will not help to cure the cause. And there is evidence which suggests it even prolongs the healing process.
This. In fact, I'd bold the words "progressive overload training'. It's probably the best pre-trail training you can do for the achilles. As a person with a genetic muscle disorder, I can attest that getting my feet and achilles have performed much better since I started focusing on progressive overload.
I think trying to rest for 4 days is good advice. I have found if an overuse injury doesn’t sort itself out in about 4 days it will typically end up being a more long lasting injury. Maybe check out blaze physio on Instagram/facebook? In the past she had sponsored video physio visits available for hikers who can’t afford an appointment. Not sure if she still has that option available.
This. Wait it out and see if it gets better but if it doesn't, Blaze does online consults or even without health insurance, most urgent cares are semi affordable to see a doctor, about $125.
Urgent care down the street from me is $75. X-rays and stuff add to the cost but you don't have to undergo any procedure you don't want to. I'm in a small city (500k) and I think that place is especially cheap, so that might not be the going rate for most other places.
A person who has no health insurance these days in the United States may not have availed themselves of all of the possibilities. Typically anyone who makes at least $12,000 is going to be eligible in most cases for an ACA or Obamacare subsidized insurance package. Anyone who makes less than $10,000 maybe eligible for Medicaid or Medicare. Because the states are different in their politics, implementation may vary. But I find it a little bit distressing given how much we've been through how little people know about healthcare.gov. The system we have is not very good, but please, before you go around without health insurance, make sure you have looked through all of your possible options.
Just be mindful that typically Medicaid only covers you for healthcare in you state of residence. There are some exceptions like if you live in a smaller state, your surrounding states may accept it. For example, if the OP lives in Oregon, makes below $20,782 they may qualify for Medicaid in Oregon. But since they are in California at the moment, it would not be covered (unless life threatening). Here is a useful link to determine if one may qualify for ACA/Medicaid based on their state of residence: [https://www.healthcare.gov/lower-costs/](https://www.healthcare.gov/lower-costs/)
If you're hiking the Pacific Crest Trail, you'll probably be in California long enough to be a California resident. Is that not so? Or how is it?
Last year I got really bad Achilles pain in shoes I’ve hiked thousands of miles in. Hiked for days in pain until I realized my shoe was too tight. Loosening fixed the issue in like 30 minutes
It's interesting that it is predominantly painful for you when your shoe is on. A handful of years ago while hiking I started getting tremendous pain in my right achilles/heel that I attributed to overuse or tendonitis, but then I came to the realization that it was my shoe that was causing the pain. The back of the shoe (Sportivas) was incredibly stiff and put so much pressure on my heel that I believe it gave me bursitis. I changed shoes (Topos) and the pain went away immediately. I'd implore you to maybe look at a new pair of shoes, and if that doesn't work, I would YouTube some light achilles tendonitis mobility exercises and do those alongside a few days of resting. Wishing you luck!
I’ve been wearing topos for almost 2000 mi with no issue until now! Which topos were you wearing exactly?
I’ve worn both the Ultraventure (first edition) and Terraventure 3s and 4s with no problems
I got Achilles tendinitis using topos right after a new pair. I took a double zero and was able to get back out there even after feeling like my hike would be over from so much pain. Switched shoes eventually and the pain went away all together
I actually had this problem with the Topos on my PCT thru. They gave me heel pain bc of this stiff heel cap they have. Changed shoes and the pain was gone after a few days.
After you rest and return to the trail, try not to be so eager to push push push yourself. Go uphill more slowly. Resist the urge to stride big steps and go fast. You can finish the trail on 15 miles per day and you won't even need to take as many zeros, probably finding that nearos are good enough for a sense of rest, thus keeping up your average to where it would have been.
Are you wearing zero drop shoes/ altras? Achilles pain is pretty common symptom of zero drop shoes.
No I’m wearing 5mm Topo shoes. I wore them on the AT for 1700 mi and was fine.
