I am in fact, in the middle of a relapse now. I have this Achilles tendon pain that I've had for around 3 weeks now. It happened right after a very hard run workout. My mind bounces back and forth from thinking it's a real physical injury to thinking that it must be a PPD/TMS symptom. Sometimes I will run through it sometimes I take a day off. When I run, I usually don't feel the pain. When I'm walking, I feel it. I visualize an inflamed tendon one minute, and I visualize a healthy, strong tendon the next. I vacillate between positive and negative thoughts. It really can be a challenge mentally so I understand where you're coming from.
What I'm doing now is stepping up my journaling a little more than normal and I'm practicing mindfulness meditation and sitting with my feelings. I"m using affirmations to reinforce a PPD/TMS diganosis. I also am taking it a little easier and running just a little bit less than usual with less intensity, but still running. It doesn't hurt while I run so I feel that it's ok. I do ice afterward to reduce inflammation. And I am taking ibuprofen to reduce inflammation. I'm sort of throwing everything I know of at this issue, treating from a physical and mental perspective with the intention of resolving it while also continuing my physical activities to some degree. And while my running intensity has been reduced purposefully, I have not reduced my frequency or intensity of my bike rides (which are very intense 1 hour sessions).
This is going to be a long post to this thread.... but I think it's worth it.
I thought I would post an update in this thread on how I ultimately overcame this Achilles pain / PPD relapse. This is, of course, my own personal experience and others may ultimately get over such things differently, but I want to post this a "real person's" experience. Sometimes I don't believe it myself... how this all works.
Going back to my earlier post... when I posted the above on March 23rd, it had already been 19 days since I woke up on a Sunday morning and felt the pain when I took my first steps out of bed. At first, I didn't think much of it. I do get pains once in a while in my body parts. I am a recreational triathlete and workout 5 days a week in my "off season" and I work out very, very hard. So
some pain is normal. I didn't take the day off from my workouts, but I did an easy run instead of the hard one that was scheduled.
From that point on, the pain never completely went away. Some days were better than others. The pain would range from a zero to a 3 or 4 on the 10 scale. I took some ibuprofen to reduce inflammation and I applied ice and sometimes elevated the foot at night. It never completely went away. When I squeezed the tendon at the insertion point of the heel, it was sore. I kept trying to tell myself that it was PPD/TMS, but my thoughts vascillated between that and a probable overuse injury.
I was at the end of week 9 of my outseason plan, a point at which intensity (speed, pace, power) are all intensified. One of my teammates had suffered an achilles strain some weeks earlier and he was totally off of running for 5 or 6 weeks, so his situation was on my mind. I really didn't want to stop my training and lose all the fitness gained over those 9 weeks of the training plan so I continued on and practiced the "Resume Normal Activity" directive. I even ran in a 12K race on 3/18 and got a PR.
Below is a chart showing my weekly workout volume (or time, in minutes). Yellow is running, Green is bike. The Red was time out on the slopes in Tahoe

. Anyway, you can see how starting 1/1, I hit the workouts consistently, week after week after week. Then "injury" on 3/4, but my workouts stay consistent. Three weeks go by and no improvement. I've been somewhat doubting the PPD/TMS diagnosis, especially in light of the fact that I increased my workouts and also (didn't mention this before) but I changed my workout level from "intermediate" to "advanced". This means tougher, longer workouts. Since getting injured, I'm also using ice, I'm stretching, I'm using ibuprofen, I'm taking it easy here and there on the runs, I'm even starting to do eccentric calf raises. I'm honestly, not treating this like it's TMS/PPD because in the back (and sometimes front) of my mind I still think there's a possibility that this could be an overuse injury.
So after 3 weeks of running through the pain, I decide I'd better take a break from running. So I stopped. Well, not entirely. I did a 30 minutes light run and still felt pain during that so I decide to go cold turkey. I went 12 days with no running. For me, this is a long time. I run 3 or 4 days per week all the time so 12 days straight is very long for me.
At that point in time, I made the firm decision to cancel competing in a Half Marathon race on 4/28/12. I didn't think I would be well and I didn't want to risk making it worse.
My breakthrough came last Friday. I was heading home from work when I decided to read some of Monte Heuftle's posts. He has helped me in the past with some pain so I sometimes refresh my memory by reading his book. Anyway, on one of his website updates he stated that "if you are a TMS person then 99.999999% of all other pains are TMS." Something about that statement clicked for me.
On Saturday morning, I did my usual bike workout. Very intense. Then on Sunday, I woke up with some pain in my heel. I was a little depressed about it.
I decided to re-listen to the mp3 I have of Monte reading the Master Practice. I tell you what... I got excited again that this was really TMS. I decided right then and there to
stop all treatments.
Then, Monday rolled around. I decided to go for a short 20 minute run. My heel never hurt so bad! I mean, any normal person would have stopped! On a pain scale, I'd say it was about a 5 out of 10. But I pressed on. I finished it. Frankly, all previous runs since being injured were probably in the 1 to 2 out of 10 range. So this pain level was very unusual. Was this the extinction burst? I thought it probably was. That's what I told myself to justify the craziness if continuing to run through the pain.
Anyway, I was not deterred. I didn't ice it or stretch it or do anything after that run. The next day (Tuesday), I woke up and rather than lightly trod around with my heel, I purposely stomped around. I was mad at my heel. I said (in my mind of course), "Pain, you are not real" and I walked hard and fast all day long. I ran up stairs. I ran down stairs. At night after work, I did a very intense bike ride. 40 minutes of torture. I felt a sensation in the heel, but not 5 out of ten. Mostly a 1 or 2. I went to bed with no ice, no stretching.
On Wednesday (yesterday), I decided to take it to the max. I said that if this is PPD/TMS, I should be able to go out and run 13 miles with no problem. So I found the time in my day and went out and pumped out 13 miles! Guess what.... I'm fine. Some pain while running but not 5 out of 10. More like 1 out of 10.... more like a "sensation" than pain. And today? I'm feeling pretty darn AWESOME! I'm feeling good and I've decided to compete in that Half Marathon on the 28th.
I still find it hard to believe how this all works you guys, but it's just amazing.
Enrique