Achilles Tendon injury and now Dr. says tendon is too short

by Sherri
(Virginia)

I have been fighting an achilles tendon injury for around 7 months now.


I have done ibuprofen treatment, physical therapy, rest, ice, casting and stretching exerising daily.

My orthopic dr. said there was nothing else he could do so he sent me to a surgeon, but he said to get some special made insert for my shoe (because what happened when my tendon started healing was it is too short now. ) then come back and see him in 36 MONTHS and he might do the surgery to lengthen the tendon.

This seems like a long time to go without some relief.

So I guess my question is the doctor putting me off or will this insert really be worth the cost ( which is $300 to $350 )and give me some relief.

Or should I look for another opinion?

I am in constant pain when I walk. I can't walk with out a limp because it hurts to walk normal, it hurts standing and it screams at night when I try to go to sleep.

It has gotten to the point where my whole ankle hurts and burns and it pretty much stays swollen especially on either side of the achilles tendon and in the front.

It is tender to the touch and there is a knot on the tendon from where it healed up.

The knot is very painful and sore especially after exercising or walking.

I am on my feet all the time and my daughters play basketball and I like to work with them, but I can't even do a jump shot. I am so frustrated with this whole thing it seems like it is never going to get better. Any insight you could give would be a great help.


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Joshua Answers

Hi Sherri.

Your tendon is goo short?

This is one of those not too infrequent times that I get to say my favorite saying, which is..."Your doctor is smoking crack."

It is INCREDIBLY unlikely that your tendon is too short.

Maybe if it was completely severed, you had surgery to reconnect it, and as it healed it pulled itself together, MAYBE then the tendon itself would be too short.

It's is a definite that your calf muscles and connective tissue -is- too tight and short, and this is putting constant tension on the injury site of the tendon.

If you have a lump there, then you have a long term dynamic of the body continually laying down scar tissue.

But doesn't it heal?" Well, yes, but when it heals, it heals less structurally strong. Meaning that scar tissue fibers lay down in all directions, which is not as strong as all in the same direction.

Then one or two of them rip off with activity, and the body goes "Oh no, we're injured again!" and does it's thing to protect you.

Hello Tendonitis and the Pain Causing Dynamic.

See: What Is Tendonitis?

Everything your doctor told you to do, and the ways you were told to do it, pretty much equal you having very little chance of healing and getting out of pain.

Ibuprofen is not 'therapy'. Ice packs a few times a day won't help. Casting is a -horrible- thing to do, unless your tendon is ripped in half or more.

Honestly, I can't say about the insert. Don't know. However, with the track record of your doctor's recommendations.....

1. Describe the injury. Was it a single event, or did it come on over time.

2. How bad? Describe symptoms, what makes it worse, etc.

3. Swelling? How much?

4. Describe the pain, at night and such.

5. Is the pain in the tendon, the muscle, the ankle, all of the above? Details.


I imagine we need to do what we need to do for all Achilles Tendonitis: Reduce inflammation. Increase nutrition to the actual site of injury. Decrease tone of calf muscles. Open up connective tissue of the structure.

Answer the above questions to give me a more accurate picture, and we'll go from there.




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Comments for Achilles Tendon injury and now Dr. says tendon is too short

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Sep 07, 2009
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starstarstarstarstar 		PART 2 - reply to questions - Achilles Tendon injury and now Dr. says tendon is too short
by: Sherri

Question 1: I was playing basketball with my daughters basketball team and it just started hurting when we were running up and down the court. It happened so long ago I don't remember if I heard a pop or not. I do remember it did hurt like crazy and I remember that I could not walk straight after that or put all my weight on it. I did not have insurance at the time so it was 4 or 5 months before I could go to the doctor.

Question 2, 3,4 & 5: Back of ankle from heel to about 1/3 of the way up leg hurts with a knot about a 1 1/2 inches from the heel.Both sides of back of ankle are sore and swell. There also feels like there is a knot where the tendon and muscle meet. The front of the ankle swells and burns.Pretty much the whole ankle swells. The pain also goes up the back of my leg to the bottom of the muscle where it burns and hurts to put my feet up and rest them on a stool without turning my leg to the side so it is not resting on the back of my leg.

The pain also spreads out to the last two toes sometimes also.The pain at night when I lay down keeps me from getting to sleep for awhile. The pain is stabbing, throbbing,burning, achey & sore to touch most times especially if I have been on my feet alot.

I really have not found anything that makes it feel better. I can flexs my toes to a pointing poistion ok but when I try to bring my toes to me I can't do that very well without a lot of pain.
When I try to do the exercises (like standing on a stair with your toes and lower your heel off step, and standing at a wall and bad foot back lean into wall) I got from PT it is very painful at the two knots I mention and at the heel, but it is also painful in the front and sides also but not as much as the back.

If you need more info let me know.

Thanks for your help
Sep 07, 2009
Rating
starstarstarstarstar 		PART 3 - Achilles Tendon injury and now Dr. says tendon is too short
by: The Tendonitis Expert

Hi Sherri.

Hmmm. The pain in back makes sense, the pain in front doesn't necessarily.

And I'm not there so I can't poke around and take a direct look. I'm a little concerned about how significant the 'injury' on the tendon is. You have more than a normal amount of swelling and pain location than 'normal' Achilles Tendonitis.

There is rip and tear from a one time injury. I don't think you're in that category.

There's a slowly progressing tendonitis and tendonosis, that eventually looks like the onset of sudden pain. I think you fall in here.

I'm curious whether you have a giant pile of scar tissue that keeps the body responding like you are injured, or if you have Tendonosis, degeneration of the tendon. That is more the scenario to worry about.