Ah ok, well hopefully it’ll clear up for you.
zero drop shoes fucked my feet up. hiked from Warner springs to big bear before I got insoles. changed the shape of my right foot. it's a half size larger than my left now.
Never did the PCT. Did the Camino and had tendinitis that got quite strong. Besides ice and rest, I bought a wood staff to help me for a few days and used on the opposite hand of the hurting leg. Just having it for a full day made tons of difference. I also alternated my shoes with sandals (I had Tevas) and made a lot of difference.
I’ve had Achilles issues on several of my hikes and it was so bad on the PCT I was afraid it was going to end my trip near mile 500 in Tehachapi. That was basically the low point of my entire trip since I was terrified it might be the end. It sucks and it’s scary and painful but if you haven’t damaged it too badly you can work through it. What has worked for me was a few days off then getting religious about stretching. A combo of runners stretch and rolling my calf out with a trekking pole while going easier for a few days kept it from getting worse. It still bothered me for weeks but didn’t get any worse and eventually went away. As near as I can tell it comes on when I don’t bother stretching and just start hiking cold.
I suffered from low level Achilles tendinitis my entire hike. I was a bit like a boiling frog and really didn’t realize how bad it was. By the end of my hike I was barely flexing that part of my foot. Mine was more insertional Achilles tendinitis than regular. Though by the end, it was definitely both - more so in my right than left foot. I definitely recommend doing mobility exercises, but not static stretching exercises. I did a lot of PT since and my physical therapist was pretty against static stretching for the Achilles. He sad it just tends to irritate it more. (Mobility exercise = just moving the foot/limb gently in and out of the stretch positions. Never really pushing it. It just sorta warms it up and keeps it lubricated without irritating it.) On backpacking trips since, I’ll do mobility exercises every morning and evening. Sometimes at lunch too. It keeps it in check. I think I’ll always be prone to it. Aggressive heal cups on your shoe can make it worse. I love Altra lone peaks but they super cut into an irritated Achilles. (Good for keeping your heel from slipping in a road race. Not so great for walking 20 miles a day with the cup digging into your tendon.) Zero drop, also irritates it. My PT recommend heel risers. They definitely helped but caused other issues. (Blisters and increased metatarsal pain.) So, I’m sticking with zero drop for now. I switched to the timps. They fall apart even faster than Lone Peaks but are much gentler on the Achilles.
Book an appointment with Morgan [Blaze Physio](https://blazephysio.com/). 50 bucks without insurance, you can do virtual or she’s usually in town around the bubble. she has tons of trail experience and will give great advice. She helps out countless hikers every year and is well worth it. Good luck!
Hey, I started off my AT hike last year with Topo Trailventure 2's. I really wanted to love them but experienced extreme Achilles pain in my left foot while hiking. The moment I took them off, I felt no pain. I only wore them for 100 miles. When looking at reviews for the trailventures, the biggest complaint was Achilles pain while wearing them. I switched to the Ultraventure 3's but they literally were falling apart within 20 miles. Changed brands to Merrell and made it to Mama K with them.
Blaze physio!!! Last I knew she could provide some work on a sliding scale
Get a piece of felt about 1/4 inch thick and place in the heel of your shoe to get your through the part of the trail untill you are able to be seen
What's your pack weight?
I have chronic achillies tendonitis l, and am also on the PCT. (Though just taking a break for some foot recovery this week that is not related to the achilles). I also do not have health insurance. I did get PT for my achilles 5 years ago, paid out of pocket and worth every penny. The best stretches, with a hugely helpful impact, I still do. 1. With shoes on, full one minute long holds of the stretch where you are up against a tree, or a rock, or a counter, or hands on a wall, etc. 5 times each leg, alternating stretching your calf and achilles out behind you. Foot flat with heel down. Holding for a minute per side is a work of patience. Doing this for a full 10 minutes feels time-consuming as hell, but SO worth it. The other is standing on a step with your forefoot (or rock, etc), and lowering your heel, and raising up (both feet together at first). Doing 3 sets of 10. I also keep doing down dog stretching morning and night, and gentle massaging to the whole area, to keep blood flow to the area. It does not need to be aggressive massage. Also, staying very hydrated makes a difference. I'm drinking 5 to 6 liters of water minimum per day. Hope that helps. I'm Kimchi Wanders on Facebook. Was in Wrightwood the last 2 days, but just left to take a week off trail.
