dfoss’s AchillesBlog

It has been several months since I last posted. I didn’t want to write anything unless it was positive and could possibly be of some use to someone else. I say this because thing were not going well in my recovery for a long time.
After debridement surgery for chronic Achilles tendonitis last November, I first moved out of the boot in late February ’13 believing that the trajectory of recovery would gradually go up. Unfortunately after a month of freedom the pain and swelling in my tendon had increased to the point that I was back in the boot. I stayed on a roller coaster like this until July moving out of the boot, slowly increasing activity only to get increased swelling and pain, diminished activity, then back into the boot. What was going on? It seemed that, while walking, each step without the boot tugged a little on the tendon causing a little more damage. I continued to look for answers and alternate treatment since what I was doing obviously wasn’t working. I seemed to be in a conundrum, I had to strengthen my muscles to walk without straining my tendon. However, every exercise or activity I knew of that strengthened the muscle also stressed the tendon. Until my muscle chain was long and strong I wouldn’t be able to walk freely. I had no strength in my calf so each step with my bad leg involved an exaggerated dorsiflexing. If I could push off at the end of each step while walking, as my good leg did, then this dorsiflexing would be minimized and tendon strain significantly reduced.
I eventually ran across something that I have not seen mentioned on this site or anywhere else, ARP Wave. I was skeptical at first and was not completely reassured by my initial investigation, but desperation is quite the motivator – I went through with it. ARP Wave is an electroshock therapy similar to a tens unit but that’s where the similarity ends. Muscles don’t work unless nerves tell them to and after months of atrophy my nerves had been asleep. Saying that ARP Wave stimulates the nerves is an understatement. It is quite painful and disturbing at first. Actually the treatment never quit hurting but the progress is so rapid that I looked forward to every session. After the initial sessions get the nervous system (and consequently the muscles) working properly, the following sessions train it to stay that way. All the while the muscles undergo rapid toning and conditioning. The important thing is that none of this strains the tendon, it reportedly accelerates healing of the actual wound in the tendon. I am not convinced of this claim but it at least increases blood flow to the wounded area. Having said that, I did experience a great deal of improvement in the wounded area during the 2 months of my treatment. Here’s some draw backs: It hurt a lot, you WILL hit your pain threshold, and some people just can’t take it. It requires daily commitment, I hour morning and night: more pain = more gain. You need to maintain a high protein diet (3 steaks a day- yea!) to feed the rapid muscle growth that’s happening. It costs at least $750 uninsured per month. Most people can get by with one month, I took two. There are few clinics offering this locally but it can be done long distance, via skype, from their home office. I started with a local technician and finished via skype.
This was by far the best 2 months of progress I have had since well before surgery. I am now walking up to 7 miles a day in moderate hills. The push off with my bad leg with each step is still much weaker than with my good leg but it is adequate, and improving. I have been doing heel drops (15 straight knee+ 15 bent knee x 3 sets x twice/day = 180/day) for a month now and experiencing the increased ROM and strength I thought this exercise would produce. Every time I started adding this exercise to my regiment before ARP Wave I would soon get the swelling and pain back and it wouldn’t go away without 3+ weeks in the boot. I have had no significant swelling or pain in the last month but there is still that dull, constant pain that lets me know I have a long way to go. However I continue to experience increased strength and ROM while experiencing less pain and swelling, not more.