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Alternatives for Achilles tendon surgery
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What are the alternatives for partially thorn achilles other than surgery?
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Re: Alternatives for Achilles tendon surgery [swimfan] [ In reply to ]
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Swimfan - where is it torn? When? Any previous treatment? How was diagnosis made, what are your symptoms?

John H. Post, III, MD
Medical Director, Training Bible Coaching
Contributor, Ironman.com
john@johnpostmd.com
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Re: Alternatives for Achilles tendon surgery [swimfan] [ In reply to ]
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Cast, CAM boot, hog tied to bed, etc.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Alternatives for Achilles tendon surgery [rroof] [ In reply to ]
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Doc, what about the Topaz treatment?

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Continuous effort - not strength or intelligence - is the key to unlocking our potential.
- Winston Churchill
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Re: Alternatives for Achilles tendon surgery [swimfan] [ In reply to ]
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Some things just have to heal and that means time. In my opinion, right or wrong, time is better than the knife the overwhelming majority of the time. Soft tissue and tendons equal time. If rroof says x, do it. I will not disclose how he helped me through a 50% tear of my hamstring at the Ischial Tuberosity (in addition to my sports MD) but he knows his stuff. I was a year coming back all the way but I am back. And I am probably old enough to be your father or grandfather. Patience. Easier said than done I know. Go swim (with no push off the wall).
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Re: Alternatives for Achilles tendon surgery [c00terb0b] [ In reply to ]
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You are right, I took 2 yrs off running due to AT. No more knot, no more pain. Course I only run 10 miles a week now but I'll take it.

_____________________________________________
Continuous effort - not strength or intelligence - is the key to unlocking our potential.
- Winston Churchill
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Re: Alternatives for Achilles tendon surgery [last tri in 83] [ In reply to ]
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In Reply To:
Doc, what about the Topaz treatment?

Well, that is technically surgery (anesthesia, incision (as small as it may be), etc.)

I suppose a Platelet rich plasma injection (i.e. Symphony, etc.) would be non surgical.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Alternatives for Achilles tendon surgery [c00terb0b] [ In reply to ]
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Hi in my case, I've had Achilles tendinitis for over a yr. I've had 4 non cortisone scrapings with local anesthesia all of which except the last provide only temporary relief. Are there any other non surgical alternative that i can explore.
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Re: Alternatives for Achilles tendon surgery [swimfan] [ In reply to ]
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swimfan wrote:
What are the alternatives for partially thorn achilles other than surgery?

Listen to rroof, and take the time. I am 11 months out from Achilles surgery (total rupture) and I still notice a little bit of difference in some movements.

John



Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |
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Re: Alternatives for Achilles tendon surgery [rah] [ In reply to ]
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Accupuncture has cured my achilles tendonitis. I of course don't know the extent of your injuries but I'd definitely seek out all methods of therapy before surgery.
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Re: Alternatives for Achilles tendon surgery [rah] [ In reply to ]
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rah wrote:
Hi in my case, I've had Achilles tendinitis for over a yr. I've had 4 non cortisone scrapings with local anesthesia all of which except the last provide only temporary relief. Are there any other non surgical alternative that i can explore.
In Reply To:

there is not a single type of achilles injury and multiple ways to help them along. Most typical is not tendonitis (inflammation), but rather tendonosis (degradation). It's kinda' like talking about the various treatments for plantar faciitis.

I've tried most of them. stretching, rolling, rest (which, after 6 months had absolutely no effect), EPAT (sonic shock wave therapy), eccentric heel drops- a million of them, acupuncture. The only thing that seemed to help my particular achilles problem was Prolotherapy. YMMV. But, now I'm down with a different type of achilles issue- more of a knot than a soreness, and I've got a bad knee now too, for the first time ever. Sadly- I won't be running Boston next week. First (and probably last) time I ever qualified too.
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Re: Alternatives for Achilles tendon surgery [trailzilla] [ In reply to ]
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Interesting! I never even thought about acupuncture. HOw long did it take 2 become effective? Honestly after reading all these surgery stories I'm TERRIFIED 2 have 1 yet desperate 4 relief. ..
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Re: Alternatives for Achilles tendon surgery [rah] [ In reply to ]
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I had achilles tendinosis in both feet for years. Got to the point where I couldn't run at all and even cycling was torture. I had topaz on left foot in 2006 and right foot in 2009. Been running without issue ever since. Prior to surgery, I tried everything - physical therapy, rest, eccentrics, PRP, etc. etc. Nothing worked for me. Topaz procedure saved my sanity. But each case did require 4-6 months recovery period. Well worth it, for me.
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Re: Alternatives for Achilles tendon surgery [Boz] [ In reply to ]
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Thanx 4 the replies! So when u say 4-6 months recovery time do u mean not being able to walk for 4 months literally?
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Re: Alternatives for Achilles tendon surgery [rah] [ In reply to ]
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A little more detail:

My first surgery in July 2006 (left achilles) - Stitches out within first 10 days. Boot and crutches first couple of weeks. Boot only from several weeks to about 4 weeks, if I recall. I attempted to do too much too soon. Was so excited to feel no pain in my achilles right after surgery that I rushed the recovery. Started doing crazy things like heavy load eccentric calf raises after a month (very stupid) and riding my bike 12 days post surgery (wearing boot). That was a no-no. Set me back several months (based on results of second surgery). Was pretty much back to running at 6 months but it was a long, slow, often mentally trying process beginning with walking around the block, then running a few minutes at a time on grass, etc. The healing process was slow and at times I was sure I had made a mistake because I expected a miracle cure and wanted to be running within 1-2 months. But by 8 months I was running 40-50 mpw with no problems in left achilles.