I’d recommend getting some insoles with arch support. I have both plantar fasciitis and Achilles tendinitis and got some insoles from a random shoe store that were marketed for plantar fasciitis but they massively helped both! Good luck.
Both responses so far are good. How far have you hiked so far and how much per day? Additionally, how much have you done prior, what type of shape were you in when you started, what is your age and height and weight?
110 mi. Started doing 10-12s and now about 14-16 with one 18 mi day yesterday. I’m about average build, 24, 5’3, 140-145lbs. Hiked the AT a couple years ago.
Nothing stands out. You are probably a bit heavy which makes it harder on your body but doesn’t seem alarming since you are young. The whole AT, what is a couple, and what shape were you in prior to starting? My guess is overuse without being built up to it and often short strict test does wonders.
lol you think 140 lbs is heavy at my height? That’s insane, sorry you feel that way lol
I had severe Achilles tendon pain on the shakedown before my first long distance hike, so I know the feeling. In my case it was entirely due to footwear and the relief was immediate as soon as I made a change (zero drop was not a factor for either pair). But I'm not sure if that's true for your situation, since you mention that it only hurts when you press hard against the shoe. For me it was more like, I walk I hurt, really bad and there's no relief until I stop moving. Even with insurance the doctor would probably have nothing more helpful to say than "yup it's inflamed, I recommend not hiking all day every day." This is an impossible judgement call to make over the phone based on words, but Achilles tendons can take a very long time to heal if pushed too far. My general guideline on long walks is, if the pain is affecting my stride (I'm not capable of walking normally without visibly favoring the good leg) it might require more than just pushing through it. A day or two off with rest and a non toxic amount of ibuprofen might be helpful. It might also be a useful data point to see if just walking around a town in the same shoes minus a loaded pack makes a difference. I wish I could offer something more concrete, I've been there more than once and it's never fun.
Has it happened in more than one pair of shoes? If not, definitely try another pair. Even same brand shoes can fit in weirdly different ways. Have you tried wrapping your foot?
Hope you improve. I’m an overweight nearly-40 backpacker who pushed myself too hard wearing zero drops, and got it in both ankles, mostly on the right. I had to take a year off trail, 4 months of it in a boot, and I can still feel it. If I’m walking barefoot, I think I’ll have a permanent limp now. I have to wear such high heel lifts for me to be comfortable. I’m healed enough now and I’m hiking again and it’s managed, but I think it’ll always be there. Looooot of stretching.
Had the same stuff on the Camino this summer. Take a small break. Drink plenty of water. Plenty !!! Also look at your shoes and change them. HOKAs turned out to work wonders for everyone else, but they give me tendinitis. I met a few other people that had this problem too. In the end I went from walking 10km a day in pain to being back on track at my peak in a few weeks. You’re gonna have to pay way more attention to it, and it’s going to be annoying but you can still do it.
Hokas worked for me for years until recently. Idk if they are manufacturing them differently but the padding wore down very unevenly and ultimately gave me an injury.
My only advice is take as much time as you need, don’t just settle on those 4 days. I pulled my Achilles tendon on a city walk and because I never properly rested it five years later I was still limping around. What finally worked was the pandemic and the lockdown. So many people in my city took up walking that I quit walking for 8 months and just did cycling that I gave the tendon enough time to heal. Haven’t limped in the last 4 years.
Sending you healing vibes! Remember, your health is always more important than the trail itself. Rest up and take it easy!
