Achilles tendinopathy and intensive eccentric calf raises?

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  • Achilles tendinopathy and intensive eccentric calf raises?
  • glupton1976
    Member

    Alfredson protocol works well if the tendinopathy is mid tendon. Not so well at the insertion where you risk complete rupture.

    Premier Icon Onzadog
    Subscriber

    My problem is, I’m struggling to find someone to give me a hands on diagnosis. Saw a sports therapist recently who decided it was all due to an inflexible pelvis.

    It feels like a sprained ankle but I’ve not gone over on it. Hurts first thing in the morning but not at all once it warms up to a bit of exercise. However, the more I exercise, the more it hurts in the morning.

    roundwheels
    Member

    yeah i had this for over a year , and it resulted in surgery (decompression of the achiles).i did the phisyo,orthotics,injections and didnt work ,

    Premier Icon Onzadog
    Subscriber

    Anyone suffered and more to the point, anyone done the 12 weeks of eccentric calf raises to sort it?

    Did it work?

    Premier Icon Onzadog
    Subscriber

    πŸ™ 😯

    Premier Icon jpacey
    Subscriber

    all the current research indicates that loading the tendon is the most crucial part of rehab and the 12 week eccentric program is a good starting point (as long as its mid tendon as glupton said) but I find it does need tweeking depending on the irritability of your symptoms.
    However, I wouldn’t want to invest 12 weeks on a rehab program if I didn’t have a definite diagnosis so its worth getting it properly assessed. Its an easy normally problem to diagnose

    glupton1976
    Member

    In my area of physiotherapy I get the opportunity to throw the kitchen sink at people to get them back to fitness in the minimum time scale. I tend to use a three pronged attack – eccentric exercises, deep tissue massage and dry needling.

    I had it personally a couple of years ago. It was the dry needling that worked best for me – bloody sore though.

    Premier Icon jpacey
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    Ah that’s interesting, Im a physio and had a spot of lateral epichondylitis that improved with the same approach.I always do this for my patients but having the treatment work on me really does a lot for my faith that a treatment works. It was the needling that really made the biggest difference in pain and allowed ne to get on with the strength program. your right it is bloody sore though. I was sat wincing in front of the TV every night feeling a little more empathy for my patients

    Premier Icon Onzadog
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    Thanks guys. From the sounds of it, I might need to switch therapist. It’s expensive trying to find the right one. Any chance one of you guys in the trade could recommend someone in or close to Nottingham?

    (or fancy doing an online diagnosis).

    Premier Icon mrblobby
    Subscriber

    If you ca travel then i can recommend one in London who are part of the same clinic as Alfredson, they’ve been treating me.

    glupton1976
    Member

    Onzadog – Email me.

    Premier Icon Onzadog
    Subscriber

    Cheers glupton. I did mail you.

    One other question has sprung to mind though. How widely know about is the Alfredson protocol in sports therapy circles? Would someone not knowing imply that they’re not that current?

    surfer
    Member

    The Alfredson protocol should be well known by any sports interested physiotherapist. There is a good body of evidence proving its effectiveness.
    Far too often physiotherapists trot out the same advice, drop heel stretches etc which can sometimes exacerbate the problem. If you have to prompt your physio I would be concerned.

    Its a pity you are so far away from me Glupton πŸ™ but I have dropped you a mail anyway

    Premier Icon Onzadog
    Subscriber

    That’s a bit worrying. He didn’t seem familiar with Alfredson at all. Time for a new therapist I guess.

    Premier Icon mrblobby
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    If you can get in to London and are serious about getting it sorted then it’s worth checking out Pure Sports Medicine.

    Premier Icon debaser
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    Hurts first thing in the morning but not at all once it warms up to a bit of exercise. However, the more I exercise, the more it hurts in the morning.

    I have had this for a couple of weeks and it’s now gotten to the stage where my symptoms are exactly like the above and I’m thinking it’s time to do something about it.

    Should my first port of call for an assessment be a visit to my GP or should I just head straight to a sports physio?

    Premier Icon mrblobby
    Subscriber

    I have had this for a couple of weeks and it’s now gotten to the stage where my symptoms are exactly like the above and I’m thinking it’s time to do something about it.

    Stop running/riding and go get it sorted. The worse it gets the longer it’ll take to sort out.

    Should my first port of call for an assessment be a visit to my GP or should I just head straight to a sports physio?

    It’s a shame that it seems to be an either/or choice and they are not more joined up really as sometimes it needs a combination of both. If I was starting from scratch I’d go see GP first.

    thegreatape
    Member

    What’s dry needling?

    surfer
    Member

    Thanks mrblobby ill have a look at that.

    its not always necessary to stop training i have “managed” achilles pain for years and if you are sensible and reduce and modify your training that may be enough. You have to err on the side of caution though.
    i have found that pain is never far away and been symptom free for months. Experienced pain and reduced my mileage and removed speed and hill work until it settles then ramp jt back up again whe pain free. It reduces the amount of fitness you lose.

    mrlebowski
    Member

    Any chance of getting an MRI to be sure of the issue?

