I just had an MRI on my left Achilles as its been aching quite a bit of late. The diagnosis from the Doc says Tendonosis. He says my days of active running are over. I say BS! Though I am 47, I have TONS of fight left in this bod!
So, my question is: Have any of you had this diagnosis and what treatments have you found effective (for the long haul) in keeping the run pace up and the pain down (or elliminated)?
Any feedback from those with real world knowledge would be greatly appreciated!
Jimbo, I’m supremely disappointed in you doctor. Achilles Tendonitis - if that’s all it is - is a temporary issue that can solved and followed by years and years of flawless, pleasurable running.
I’ve battled with achilles tedonitis and a few of athletes I have known (a couple I coached and a couple I’ve known) have as well and come through it in the end.
Here’s my thinking…
let it rest for a while - stop running, keep fit with one foot push offs while swimming, ride flats with moderate cadence.
develop a 20 minutes healing program that you can do twice a day: 10 minutes of exercise/massage/stretching and 10 min of icing
let the exercise start with very light resistance - at first it can be pressing against a pillow and might progress to single leg calf raises (in time). The massage can be your thumbs with some penetrating antiinflam stuff like Nemidon Gel - massage the calf muscle as well as the achilles itself. Then stretch both the calf and the soleus (the former with a straight knee and the latter with a bent knee). Stretch VERY gingerly at first - aggressive stretching might prolong this injury. Then ice for 10 minutes with pressue and elevated. Do this twice a day and I bet you’ll be back on track within 6 weeks.
After you’re 100% then protect and maintain the area with balance exercises on a wobble board or a half ball or think foam mat - this will address the stabilizers in the ankle joint and around the lower leg. Keep the lower leg muscles strong with standing & seated calf raises and something that address the anterior tibialias (long thin muscle beside shin). That work plus stretching will likely keep you strong & healthy while you run into your 90s.
eccentric training, ie, the lowering down aspect of a heel raise. Done very slowly. Will hurt probably, but ok. Try to get in touch with a physical therapist/chiro who is an athlete themselves. I can’t stand it when a doc says to an athlete “give up/ you will never ____”
Edit: keep in mind there is a difference b/t tendiosis and tendinitis. Tendinitis is active inflammation, whereas tendinosis is a chronic, longstanding problem.
runnersworld.com forums are a better source of information about running injuries. There is a quite active forum there dedicated to various kinds of inuries.
As for my personal experience, yes I have had it before, they can be caused by different reasons. The classic too much too soon is the main cause in the majority of cases. Overpronation and wrong type of running shoes also contribute to the syndrome. Tight calf muscles or imbalance in the strength of lower leg muscles can also lead to this problem. Two things that really worked for me were icing it three times a day and calf raises followed by stretching calf muscles twice a day.
I would sasy you should take at least 2 weeks completely off running (depending on how severe your pain is) and start very slowly and gradually. Absolutely no hills for at least a month, but in the long term hill workouts are great for strengthening and injury prevention of such kinds, if done properly.
I hope what your doctor said about your active days of running is an exaggeration, I don’t know how bad your case is (if the tendon is ruptured, it can take several months to heal and you might need a surgery) but this is one of the most common running injuries and many people have experienced at least a mild case of it. In the perfect world you would like your doctor to be a marathoner too (mine actually is!)
Ahhhh, bullsh…1) get a new doctor. 2) find the biggest and meanest MT (or PT) in town and set him/her loose on your bod. My MT and I have a deal - he does what he wants and all my squirming and laughing (I laugh for some reason when it really hurts) are not to be considered. He only stops if I say so and that has not happened to date. Getting my ATs adjusted is really special - it is that white hot searing pain - and it works. 3) take your time and come back right. There are damn few injuries you can’t come back from - I am living proof of this statement.
I had severe achilles tendonitis about 12 years ago. It was so bad the tendon was very thick and swollen and you could hear/feel the creaking. I had so much scar tissue that the tendon had pretty much adhered to the tendon sheath and I couldn’t do anything without pain - walk, push off a wall to swim, bike, nothing. I was fresh out of my final year of collegiate running. After exhausting all alternatives I finally had surgery 3 months post-injury to clean out the scar tissue and repair the tendon. 6 weeks after surgery I started running again. Two months later I was back up to 60 miles a week of running (I was 21 at the time so the healing time may be slower for someone older) and I was back racing two months after that … all pain free. I had to really concentrate on my rehab stretching and exercises but I was back 100% and have had no problems since. I ran in the pool with an aquajogger during my whole layoff. To say your running days are over I would think is false. I was told my injury was very, very extreme and I’ve completed several marathons, ultramarathons, and 3 ironmans since. Please go get a second opinion from an orthopedic who works with athletes. I’ve had a few serious injuries (unfortunately worse then the achilles) since then and my doctor has never told me my athletic days are over, and he’s been right every time. Hopefully yours can be treated with stretching, massage, ART, etc… and never have surgery! Good luck and stay positive!
oh and I forgot to say, many people swear by ART (Active Release Techniqe) practiced by many chiros nowadays. A runner that I know actually ran a marathon this season on sore achilies (not exactly the smartest thing to do, but you know how it goes) and she said that ART was very effective.