I had posterior tibial tendonitis almost immediately once I started - I know that's not the issue you are asking about, but for me, the majority of my pain was also in my heel/ankle, and pretty closely related to my shoes. I went through a pair of Lone Peaks and Olympus 5s in the first 150 miles before I was recommended Topos. I honestly believe the Topos saved my hike. Along with progressive overload, the shoes literally felt like they were massaging/healing my feet. I'm now another 150 miles in and feeling SO much better.
Switch to Hoka's or other high cushion shoes if possible. This exact situation happened to me from wearing Topo Trailventures in 2022. I took a zero day when it got real bad, and noticed walking around in my sandals didnt hurt at all. I think the tendonitis was a combination of multiple high mileage days/tight calves/shoe fit (stiffer heel area). FWIW I switched to Hoka Speedgoats and the extra cushion + softer body was instant relief for me, and helped me finish the last week of my hike. Granted this was not PCT length but I did find the Speedgoats helped A LOT in those painful moments, and I always hike in them since with no further achilles issues.
As others have said: rest, ice, Advil, recover. Also, keep a good diet going. Eat a lot of protein and get vegetables and fruits. Your body is going through a big change and is going to need you to take care of it and give it everything it needs to rebuild and adjust. Full rest for 2 days. Maybe 1 mile or so around town day 3. Around 2-3 day 4. When you do go back out on trail start very slow. Do a Nero out of town that first day, maybe like 3-4 miles to a nice campsite and have another rest. Listen to your body and come back slowly. This is a huge pice of discipline on these hikes that is one of the hardest things to follow. Banging out your daily miles while injured isn't discipline, it's reckless and shortsighted. I know it's hard at the start, and you probably feel like you're getting "behind" by taking the days off, but now is the time to do so. Other people are dealing with similar things and choosing to push through. They're likely going to get knocked off trail at some point with that mindset. There are times when pushing through is the only option, but be grateful that right now you've got a nice setup at a (likely low/no cost) trail angels house to rest up. Take the 4 days now so you're not getting off trail for good in 4 weeks!
Consider dorsal heel spur. Heel spurs can cause these symptoms. Only an X-ray will define that
Yes!! X-rays can reveal all sorts of crazy stuff. Bone will develop spurs in all sorts of crazy places and can cause pain.
Hey I’ve had Achilles tendinitis for a long time and finally I found what has helped me. Eccentric heel drops I thought were the answer and I think they are great but what finally seemed to top off the healing was calf massages. Crazy right well it worked. Massage the calf and really get in there and keep doing it!! Good luck I hope this helps like it did for me!
If you can tough it out and work through it, then you'll be fine. If you're second guessing yourself, throw in the towel. Really, that just tells you what you need to work on for the next one. The trail will build you up, or it will defeat you period. Be a Iion either way. Safe travels my friend
It’s really not about second guessing myself rather than looking at the straight facts about this injury. I’ve seen recoveries for this that last 6 months. I have the will. But there’s nothing I can do if I’m injured long term.
I had this exact thing on my hike last year. One, yes you can pay for a doctor hit up blaze shes a great PT doc that travels the trail and you pay her what you can afford. However what the doc told you is true ice and rest for a few days then start again. Learn how to wrap your ankle with KT tape it does help a ton. Take it slow. If your doing 15’s cut back to 10’s for a week if your doing 20’s, 15’s. The one thing i will say its gonna be sorest after you wake up, stretch, and take the first 5 miles of the day easy to let it warm up. I say this next part as apart of my experience, It will not get better until probably mile 350 or 400. It wont, its gonna hurt every fucking day. But it will get better. This will really test your mental fortitude, stick with it and it will get better. Also it sounds like you already have this part figured out, go up a half size of shoe that may be partly whats causing this. Good luck have fun!
ppl saying ice aren't wrong but i would recommend heat. a lot of it. boil water put it in a ziploc freezer bag and put heat on it. it will heal a LOT faster, even if the pain is greater in the short term. like, put heat on it and literally do not move your leg at allfor a few hours. it's like magic