Have you ever tried anything like this- CEP Achilles Compression Brace?
Have you ever tried anything like this- CEP Achilles Compression Brace?
Haglund's syndrome (a bony spur on the back of the heel that perforates the achilles) is another possibility to consider. The symptoms are very similar to tendonitis, but will not resolve with rest or stretching. Eccentric calf raises may actually be contra-indicated in this situation. Treatment involves surgery to remove the spur. This often requires the tendon to be removed and reattached with an anchor. My surgeon took a different route and only cut into about 10% of the tendon, cut out the spur, filed the heel smooth, performed radio-frequency oblation on the tendon, and closed me up. I was on crutches for three weeks, in a walking boot for three more, and started running at 3 months. I slowly built my mileage back up and have actually run more than ever over the past three years (up to 90 mpw). Here is an article about the surgical option which involves detaching and reanchoring the tendon:
http://runningtimes.com/Article.aspx?ArticleID=21195&PageNum=2
An MRI SHOULD catch Haglund's Syndrome, but the first orthopedic surgeon I went to missed it, even though the MRI report mentioned a Haglund's deformity...
I'm currently in my 5th year as a Division I runner and I had a similar surgery a year and a half ago. I had Haglund's deformity and a ruptured retrocalcaneal bursa. The surgery went well but it took me quite a bit longer to get back into running, but I'm now running around 75 miles per week and in about 25:00 8k shape (with some pain and stiffness).
It took a decent amount of time to get back into running, but what really helped the most (aside from graston, icing/heating, and eccentric heal drops) is a sort of stretching/mobility exercise that I picked up after extensive research on the subject. I read some pretty obscure medical journals on achilles injuries.
To do the particular exercise that I thought benefited the most, you stand about two to three feet from a wall and bend the knee of the effected leg like a traditional achilles stretch. Then you lift the other leg off the ground and balance on the bent leg, and reach the leg that is off the ground straight towards the wall. Then you bring the foot back underneath your body, still balancing on the effected leg and reach back towards the wall, but this time to the inside of the leg that is balancing. Again you bring your foot back to the middle, and then reach again to the outside of your body and touch the wall.
So you essentially are touching three points of the wall with your other leg, which causes a really unique stretch that helps to align the collagen fibers in your tendon so then can be strong enough to withstand the demands of distance running. It also helps break up scar tissue.
By the way, my surgeon was Dr. David Porter from Methodist Hospital in Indianapolis, and he is a specialist in sports injuries of the foot and ankle. I wouldn't be running now without his diagnosis and subsequent treatment.
I lost 2 years to a similar pain before they found that I had a Haglund's deformity on my calcaneous. I did so much prorotherapy that my heel was a pin cushion. I did everything from ART, to massage, to accupuncture...nothing worked. Finally they removed it through surgery and I am now back to running (took about 5 months to be back training).
Get an x-ray of the calcaneous to see if there is a bone deformity that is irritating the tendon.
If that is the problem, you will be fine once surgeon takes a whack off the bone. In most cases they don't have to detach the tendon.
Achilles injuries just don't last 3 years unless you were in some horrible accident. I've seen spinal fusions heal faster. I know its a low-blood flow area, but not 3 years long. Maybe you just need surgery. It doesn't sound like something that's going to go away. 7 years down the line you wish you would have done more and now life has moved on.
dkfja;sdhgpoafgupigu wrote:
Achilles injuries just don't last 3 years unless you were in some horrible accident. I've seen spinal fusions heal faster. I know its a low-blood flow area, but not 3 years long. Maybe you just need surgery. It doesn't sound like something that's going to go away. 7 years down the line you wish you would have done more and now life has moved on.
Yes they do. Once the collagen fibers have become unaligned and chaotic from repeated injury, they'll stay that way forever unless there's a stimulus to break down the old, misaligned collagen fibers and lay down new ones in the proper orientation. Most or all of the scientific papers on chronic cases of Achilles tendonitis have subjects with multi-year cases of Achilles pain. Håkan Alfredson's first big study in 1998 had one patient (who made a full recovery with the eccentric heel drop protocol) who had been injured for over eight years! It's interesting to note that this study found that subjects who underwent the eccentric heel drop protocol had a BETTER outcome than surgery. Anways, read the blog post I linked to on the first page; it explains more.
The only other thing I can add is that many people have Haglund's deformity and it's completely asymptomatic, so there's a chance chronic Achilles tendonitis + Haglund's is only coincidental. Of course if there are other reasons to believe that the bone is involved (like a ruptured bursa, as one poster indicated) obviously you'd have to take a closer look at the bone structure.
Did you happen to run 1:51.x freshman year?
If this is you best of luck my friend, It will be a long slow transition back to full strength. You can do it, stay consistent and focused. You can do it.
I'm with some of the previous posters who recommend looking into the compartment syndrome issue. Make sure you are not getting added creatine into your diet. Many whey protein supplements add creatine into their mix and runners need to avoid those. I would also recommend adding hyaluronic acid (HA) as a supplement.
To original post: I think I have exactly the same problem as you. It's been bugging me for the past 3 years or so, and although my pr's are nowhere near yours, and I'm only a high school senior, I've experienced all of the same symptoms. In my soph year I had the tests done for compartmental syndrome and eventually had the bilateral fasciotomy done. After 6 months of a horrible recovery, the surgery did absolutely nothing and I was back to square one. ART did seem to help and doing some other chiropractic work done helped to, as well as PRP therapy (it's pricey). Now I'm doing some eccentric work, but every couple weeks I end up having to take a few days off to let the pain settle. Any other help would be greatly appreciated!