billyclyde’s AchillesBlog

Wow just reading your blog, so much of what you say I can related to. I also have tendinopathy and I could not stand up for more than a few minutes for months before I got an aircast splint. I have decided I’m going to perserve with eccentrics as everything I have read seems to support these. The experience you describe of keep trying, going one step forwards and two backwards is exactly as I have experienced (sorry about the pun)… Not being able to walk is one thing, but not being able to stand up is the pits. I have been told if I have surgey it will be a repair and graft. I still want to go down the conservative route IF POSS as Ive already had almost 6 lovely months of deconditioning. On the upside I am feeling more in control and knowledge helps, plus I actually sat in the pub today for around 2 hours WITHOUT having to keep leg elevated. I will know I have really improved when I don’t think about achilles every step. How are you now?

thanks to all who commented on my pt…figuring out if graston tech, was correct choice… the pain has finally subsided after rest for 7 days(no activity,bed rest)have a question for everyone? can anyone desribe what the pain from tendonitis/tendonopothy feels like? does it ever change? hot sharp pain/ knife cut across tendon/ poke/ pluck(guitar string), dull ache, just asking. getting bounced to my 6th ortho on fri. no one knows exactly what to do for the micro tears in my tendons, or they just dont want to deal with it… ortho(mr. i graduated from dartmouth, dont question me) who suggested pt, i called to inform him on how painful pt had been and how i cdnt walk(even in my aircast), he’s passin me off to another ortho. he had originally said, if pt didnt work for me that we would operate… guess he changed his mind, wdnt return my calls personally to xplain. his nurse called to tell me that he was refering me to someone else. anyhow, if anyone could help me with trouble shooting the pain id appreciate it. oh, has anyone heard of the new tendon grafting technique being studied in the uk, using manmade fibers spun together, graft

Hi, BillyClyde.

What you describe in your PT with the ceramic trowel is a kind of therapy called the Graston technique. I’m not sure why they are using it on you, but you may want to research that. I’ve heard it can be quite painful but may be useful in breaking up scar tissue.

I found a bunch of studies on eccentric exercises and how
they can help people with tendinosis when I was poking around a while back. I think this could be helpful for you!! Here are a
few links: http: //ajs.sagepub.com/content/26/3/360.abstract,
http://www.sportsinjurybulletin.com/archive/achilles-tendinosis.html,
and http://www.carletonsportsmed.com/chronic_achilles_tendinitis.htm.

I don’t know that many of us here have had your condition, but I agree with the other posters that severe pain is usually bad, and you should ask your PT and doctor about what benefit they are hoping you’ll get from the therapy and make sure they realize what kind of pain you are in.

Good luck!

Does you doctor know how painful this is? It doesn’t seem right that you’re in as much pain as you describe for several days after PT. I never had what I would call “real” pain. The massaging was uncomfortable, maybe verging on being painful, but that went away within minutes after my PT stopped doing it. If the PT says it is supposed to be painful, I think you need a new one.

Have to say my PT has been non painful and is working well. Its focussed on what I do myself (i.e. the exercises and stretches), with some massage to break down the scar tissue - but this is not painful at all.

My view on PT is that it is an exercise expert providing guidance at how to get back to being physically normal. I don’t go in expecting him to fix me, but I go to get the tools and guidance so I can fix myself.

But I know there are all sorts of PTs.

Hi Billy,

I have often wondered about many of the things I read here about PTs doing to people. Are the various sorts of stimulation and massage really any help, especially if it hurts? My rehab from surgery after a rupture was simple, fast, and painless, so I wonder if some of this professionally-administered torment is helpful.

I wonder what your PT or your doctor would say if you asked for good evidence that the pain being inflicted on you is good for anything? Does your doctor know exactly what your PT entails? “PT” can mean a lot of things. How good is the evidence that your particular treatment is helpful? Ideally, you could get the references from whatever medical journal the studies are in. If you could do that and put them on your blog, maybe some of us could help you sort out the studies.

I haven’t researched tendinopathy without rupture in great detail, but my understanding of the basic approach is to rest until the sharp pain is gone, then gradually work on flexibility and strength, with some evidence encouraging using eccentric (muscle working as it lengthens) exercises in particular.

At any rate, I’m

have a question for anyone going thru pt. i have been doing pt every 4 to 5 days for 2 weeks now. sessions last 35 to 45 mins(including 10-15mins of icing afterwards). a ceramic trowl is used to break up scar tissue in my calves/tendon, to improve blood flow, each leg is done for 5-10min( it is extremely painful…), but then it’s massaged(that feels better), then i do my stretches, then ice. my main question is about the pain that sets in afterwards, i can barely walk, and not to far. the next day is even worse. 3rd and 4th day are better, but then comes pt… it starts all over again, 1 big cycle. b4 i started pt, i could walk with relatively no pain, drive to the supermarket, walk the aisles, buy groceries, etc… since my pt, i’m lucky to stay on my feet for 10min or so(at any 1 time). does it get better? need suggestions/ and or comments, thanks. quick history- both achilles have severe micro tears in each, ortho doesnt want to operate( he told me to do the pt, suggested 6 wks should be enuf to get idea of damage), have been in 2 aircasts for 3 months, cant walk bare footed, have tried.. so painful i have to ice and get in b

thanks for sharing that story with me, i can honestly tell you that it has been a very, very long time, since i laughed outloud… i most definately appreciate your suggestions. i researched foot/ankle specialists in my area, and have a few to call tommorow and schd appts. again, thank you for your help. by the way, checked out your pages, looks like you have had quite the journey yourself. if nothing else, you have inspired me… thank you

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OMG, you got the typical arrogant surgeons. My wife is a doctor and while she generally respects surgeons for what they can do, neither of us is inclined to want to be around them due to their arrogance. We were having a nice dinner at a good restaurant here a few years ago when some jackass doctor and his trophy wife told us they would like us to move to another table because, as she put it, “he’s been in the ER all day saving people’s lives.” I told her he hadn’t saved mine and that I had my chewing gum stuck under the table for later so I wasn’t willing to move. True story. The guy was as much of a jerk as his airhead wife. They are people and they are not infallible. They do make mistakes. You have the right to a straight answer and if neither of them will do that, I know I would be finding another doc. I’ve fired three over my ATR, four surgeries and four different surgeons.

thanks for the support, ist was general ortho, 2nd was a “sports” ortho specialist… not necessarily a foot/ankle specialist. will check into this, thank you. my only question to both doc’s, fell on deaf ears…. why am i not being put in a cast to immobilize my ankle/tendon? just becauase i CAN walk in a aircast(on both feet), doesnt mean the achilles is getting rest to properly heal…(then i’m reminded that i am not the doctor with a degree from dartmouth and i need to TRUST him). well, anyhow… thank you for your response to my post, it was very much appreciated….

Wow, that sounds pretty miserable. OTOH, if you haven’t actually ruptured the tendon I can’t see what good surgery would do and surgery is fraught with a lot of peril. Read my blog for just some of things that can go wrong. Are either of the docs you’re seen foot/ankle specialists or just general orthopods? I found out the hard way that it does make a difference. Just because someone is good at replacing knees doesn’t mean they know much about ankles and feet.