Hi Paul, shoot me an email rlskaggs2003@yahoo.com and I will send you details.

I've noticed that inflammation around the region of the mid tendon is more of a problem (it seems) than the tendon itself. So inflammation = pain and dysfunction.

Also that injury of those "sheath" or gliding tissues occurs before the runner feels it, so it's like being burned with high temp, once you feel it the damage is done.

So from what I read, the procedure address the high blood flow to, and also mechanically reduces irritation or restores the movement of the tendon in the supporting tissues?

Is that correct?

BTW I was recommended to a doc that does external scraping on the tendon + other mechanical work, he has reduced the size of my AT bump in a couple of visits.

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So frustrating... update on this. I was put in an aircast today for 4 weeks. No cycling, and running (haven't run in 4 months anyways), can swim but only with a pool bouy...wholly frustration with this friggen injury. What other exercise type things can I do while i'm in this boot for 4 weeks? Help, I don't want to be a total cow!!!!

not sure this has been mentioned. it sounds like you have tried most western remedies, give the east a try. acupuncture. have read some pretty amazing reports and success stories in all areas. many tour riders and other athletes are using it.

I know a person who took off like a year from running before it healed.

.

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Now it is my turn to get this. Was running up to 3 hours pain free. Ran the New Hampshire marathon - was super hilly - and my Achilles is sore with a bump. I guess it was the walking/running up the steep hills aggravated it?

I thought rest/ice would heal it but after a month of no running it hurts as soon as I put on running shoes. No pain from dress shoes as they don't go as high up.

Saw foot doctor today - diagnosis of midsubstance Achilles tendinosis. Prescribed PT including the eccentric exercises. Will get to the PT and get that started.

Can ice or a topical inflammatory help while waiting for PT?

Thanks, John

 

Try KT tape, Rocktape, whatever brand you prefer. I usually have a flare up of an old achilles injury on my right leg every year in the spring when I tend to push the mileage up a little too fast. I'm no doctor, but this stuff works magic for me. I get almost instant and total pain relief when I put it on, can train like there is nothing wrong, and in a week or two, the pain eventually goes away.

Thank you. Ready to try all available remedies.

PT Eval today.

Tightness in calf and plantar contributing or causing issue. Started stretching and strengthening exercises. Also received an Asytm treatment which felt like a butter knife being pulled across my calf and foot. Not sure what that does but the PT said it was good for my injury.
John

I hope the ASTYM helps you. It set me back quite a bit as I couldn't walk 24-36 hours after each treatment. Theory of it seems fine for muscle fibers. I do not believe this is the right treatment for tendonopathy. Like I said, hopefully it helps you. I believe you will find greater benefit focussing on the strengthening and loading exercises. Most research supports this. Whereas research results are lacking for most manual techniques on the achilles tendon.

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I honestly has no pain from it. It just felt like rubbing something along my calf, achilles, heel, and foot (which tickled). I agree that the stretching and strengthening seem the be the items that will get me back running. Can I keep icing it at this point?

I have used combinations of ice and heat. I used contrast baths that were helpful for discomfort. 10 minutes with my foot in an ice bath, 5 min of really hot bath and then 10 of ice. I would have two buckets that I would switch back and forth between. They were helpful for the pain. How much they did for the actual healing, I don't know. I used compression socks as well, and those were helpful. The most helpful was when I started doing heavy weighted concentric and eccentric calf raises. Both. Not just eccentric. I did them on flat ground and a stair. Then moved to gentle ply exercises, then back to normal, albeit much slower, running.

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Thanks very much for weighing in. I am a little sore from the session today - is it OK to take something for the soreness or allow the inflammation to help heal it (more blood flow?).
Thanks, John

I might write a little post about this tendinopathy like the one i did in the high hamstring tendinopathy thread since I believe it is most needed. Hate to see so many athletes in pain and disability for so long, partly fueled by hopeless treatments sharp things and blunt things applied with varying degrees of force.

Meanwhile, take a look at this infographic:

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede

WOW - thanks for posting this. I have been in fear for a month that my achilles will rupture. What I don't understand at the moment is what will stop the inflammation and pain? Should I just anything topically? Won't strengthening exercises exacerbate that? I am not trying to be dumb with my questions, just don't understand.
Thanks, John

Some of the info in the graphic above is correct, some isn't. The discomfort you are getting at this point isn't inflammatory, it's more what we call mechanical...meaning, the tissue is fibrotic and stiff...(think of a birds nest or a bowl of cooked spaghetti). Thus, when you load it, it doesn't have the mechanical properties to handle the load and it's uncomfortable. The reason the exercise stuff is key is that it will help restore healthy tissue... allowing the tendon to accept load. Having a little "pain" during rehab is fine. Let your PT guide that. Pain and tissue damage are 2 different things. Pain neurophysiology research strongly supports that beliefs (fear, worry, catastrophization, in your case..."I may rupture my Achilles") will heighten neural sensitivity and tell the brain to produce pain. I know its easy for me to say this...but don't fear, you'll get there.

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CB
Physical Therapist/Endurance Coach
http://www.cadencept.net

Remember that pain stop way before any changes happen to the tendon itself. You probably should not tell anyone who is afraid of rupture that their tendon is a bowl of spaghetti. Even a tendinopathic tendon is very strong, and those at real risk of rupture are those who go through the stages of tendinopathy with no or minimal pain. The infographic is based on Prof Cook's work and she is absolutely world class in tendon rehab. What do you consider incorrect? I might find the references if you want.

The rest of what you said is gold. Pain is influenced more by "everything else" than tissue damage.

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede