Healed

By | November 11, 2013
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As I mentioned in my last post, I have been able to be pretty active without any serious achilles pain for a number of weeks now. The weeks since then have brought more progress, and I guess I can officially call this injury ‘healed’ for now. No more pain or soreness, aside from a VERY slight amount on only some mornings, and only for the first step or two after getting out of bed. I am certain that within the next few weeks that little bit of occasional morning soreness is gone.

Based on that, I’m happy to say that my self-administered protocol worked. And was a hell of a lot cheaper than multiple weekly physical therapy sessions, and most importantly – I healed up much faster as a result.

To recap: when I injured the achilles the first time back in early January, I wasn’t able to run again until five months later. And that five months included multiple visits to doctors, and 3 months of 3x per week physical therapy as well as strenuous stretching and other exercise.

This time, after re-injuring it on July 18, 2013, I can say I was pretty much healed up on October 18, 2013, and aside from occasional morning soreness, have suffered no symptoms and have not been limited since then in terms of activity. That’s only 3 months. Much better!

Protocol

The protocol I followed was simply this:

For about 8 weeks, I did the eccentric heel drops once per day, 2 sets of 15. I was supposed to do them every day for 12 weeks per the Johnson protocol, but didn’t.

I also built up a lot of strength and flexibility in my ankles, calves, and overall body, by doing a 3x per week (and have stuck to it successfully, without missing any days) full body workout that consists of:

1. Cardio warm-up for 7 to 10 minutes on an elliptical machine

2. About 10 minutes of static stretching: gastroc, wall/ankle, and others. My flexibility is now better than it has ever been. Note that I have very, very poor flexibility still in my upper-body, and am working on that too. I am convinced that my tight calf muscles and ankles are what caused the achilles problem in the first place. This is something I’ll have to keep on top of for life I suppose. Also, I will also do some quick foam rolling but since my gym ditched the good foam roller in place of a too-soft one, I don’t spend much time on it.

3. Weightlifting routine – 3 sets of 10 of the following:

  • Barbell Squats
  • Dumbbell Rows
  • Chest Press
  • Shoulder Press
  • Bicep Curls
  • Tricep Pressdowns
  • Eccentric heel drops, while holding either a weight plate or a dumbbell; I do these on a step, alternating legs

I did a little cardio here or there but not much. In its place I just go through my lifting routine quick enough that my heart rate is elevated throughout.

Do I think the weightlifing helped with my recovery? No idea. Definitely I think the eccentric heel drops did. And the static stretching probably helped healing but I think the real benefit is in reducing the chance of re-injuring the achilles. I figure if the tendon is longer (due to consistent stretching) then my chances are better to avoid re-injury.

I’m Crazy But Can’t Help Myself….Soccer again?

The Sports Medicine doctor told me, when I last saw him, to stop playing soccer. At the time I was in pretty bad pain from the re-injury, and just immediately said to myself I would quit, that it was not worth going through this again. But lately, with helping out coaching my son’s U-9 team, I’ve gotten the itch to try it again. Dumb, but I’m seriously considering registering for the Men’s Over 35 weekly soccer league that starts up in 10 days. Wish I had a few more weeks to decide though. I’m 50/50 right now. I no longer have a ‘team’ so I sent an email to the organizer asking if there is a house team I could join for the season. If he responds saying that there is, then I will likely give it a shot. But this time I won’t over-do it. And see what happens. I know it’s crazy and not very smart to do it but with winter here, I’m flat-out bored and need something. Otherwise I sit around all night on my computer. That’s no good.

So I don’t plan on posting much to this blog going forward unless I do re-injure the achilles. I’m hoping I never have to post a “Re-Injured It” post, but we’ll see. In the meantime, if you are suffering from Insertional Achilles Tendonosis and have been following my progress, I wish you the best. If you have any questions or comments, please leave in the comments. Good luck!

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  • ignoranceIsBlisss

    Congrats on getting healed. I have the same, have had it at the beginning of the year and now re injured again. Have you done any xrays? Did you have any calcifications / bone spurs at the insertion? Did it hurt when you pressed the thumb at the insertion? For me this re-injury is a bit different. The first time I had it I had stiffness in the morning, stiffness as I began running which went down as I got warmed up. This second time, I don’t feel stiffness in the morning, but I can’t run at all. I get instant pain.

    • mark2741

      Hi,
      I did an xray when it was first injured. Showed bone spurs both on the bottom of my foot but also at the heel as well – right near the insertion point. Also a “touch of plantar fasciatis” (doc’s words).

      Both times I injured it were similar, except for when I reinjured it it hurt way worse the first two weeks. So bad that I was worried I had torn it fully, and wound up going to the emergency room (I was leaving on vacation the following day and couldn’t get in to see my sports med doc). Other than that, the pain/symptoms were pretty much identical.

      I had (and still slightly have) a ‘bump’ at the insertion point. This is a telltale sign of mangled tendon fibers. It goes away with ART. Pressing it with my thumb was painful. But necessary – a highly-qualified ART-trained physical therapist basically spent 10 minutes 3x per week ‘digging into’ the mangled part of the tendon with his thumbs for about 2 months the first time I injured it. That was very worthwhile treatment. A little painful but definitely helped a lot.

      After reinjuring it, I did the ART myself, but only a few times.

      There’s no way I could have run the first 6 to 8 weeks after injuring it – I had trouble even walking the first month without a lot of pain.

      Good luck!
      mark

      • ignoranceIsBlisss

        Thanks a lot Mark! It’s good to know that you can get pain free even when you have bone spurs. It’s a lot of contradictory information on the web, and surgeries for removing the bone spurs look like a mutilation.

        Here’s my xray, http://imgur.com/KPL5IMq . I see the bone spur on it, but from the outside I have no visible bump.

        I also thought I need to wait until I would be pain free when pressing the thumb, but I will now start with the eccentric heel drops.

        • mark2741

          I think I have you slightly beat with regards to the bone spur at the heel/insertion area : ) I just posted a copy of the x-ray I had done back in February/early-March of this year here: http://myachillestendon.com/2013/11/17/x-ray-of-my-foot/

          You’ll see I have two very pronounced spurs.

          As far as waiting until the pain subsides – it depends on how you define ‘pain’. I get emails from guys a lot saying they have the same injury I had, but then they say “it only bothers me when I run”, or something like, “So the next day after injuring it I started running and it got even more sore!”, etc. There is *no way* that I could have run, even two strides, with my injury. The pain would have been unbearable. Not for at least 2 months. So my suggestion would be this: ART is supposed to hurt some. But it shouldn’t be so tender there that you’re in excruciating pain.

          In my case, I waited out the first 2 weeks (when it was so sore I couldn’t walk without serious pain) and the major swelling went down. I then started doing a little ART and the eccentric heel drops.

          The heel drops: not totally sure if they are the magic I hope they are. I just know that my recovery was much faster this time around by doing them (and not going below parallel until there was no pain, which was a couple of months). The real test is if I re-injure it. If I do, then the theory that the eccentric heel drops “rebuild” the tendon by straightening the fibers, is bunk. We’ll see.

          Also, something I may not have stressed enough in my posts because I guess it’s a given: during the last 3 months I’ve done a lot of stretching. Minimum of 4x per week spending about 10 minutes doing lower-body stretches, in addition the heel drops. I am certain the stretching helped and, perhaps more importantly, they may guard against re-injury.

          Good luck, and keep me posted!

          mark