Second surgery in Dec 2009 (right achilles) - Based on what I learned first go around, I chilled and let things heal un-rushed knowing that the procedure was going to work for me. Healed much faster and was pretty much back to running normally in around 4 months.

Since then, no problems in either and I can run as much as I desire.
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Re: Alternatives for Achilles tendon surgery [Boz] [ In reply to ]
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I'm so glad it was effective 4 u! I don't run but just walking is painful & I'd like 2 b able 2 get back on the stairmaster. Now the surgery my surgeon wants 2 do once I've exhausted everything else is cutting the bad part of the tendon & re attaching it. I'm assuming that diff from this topaz thing u did? In the meantime I'm icing & seeing a naprapathic dr....
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Re: Alternatives for Achilles tendon surgery [rah] [ In reply to ]
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Walking was very painful for me too for years. Every morning same ritual. Ease out of bed and shuffle around the house until tendons loosened up sufficiently to where I could walk normally. That was such a drag. My topaz procedure included going under the knife. I have about a 2.5" scar along each tendon. Doc opened me up and performed the topaz on exposed tendon. I've read that some doctors do it through the skin.

This is the dr. I went to:

http://www.footankleinstitute.com/technology/

In 2006 few drs were doing this procedure. At the time, I was living in Florida. I had gone to numerous doctors for advice/treatment/help. Orthopedics, podiatrists, etc. Their advice to me at the time was all the same: You have tendinosis. Your running days are over. I even had a 'world renowned' ankle reconstruction surgeon tell me that. They either hadn't heard of topaz or basically poo poo'd it. I was at wits end and willing to try anything. I figured if I couldn't run anyway, what the hell. So, after a bit of research I came across the dr. in the above link, called him, sent him my MRI, he agreed to see me, flew out to CA, had the procedure, flew home the next day. 10 days later, took the stitches out myself. A couple of years later, I moved to CA, saw him again for my right tendon. The rest is history.
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Re: Alternatives for Achilles tendon surgery [rroof] [ In reply to ]
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rroof wrote:
In Reply To:
Doc, what about the Topaz treatment?


Well, that is technically surgery (anesthesia, incision (as small as it may be), etc.)

I suppose a Platelet rich plasma injection (i.e. Symphony, etc.) would be non surgical.

Timely thread. I did a search for Haglunds yesterday & saw some of your writings...

I was supposed to do IM Melb 3 weeks ago, and didn't run for the last week up to it due to my left achilles being very sore. I seized up in the back on the ride, and didn't get to the run, which was a blessing in disguise. I ended up doing a sprint tri on Sunday, and got through ok, but was sore later in the day, and really sore on Monday morning.

After three Ironman builds in the last three years (all ending in achilles tendonitis), I went to my sports doc yesterday, who said "Haglunds...off to the medical imaging folks for you', where I had both achilles ultra sounded.. the right one had very minor inflammation (barely noticable at the moment), but the left one was pretty cactus. Lots of inflammation around the insertion points, and some torn fibres. They gave me a plasma injection to try to repair some of the fibres, and I am sleeping in a night splint for the next month (with a hole cut out of the back), when I will go back to the doc.

I really don't want surgery, but want to keep running at some level... what are my chances?
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Re: Alternatives for Achilles tendon surgery [NAB777] [ In reply to ]
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Your chances are good, but a healthy dose of patience is always needed with achilles tendon or posterior heel issues (tendonitis, tendinosis, paratendinosis, insertional/enthesopathy pain, retrocalcaneal bursitis, etc.)

The worst diagnoses are the structural ones (rather than the typical overuse injuries that afflict us all) like a large bursal projection (i.e. Haglund's deformity or "pump bump") since these don't ever go away (same with insertional spurring - love it when people say they somehow got rid of/dissolved them ...) and are a constant source of irritation to the tendon. You can't stretch you calf/core out of these sometimes. Of course all that matters are your symptoms and I've seen very large Haglund's deformities that were completely asymptomatic.

This is precisely the reason for the inventions of what I call intermediate steps for those that fail traditional treatments/therapy, but either don't want or need more conventional surgery. Examples would be the Topaz procedure or the FAST technique.

http://www.topazinfo.com

http://www.tenexhealth.com/

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
Last edited by: rroof: Apr 9, 13 17:00
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Re: Alternatives for Achilles tendon surgery [trailzilla] [ In reply to ]
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Could you tell us more about your experience with acupuncture? How bad was your tendonitis? How many treatments? How soon were you able to run pain free??

Thanks
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