Just to add my story to the mix. Went to see the best sports Doc I could find (ex-Olympian too), as my right Achilles was sore. He did some prodding and squeezing and then scanned both Achilles and showed me the print-out. Left: thin and white showing good blood flow; right: thick and black - limited blood flow. Achilles Tendonitis.
I was banned from running, but allowed to cycle and swim, and I had to massage the Achilles everynight (with some ibu. gel) for 10 minutes, plus calf raises every day. He stressed that as the calf raises got easier I should ‘load’ more (e.g. stick a pack on my back) as opposed to doing more reps. Acupuncture was not recommend, as the needles could contribute to a tear.
He then sent me for ESWT, which he performed himself (I was fortunate on the cost as insurance would cover most of it). He mentioned that he’d start at a low level and then raise the level gradually. He gave me the numbers, I think he said he’d start at ‘3’ and then go to a ‘7’ and then on the next treatment he’d start higher and then go to ‘9’ (I only had two treatments, around 20/30 mins each). One thing I clearly remember him saying, was that he was using ultrasound to ‘aim’, to ensure that the waves didn’t hit my bone, that allowed him to use a higher strength signal - he said that at the higher levels it could damage my bone.
The ESWT came in pulses, and the only way I can describe the sensation is that someone was inside whacking my Achilles with a hammer. It hurt! Maybe I’ve got a low pain threshold (‘you haven’t been through childbirth, you don’t know what pain is’ - as wifey likes to remind me), but I was sweating and gripping the bed, focusing on not moving and giving an occasional ‘holy hell’ grunt (OK, maybe I didn’t use ‘holy’)!
The sensation (pain) I felt did seem to align with the point of the process, which is to generate blood flow into the injured area by aggravating it. I do think it helped with my recovery, and future scans did show the black area becoming white. How much can be attributed to the treatment; the placebo effect; regression to the mean - I don’t know, but personally I feel that it did contribute a large percentage to the healing process, and I would go for it again.
It took me 8/9 months to recover, so I could run again. I still get twinges and try and massage it regularly and to do calf raises. I also ditched my Newtons, although I have no firm evidence, I personally think that the change in my running ‘form’ may have contributed as my calf wasn’t ready for the extra load and so diverted responsibility to my Achilles.
Hope you get better soon.
Guess he got a good look at both tendons.