Return of the a Achilles tendinitis

[Marbles]

I would find a good Physical Therapist.

I would also stop icing. There is zero evidence it helps with healing and a suggestion it might slow healing, particularly in low blood flow tissues. Icing caught on because it helps with acute pain, it has quietly been abandoned for anything other than that use in professional literature.

Icing is deeply rooted in myth at this point though, so I expected to again be told I'm stupid, as has happened in past threads were it comes up.

There is not clear evidence for this, but I personally would combine heat and light compression (15-20 knee high compression socks) with use. The goal being to increase blood flow and stimulate building. What is not used atrophies. Where a PT will help is safe use. Stretching slone has never resolved an issues for me, targeted exercise has.

I've not dug ino the evidence, but based on Scott Johnson's recommendation have been using self massage. It appears to help. The booke The Roll Model is what he recommendeds in Training for the Uphill Athlete.

Ibuprofen and NSAIDS also have no long term healing benefits tht I am aware of (would love if someone can provide an RCT to show they do). For a while it was thought they might cause harm in regards to healing, but that has not held up. However, given a lack of benefits, unless pain control is needed, I personally don't use them.

Disclaimer, I work in medicine, but not sports medicine or orthopedics, so you are getting the results of study done for my own use only. Now that I typed out what I think I know, I'll go check it in a subscription reference and update.

 

[Marbles]

Ok, from UpToDate on Achilles tendonitis.

"Rehabilitation using resistance exercise — We suggest that patients with chronic midportion Achilles tendinopathy be treated with a rehabilitation program that emphasizes resistance exercises using heavy loads, such as weighted heel raises"

"Patients may perform other regular exercise while participating in either type of rehabilitation program, provided that the activities do not exacerbate symptoms. Mild discomfort is permissible."

There is limited data on orthotics and braces, they may help. My bias is against them.

Massage therapy may be useful combined with an exercise program.

No discussion of ice or NSAIDS.

It covers other things, but those hit what I see as the key takeaways.

The biggest take away is the only proven nonsurgical intervention is resistance training.

 

[FRANKBUCK]

PRP would be another route to take if the advice mentioned above doesn't work. Personally, icing helped my issue. But what works for some, may not work for others. I am by no means an expert or a physician. I am only offering thigs that helped me.

 

[flyfisher117]

Flyfisher117...Do you know your blood type? If so, there is a website that you can use for looking at foods that may or may not agree with you. For me, avoiding dairy was huge...which sucked because I love cheese. lol However, it helped. There is a product called Ultrainflamix350 plus that you could try also. It is expensive but it works. Hope that helps!

Not sure on blood type I'll have to see if I can find it.

I don't know if was mentioned, but I recommended a zero drop shoe to help build foot and ankle strength.

Sent from my Pixel 3 using Tapatalk

I did just get new lifting shoes which are zero drop. Hoping they will help.

Interestingly I have worn cowboy boots for 10+ years now daily. About the time this issue started getting bad I bought new boots. They are a zero drop lace up boot. I've questioned if they are adding to the issue because I stopped wearing them this summer and that's when I realized the issues went away some. Still researching that.


I'm still working on getting into a PT. Apparently my work has the worst insurance for that so getting it approved has been a hassle.

Also working on stretching the ham strings. I've noticed if my hamstrings get tight the tendonitus gets worse.

 

[FRANKBUCK]

100% on the stretching. If I don't stretch, it jacks me up almost everywhere. Regarding the Achilles, I always try to stretch my hamstrings, calves and Achilles. In the backcountry where you can't lean into something, just squatting on your haunches and leaning forward will get you a good stretch for the A. Keeping the muscles stretched helps to keep the tendon from pulling away from the bone and developing micro-tears.

 

[The Fat Coyote]

Currently dealing with mid-Achilles tendinitis and came across this- Statistically better outcomes than surgery- I just started this protocol today but will report back after 12 weeks!

https://andersonclinic.com/wp-content/uploads/2022/05/achilles-midsubtance-tendinitis.pdf

 

[Marbles]

https://theprehabguys.com/podcast/talking-tendons-with-jill-cook/
I would recommend listening to this yourself. I listened to it on my run today, it was just up next in my play list, so was not taking notes and am trusting memory for this summary.

-RICE did not work and "nobody got better."
-Never rest a tendon and if you have been resting, expect a much longer rehab of up to 6 months.
-Tendons love slow heavy loading and you will not hurt a tendon doing this, it takes 6 plus weeks to see improvement with heavy loading resistance training.
-Isometrics give faster relief, but must be done properly (45 second hold and heavy load with a 2 minute break between and 5 sets) if isometrics do not improve the problem you are either doing them wrong or it is not a tendon issue.
-Misdiagnosis is possible and common with tendinopathies, primarily people are diagnosed as having them when it is really something else.

https://theprehabguys.com/ Have a subscription model that could be cheaper than PT through insurance depending on your deductible. It could also be better given that it targets athletes, but that will depend on the PT you see. I have not used them, but am considering subscribing as I'm planning a lot of training for this year for a non-hunting goal.

Anyway, I'm trying to fucus on family and stay off the computer, but thought of this thread and decided it was worth logging back in to share.

Based on all the above, what @The Fat Coyote shared looks like a great free resource.

 

[flyfisher117]

https://theprehabguys.com/podcast/talking-tendons-with-jill-cook/
I would recommend listening to this yourself. I listened to it on my run today, it was just up next in my play list, so was not taking notes and am trusting memory for this summary.

-RICE did not work and "nobody got better."
-Never rest a tendon and if you have been resting, expect a much longer rehab of up to 6 months.
-Tendons love slow heavy loading and you will not hurt a tendon doing this, it takes 6 plus weeks to see improvement with heavy loading resistance training.
-Isometrics give faster relief, but must be done properly (45 second hold and heavy load with a 2 minute break between and 5 sets) if isometrics do not improve the problem you are either doing them wrong or it is not a tendon issue.
-Misdiagnosis is possible and common with tendinopathies, primarily people are diagnosed as having them when it is really something else.

https://theprehabguys.com/ Have a subscription model that could be cheaper than PT through insurance depending on your deductible. It could also be better given that it targets athletes, but that will depend on the PT you see. I have not used them, but am considering subscribing as I'm planning a lot of training for this year for a non-hunting goal.

Anyway, I'm trying to fucus on family and stay off the computer, but thought of this thread and decided it was worth logging back in to share.

Based on all the above, what @The Fat Coyote shared looks like a great free resource.

Thank you ill get this one added into my podcast queue and check it out.

Depending what I find out on my insurance I may try their subscription. Just to see what is offered