torn achilles

[steinbej]

Hi folks,

One reason I've been quiet for a while is new baby which keeps us plenty busy. But the other reason is a very freak injury which has produced a torn achilles. Most achilles tears are where the muscles of the calf meet the tendon. But mine is different. I received a crush injury to the back of the heel where the achilles attaches to the upper back part of the heel. That was back on August 3, 2013. It still hasn't healed. Seen several doctors, finally had MRI, still not conclusive, more doctors followed. Achilles are tough to deal with because they just heal very very slowly, when they heal at all. There's no cortisone injection that will fix 'em (in fact, cortisone will lead to complete rupture), there's no strengthening or stretching that will fix 'em. Just takes a hell of a lot of time. No fun.

-- Josh

[Antonio]

"steinbej" ha scritto nel messaggio
news:4e43a4bc-35f2-4779...@googlegroups.com...

quote. I suffered a light injury on my left achille's tendon in December
2012. I have been able to run all the same since then, but with more or less
pains and had to avoid uphills.
I can tell that the pain has ended completely only 12 months after! maybe if
I had rested more and/or had some massages on the calfs... who knows.

[Tim+]

Oh bad luck Josh. What happened? Did something clobber you from behind? Can
you cycle?

Tim

[Jos Bergervoet]

On 3/8/2014 2:22 AM, steinbej wrote:

....

> more doctors followed. Achilles are tough to deal with because
> they just heal very very slowly, when they heal at all. There's
> no cortisone injection that will fix 'em (in fact, cortisone
> will lead to complete rupture), there's no strengthening or
> stretching that will fix 'em. Just takes a hell of a lot of
> time. No fun.

I hope you will fully recover! But just out of curiosity,
wouldn't the following reports suggest that there *are*
some useful strengthening or stretching exercises for it?

http://njsportsmed.com/files/alfredson-heavy_load_eccentric_achilles.pdf
http://bjsm.bmj.com/content/38/1/8.full
http://www.sportsinjurybulletin.com/archive/achilles-tendonitis.html‎

(google "Heavy-load eccentric achilles treatment")

--
Jos

[Tim+]

Interesting links. Thanks for posting.

Tim

[Jos Bergervoet]

I can add that at least the method did not harm me
when I tried it (I used a heavy wooden table to lift
and then slowly sink on one foot, stretching the calf
and achilles). My injury went away, but of course it
might have gone just the same on its own..

Anyhow, the theory is that the heavy load makes sure
the "right" type of collagen fibers are formed in the
healing process. I forgot whether that should be type
I or type III collagen, but Google seems to know:
www.google.com/search?as_q=collagen+type+heavy+eccentric+load

OK, I see at this site that you should aim for type I:
www.takethemagicstep.com/coaching/families/health-management/managing-achilles-tendon-injuries/
but also that if the injury is at the insertion (the
attachment of the tendon to the bone) then it would
be more complicated..

Happy recovery,

--
Jos

[rms]

> One reason I've been quiet for a while is new baby which keeps us plenty
> busy. But the other reason is a very freak injury which has produced a
> torn achilles.

Very sorry to hear that, man. Heal well, and congrats on the baby!

rms

[steinbej]

> Oh bad luck Josh. What happened? Did something clobber you from behind?

Yes, precisely. Got me on the back of the heel bone exactly where the Achilles attaches to the bone, which is quite different than the usual achilles strain farther up the tendon where the tendon and muscles of the calf meet.

> Can you cycle?

Yeah, can cycle, but cycling isn't nearly as good a workout as running, cycling is even less possible in cold icy winter of Upstate NY, and I've never liked it as much. When I do triathlons, I prepare for the run and swim. I just gut out the bike part.
-- Josh

[steinbej]

> I hope you will fully recover! But just out of curiosity,
> wouldn't the following reports suggest that there *are*
> some useful strengthening or stretching exercises for it?
>
> http://njsportsmed.com/files/alfredson-heavy_load_eccentric_achilles.pdf
>
> http://bjsm.bmj.com/content/38/1/8.full
>
> http://www.sportsinjurybulletin.com/archive/achilles-tendonitis.html

These are great articles, thank you so much for sharing. The third link is just a layman's description of hte first article, so they essentially are the same. The second article is different but not clinically relevant, as the outcome is tendon thickness and character on ultrasound, not clinical athletic performance. But the first article is pretty interesting.

Now I will point out that these athletes have a different injury than me. Theirs are 2-6 cm above the bony back of the heel where the Achilles attaches, whereas my injury is exactly where the Achilles attaches. BUT, this is probably the closest I'm going to get in the medical literature on an injury like mine, so the guidance and therapy might apply to my case.

Since I am a forefoot strike runner, I am kinda doing the eccentric loading big time simply by returning to running. But that's probably with impact which is too great, too quick, and too uncontrolled compared to slow careful eccentric maneuvers described in this article.

And I have the perfect weight to load on my back... baby now 8 months old in baby backpack. I'm psyched to try the rehab regimen recommended here. Thanks so much for recommending it.