Thanks for your feedback. It is helpful and positive! I know I can beat this!
A little background. I have been an active runner for years. Ran the the Boston Marathon twice when I was 20 & 21. Ran it in 3 hours flat the second time! I have also been an active cyclist for the last 10 years. I am a fit & strong athletic guy and have recently picked up TRI in the last 3 years (if only I could master swimming). I love it! I train hard from January to the end of TRI season in September. I take it easy for Oct/NOV/DEC and part of January, then I am back on it. I am not world class but I am in the top 3rd of my AG. Its ok, I can live with this fact! I also train with an awesome coach, which really helps.
5 years ago I skiied into a stump heli skiing and ruptured my right Achilles. I had surgery by the best of the best, and a year later I was back to my normal self. The only thing I noticed was a slight imbalance between my left calf and right calf (naturally). Ever since then, the left achilles takes more abuse as a result of this imbalance. Plus my calfs are always tight, as are my hamstrings when I push hard running. I think this is normal?
I have learned to live with the tendon pain, but only this fall I noticed it more than ever, hence the visit to the Doc and the MRI. IT IS TENDONOSIS (not tendonitis). I can still run OK, but it defininitly hurts more now, and I need to fix this before its a MAJOR problem. So essentially I am being procative now so I can do my first IM in 2008!
I will check out runnersworld forum (good idea). I am also doing PT now twice a week, and I like the idea of a couple of weeks of from running all together (though thats like abstinance!).
I was reading up on ART. Anyone try this? Experiences? Results?
Please keep the ideas coming. I appreciate the collective insight from people who have been there and done that. I also think I will go for a second opinion just to be sure.
I swear by ART. I go about once a month for injury prevention and more often if I’m having some type of issue. I had a 3rd degree (borderline surgery) shoulder seperation a year ago from a crash in a crit and with ART and accupuncture (something else I swear by) I was back racing crits again in 5 weeks with no pain and I avoided surgery. The guy I go to is a chiropractor who does ART and accupuncture. I went 2-3 times a week after my shoulder injury to aid it’s healing. It really breaks up the scar tissue - far better then massage can do. I would definitely recommend trying it. I would also recommend accupuncture - the two combined work wonders.
You seem like a nice guy. But would you really trust this forum over a doctor who has performed/read/analyzed your MRI. Find a couple of other leading doctors (would be helpful if they have experience in running related injuries), go see them all and form an opinion based on the collective wisdom of the experts.
The article posted by Rob C is a good summary of the research. That protocol of eccentric loading has the most support for tendinosis. The only difference I have seen is instead of 3 sets of 15 per day, try 2 sets of 15 performed 2 times per day. Expect a “moderate” level of discomfort while performing the exercise initially. This should improve. You should not be left hobbling afterward, but you may be uncomfortable. Once you get to the point that 2 sets of 15 is no longer uncomfortable you can add weight to the exercises. Also, get yourself to a good PT so that you can have them examine it and also look for any other issues that may be contributing to this issue.
Thanks for all of your replys. I view the forum as an enabler to recieve as many informed opinions on a subject that similarly minded people have experience with. Do I take what everyone has to say on any forum as gospel? Absolutely not!
That said, there are some very helpful ideas and solutions that I did not know about. Eccentric excersizes and Active Release Technique (ART) seem like very applicable techiniques I should consider as a solution. The Doctor I went to was a junior guy to the best of the best that did my first achilles (Arnold Scheller, team physician to the Boston Celtics, now retired), but I have to say I am quite disppointed in the junior guys approach and recommendation. So yes, I am going to get another opinion.
At that meeting, I will present all of the ideas and solutions and ask him his prognosis based his take on my situation. I am a firm believer in positive attitude yields positive results. You will see me at my first IM at the finish line at IMC in August 2008 in a time of under 12 hours. Like George Zimmer says “I guarentee it”.
The only additional advice I can throw in is after it feels great again, give it another week or two then introduce running very, very slowly. You might also try a night splint to keep the AT elongated all night.