    Not so sure about Pure Sports – not heard great things about them & they missed my Chronic Patellar Tendinopathy!

    Try this:
    Dr Simon Kemp He’s head of Sports Medicine at the RFU

    I’m doing this on my knee Shockwave Therapy

    glupton1976
    Member

    Onzadog – Didn’t get your email, but have sent one to your address in your profile – reply to that and I should get it. Alfredson is considered the gold standard for treating mid-portion achilles tendinopathy. A good therapist should know of it.

    Surfer – I’ve sent you a reply.

    Debaser – go to either one. Either should be able to set you off on the right path.

    Thegreatape – similar to accupuncture -stick some needles in trigger points, wiggle them about a bit. Forces the muscle to relax and promotes healing.

    thegreatape
    Member

    Thanks glupton. Presumably not something one can do at home (like foam rollers, wobble boards etc.) ?

    Didn’t take much googling to find the answer to that is no.

    glupton1976
    Member

    Not something you should be trying at home unless you’re trained in it. πŸ˜€

    thegreatape
    Member

    I’ll stick to DIY toenail surgery then

    Premier Icon debaser
    Subscriber

    Thanks folks, booked an appointment with my doctor, though the first available was 22 October 😯

    I might well give FASIC a call as they were decent when dealing with a rotator cuff injury a couple of years back.

    Any other Edinburgh options worth considering?

    glupton1976
    Member

    Debaser – I’m in Edinburgh. Email me.

    surfer
    Member

    Thanks Glupton I really appreciate the time you have taken and the excellent advice you have given. Thanks πŸ˜€

    gee68
    Member

    I’ve been suffering for several years now with a sore tendon on the back of my ankle and can no longer run, if I walk to far then rest it tightens right up and causes me to limp quite badly.I went to the doctors 3 weeks ago(again!!!)and he diagnosed tendonitis,there’s also a lump on the back of the tendon.

    He has put me on an exercise plan and told me to apply Ibuprofen and ice.
    For those of you in the know in this thread is this the way to go as he appeared very vague

    Sorry for piss poor spelling and grammar but having to rush as im at work.

    Premier Icon Onzadog
    Subscriber

    Glupton, thank you very much for giving your time so freely.
    Cheers.

    glupton1976
    Member

    gee68 – as above, look up Alfredson and maybe consider getting a deep tissue massage to your calf muscles.

    Surfer & Onzadog – no bother. Happy to provide advice, because I know just how annoying this type of injury can be and how difficult it sometimes is to figure out if it’s not your area of speciality in life.

    Let me know how you get on.

    Premier Icon MadBillMcMad
    Subscriber

    No idea if I have the same issue but my symptoms are very similar right down to the pain as I walk along the bedroom corridor & the pain has gone by the time I get down the stairs.

    but I do those same exercises combined with streches lasting 2 minutes on each achillees.

    & after a good few months the issue appears to have abbated.

    gee68
    Member

    Thanks glupton, I’ll do a bit of googling tonight. πŸ˜€

    @ Onzado. Did you find anyone local as im also in Nottingham?

    glupton1976
    Member

    Gee68 – a mate suggested that I recommend http://www.keyworthphysio.co.uk/ for a nottingham physio.

    gee68
    Member

    Thanks glupton πŸ˜€ I’ll take a look but im more north Nottingham(Mansfield)than south.
    Might of helped if i’d mentioned that earlier,sorry. 😳

    Davidian
    Member

    Hey,

    Nearly a year ago I had an op due to long standing insertional tendinitis but I’m still not able to do any explosive movements without pain.

    I have recently started on the Alfredson method (not that I knew that was what it was called until just now). I’ve just read the link below and it mentions about “not lowering the heel below the level of the step” so recommends heel drops on a flat surface. Can anyone tell me how you drop the heel without being on a step????

    Cheers

    http://www.theglobeandmail.com/life/health-and-fitness/sore-achilles-things-have-to-get-worse-in-order-to-get-better/article551003/

    Premier Icon Onzadog
    Subscriber

    My understanding was you lift onto your tiptoes using the strength of the good leg, then lower slowly using the bad leg but do the whole thing on flat ground.

    I’m not expert though.

    glupton1976
    Member

    I wouldn’t worry about doing the exercises in a way where you don’t drop your heel below the level of your toes.

    But aye – use the good leg to lift you upon to your tip toes, then lower on the gammy leg. Pain is to be pushed through for once (within reason).

    HOWEVER – if you have insertional achilles tendinopathy you need to find a different solution. You’ll need to see a good physio to sort that out.

    glupton1976
    Member

    Risk factors for Achilles Tendinopathy – by Seth O’Neill

    There’s a wee link to a post about the risk factors of achilles tendinopathy.

    kurt
    Member

    Some of the more recent literature suggests that probably don’t need to worry about loading purely in a eccentric fashion so I wouldn’t necessarily bother using the good leg to lift your bodyweight if you can manage to do it with your bad one.

    surfer
    Member

    @Kurt

    Do you have any references? I have been following this method with some success and my Achilles is pain free when doing the eccentric stretches. I have avoided pushing back up using the injured leg but I know I could do it pain free.

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