Best,
-- Josh

[Ed Prochak]

>
> Now I will point out that these athletes have a different injury than me. Theirs are 2-6 cm above the bony back of the heel where the Achilles attaches, whereas my injury is exactly where the Achilles attaches. BUT, this is probably the closest I'm going to get in the medical literature on an injury like mine, so the guidance and therapy might apply to my case.
>
>
>
> Since I am a forefoot strike runner, I am kinda doing the eccentric loading big time simply by returning to running. But that's probably with impact which is too great, too quick, and too uncontrolled compared to slow careful eccentric maneuvers described in this article.
>
>
>
> And I have the perfect weight to load on my back... baby now 8 months old in baby backpack. I'm psyched to try the rehab regimen recommended here. Thanks so much for recommending it.
>
>
>
> Best,
>
> -- Josh

I'm very late (not been able to visit here in a long time), but Congratulations on the baby and sympathies on the injury.

Could this type of injury lead to a heal spur long term?

Enjoy what you can. And especially enjoy every moment of the baby!
ed

[steinbej]

> I'm very late (not been able to visit here in a long time), but Congratulations on the baby and sympathies on the injury.

Thanks. Baby is very helpful for injury. Article says one must do "heavy-loaded eccentric heel/achilles exercises". That for some people means filling a backpack with heavy books and weights to increase the load on the achilles. But for me it means putting 20 pound 9 month old in baby backpack and doing exercises. Works great!

> Could this type of injury lead to a heal spur long term?

Nope. What people call "heelspur" is plantar fasciitis, which is on the bottom surface of the heel bone, the part that strikes the ground with walking. My injury is at the posterior (back) surface of the upper aspect of the heel bone where the achilles cord runs down the leg and attaches to the heel bone.

> Enjoy what you can. And especially enjoy every moment of the baby!

Especially those moments when the baby decides he's done sleeping for the night at 4:45 AM... But he is cute as all get out, so it's hard to stay grumpy.
-- Josh

[steinbej]

General update: I've been doing the heavy-loaded eccentric heel exercises as advised here on this very discussion group. I'm 8 weeks into the 12 week regimen and I must say it's been very successful, surprisingly successful! I have been able to run the entire time, which I could not do previously nearly at all. I've gone from gentle ginger running to nearly returning to normal form. I've been able to push speed a little bit and enjoy a nice sprint in gorgeous spring morning before work a couple of times. I continue to do the exercises and I continue to build confidence that I'm going to heal and recover. I still have a large very sensitive somewhat sore bump on the lateral aspect of the back of my heel bone. But as long as I don't whack it on anything by accident, it doesn't bother me too much. If my improvement continues, I will be able to imagine running a race or two and maybe a triathlon next season. I could not have those ambitions 8 weeks ago when I began this last ditch rehab effort to avoid PRP injection and/or surgery.

I'll post again in another month or two.

Best,
-- Josh

[rms]

>If my improvement continues

Awesome news, man! Don't overdo it

rms

[Jos Bergervoet]

On 5/29/2014 2:19 AM, steinbej wrote:
> General update: I've been doing the heavy-loaded eccentric

heel exercises as advised here on this very discussion group.

I'm 8 weeks into the 12 week regimen and I must say it's been

very successful, surprisingly successful!

Great! Sometimes you can trust what you read on the
internet. Your report gives me more confidence in
the method as well (I brought it up here because it
helped me once, but one recovery can just be by
coincidence of course..)

> ..

> I'll post again in another month or two.

Yes, no premature final conclusions! I hope there
won't be averse side-effects or relapse. Success!

--
Jos

[Jos Bergervoet]

On 5/29/2014 2:19 AM, steinbej wrote:

> General update: I've been doing the heavy-loaded eccentric
> heel exercises as advised here on this very discussion group.
> I'm 8 weeks into the 12 week regimen and I must say it's been
> very successful, surprisingly successful!

Great! Sometimes you can trust what you read on the
internet. Your report gives me more confidence in
the method as well (I brought it up here because it
helped me once, but one recovery can just be by
coincidence of course..)

> ..

> I'll post again in another month or two.

[steinbej]

> > I'll post again in another month or two.

Ok, it's been a little more than a month or two.

I enjoyed a full recovery doing those heavy-loaded eccentric heel lowering exercises for my achilles. Eccentrics are now standard of care in sports medicine tendon injuries per my sports med buddies. Now 53, I find myself working through a series of other injuries, which does include renewed Achilles troubles. But I'd say I enjoyed 6 injury-free years thanks to the advice here! Thanks!
-- Josh

[Tim+]

I think I must have picked my parents well. I’ve enjoyed injury-free
running for many years, despite my best attempts to abuse my legs. ;-)

Tim
--
Please don't feed the trolls

[Ed Prochak]

Thanks for the update! That's dedication to follow up after 9 years. Stick around.
Glad to hear you got help here.

Enjoy the run.
ed