First post, asking for input. Please help, Achilles trouble

search the boards. there are tons of threads on this.

Eccentric heel drops. Lots of them.

Take a look at Graston with a good chiro. It works. You should also take your imaging to a foot and ankle MD for a second opinion. I would not trust an Achilles injury with a podiatrist.

History of systemic disorders?

ever have a cortisone injection in your achilles?

just one leg, not both?

use of antibiotics in the past(cipro/levaquin in particular)?

any familial lipid disorders(dyslipidemia?)

has this ever happened to you before in any capacity?

does ice/resting help it or does it still hurt while non-weightbearing? does it hurt while biking or just walking

?

is this an everyday pain?

pain worse or better or same after your procedure/PT?

im sorry to hear about your achilles tendinitis. MRI is diagnostic for this and is usually a straight forward diagnosis. im confident the radiologist and podiatrist read the MRI correctly. as for the treatment it seems like you are not progressing as quickly as you would like, i understand. sometimes the bursa(in between your achilles and heel bone) gets extremely inflammed and needs to be removed. cortisone injections are not common in the achilles b/c it can predispose you to ruptured in the future. Have you tried prednisone dose pack? im not sure if this is an acute situation anymore since you have tried multiple therapies so im not so sure prednisone will help you too much. if there is swelling then you need to ice everyday.

i think NSAIDs will help for breakout pain

Heel lifts are a must. they shorten the lever arm of your achilles therefore decreasing the strain.

i would agree with gastrin/more PT after your procedure.

these things can last a while and just the pain/swelling from the procedure can take a while to recover from.

Thanks for all of the replies, I really appreciate it.

Happy Tail: I have done so much reading and searching, I started to feel overwhelmed with info. That is why I decided to ask for the advice or experience of others, rather than trying 10 different things at one time.

GOML: I have refocused and doing the Eccentric Heel Drops as carefully as possible. Seems like there is a lot of supporting evidence for this, so I will definitely stick with it.

Precious Roy: Thanks for the advice. I will look into the Graston and see if my Chiro has any interest in treating me as well.

Student: This is a very thorough response, thank you. I do not have any systemic disorders or experience with this in the past. It is only my left achilles, not the right. I believe it was injured during heavy weight training, where the following morning it was extremely swollen and never went down. I have never had cortisone and not taking any medication.

Ice and rest are somewhat helpful, but it seems to be inconsistent overall. One day I wake up very tight, the next day wake up feeling pretty good. Some days I can walk around without much limping, other days it hobbles me significantly. Sometimes the stretching alleviates the tightness, other times it seems to flare up afterwards.

Before the surgery it was all day, every day pain. I had the procedure done and was on crutches for 20 days, then in a boot for 3 more weeks. I now can walk slowly without the boot, with not much pain. If I increase my speed, it is just too tight and pain becomes relevant. I assume that the part of the tendon that is healing is not yet as flexible as the rest, so therefore tightness is present. Being that the insertion point is so low, I find it difficult to really get a perfect stretch. I am going to continue with the advice from you guys, really focus and give 150% to mentally getting past this problem. I am currently doing the PT myself because I wasted all of my allotted visits prior to surgery, but I think I can do these exercises just as good at home. I am also using a rolling pin (kitchen tool) which really gives a nice massage to the calf and tendon.

The hardest part has been the ups and downs with recovering. One minute I walk pretty well, feel almost euphoric to simply get around like normal. Then hours later it feels like it reverts back to tendonitis and tightness, which leads me to search for more answers etc. I expected the surgery to completely remove tendonitis, but that does not seem to be the case. Hope it at least gets me to a point where I can finish the recovery on my own.

Thank you all for listening and contributing. I will post again with some progress soon.

-chris

Håkan Alfredson is the man who reinvented the eccentric heal raise. Listen to the podcast. About as solid information you can get on tendinopathy. In your case i would consult my MD before starting tho. Good luck!

Bar2020: thanks for your post. Im curious how you’re doing now? Did graston help, anything else? Did you get a second opinion? Another surgery?

I had Tenex on both Achilles, and I’m 6/8 weeks out, after initial pain from surgery went away and I came out of 2 weeks boot wearing each, I am making zero progress. inflammation starts immediately after normal careful walking, even in heel raise shoes. I am still much worse than baseline before surgery.

I’ve had it, chronically, for years. Unlike you though, I could run through it, for the most part. Because it’s notoriously difficult to get blood flow down there, it NEEDS exercise. I found that walking before going for a run was good, and I always did eccentric heel drops after running, and then icing it.

Sleeping in a night splint can also be very helpful!

One alternative treatment that my doctor recommended after a long bout of Achilles tendinitis was to place a nitroglycerin patch on the Achilles at night. The nitro patches are the same thing that people use for heart issues. It helped generate more blood flow to the tendon to promote healing. I noticed a difference in how the Achilles felt just after a few days and I had a greater range of motion. Lo and behold, the treatment worked after a few weeks.