1. Do you have previous foot injury, sprain, etc, that could explain the pain in the front?

2. How much swelling would you say you have, how often, and for how long? How big an area is swollen? The entire ankle? Please put as much detail into this answer as possible.

3. Are you on any Statins?

4. Taken any antibiotic like Levaquin or Cipro?


Here's my first stage suggestion.

To help identify the actual injury sites, let's get all the inflammation and swelling out of there. This will also reduce pain down to just the injury sites, ideally.

For the next 7 days, hardcore, get a 5 gallon bucket, full of ice, frozen water bottles, whatever, and dip the entire lower lef for 10-20 seconds AS OFTEN AS YOU CAN.

If you want to lower your pain levels, we're talking 20+ times a day, and don't really expect results for at least 2 days (though you will notice something as soon as you start, speed of results vary person by person).

It's simple. It's annoying. It's messy.

Find a way to make it fun. It works. It deals with the whole ecology of the lower leg.

After we do this, we'll focus in more specifically. But this will help me/us identify what's going on and what best to do about it.

Start dipping. Answer the above questions. Keep dipping.



Dec 02, 2009
Rating
starstarstarstarstar 		What happened?
by: Marietta

I would love to know where this story ends? Am I missing the ending somewhere or was there no final response?


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Joshua Comments:

Haven't heard back from Sherri, so we'll have to go with the 'no response' option...:(


Dec 27, 2009
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starstarstarstarstar 		achilles knot
by: Barry

I am going to try this ice treatment for a week.

I have similar problem. I have knot above heel on my right foot and Plantar Fasciitis on left foot. I believe was originally caused by running with tight calves and not warming up enough. I have significantly reduced tight calves and lost 25 pounds since problem originally occurred.


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Joshua Comments:

Great job on dropping the 25 pounds and loosening up the calves.

Icing to reduce pain and get inflammation out.

Light stretching and lots of self massage on and around the painful spots and the attached structures.

More calories/protein to heal any actual damage, especially when/if you get back to running.


Feb 12, 2010
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starstarstarstarstar 		Tendons can be too short...
by: Sydney

My tendon was too short, and I had to get surgery to lengthen it. Well, both of them were too short. My doctor made 3 insisions in each one and the tendon grew into the slits, which made them grow longer.

I walked on my tippy toes my whole life before I got the surgery because my foot wouldn't go all the way down. I was in a wheel chair for the whole summer with casts up to my knees.

It sucked.


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Joshua Comments:

Hi Sydney.

Normally I would say that 'tendons aren't too short', that it's muscles that are too tight that pull on the tendons too much and restrict mobility.

But as everything is on a bell curve, I'd say the doctors may have been right this time. Some times, the body does funny things, and you might just have been gifted with a genetically too short structure.

That's why health care isn't as cut and dry with black and white results. Everybody is different.

Thanks for sharing.


Apr 20, 2010
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starstarstarstarstar 		Help!!
by: Anonymous

I have Achilles tendonitis.

My dr. Said to rest it and take some meds. It hurts way more than it did when I went in. I'm wrapping it up now. Should I go back to the doctor? Should I buy a splint, brace, or night splint?


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Joshua Comments:

Hi Anonymous.

I'd need to know a bit more, but right off hand I'd go with a night splint, to help lengthen the structure at night while you sleep.

I'd also suggest that you get my Reversing Achilles Tendonitis ebook. It has the bulk of what you need to reverse the progressive dynamic of your lower leg problem, and help heal any tendon damage.

The important thing to know is that rest isn't going to fix it, and meds aren't going to fix it.

Whether it's Tendonitis or Tendonosis, you HAVE to deal with the progressive muscle tightness, connective tissue constriction, and inflammation process if you want to 'fix' the problem.


Nov 16, 2010
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starstarstarstarstar 		tendons shortened after coma from being hit by a truck
by: james decicco

hi i got hit by a truck not a wreck i got ran down on new years and i was in a comma til march 11 and my tendons are short in my arm and leg what should i do?


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Joshua Comments

Hi James.

OUCH!

Welcome back to the world!

So, other than the impact trauma, you were immobile for at last three months.

You should:

** Take longer and longer walks, conscious of taking longer and longer strides.

** Swim, using your body in full range of motion motions.

** Take a gentle yoga class.


Essentially, you want to use your body gently, creating more and more length. The more big motion, the better.


More (specific) questions, more answers.
Jan 19, 2011
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starstarstarstarstar 		I don't know what to do next
by: El

I suffered the same thing as Sydney. My tendons were way to short and I walked on my tippy toes - I couldn't get my heels close to the ground at all! The pain was terrible, I would wake up at night screaming. I has surgery on both of them, and was in a wheelchair with casts on my legs for a period of time.

Recently I injured my tendon during sport, and I also injureD the other just walking. I had a growth spurt, and my tendons did not grow. They are very tight again and it is hard to walk on my heels. They have caused problems by tearing where they connect to the calf, and have also caused problems in my hamstrings, quads, and recently the muscle on my shin pulled of the bone in a few places.

For the past year I have suffered constant pain, and it just keeps getting worse.

I went to the doctor to ask what to do, and he thought it was in my head.

I an now at a loss as what to do next.


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Joshua Comments:

Hello El.

One of two things is happening. Either you were born with genetically short tendons and you've had this up-on-your-toes problem all your life, or

Or the problem is not your tendons.

Tendons don't 'get short'. Tendons are, basically, inflexible chunks of connective tissue.

If you used to have normal range, and then you ended up on the balls of your feet with 'shortened tendons', then the problem is not with your tendons. Not even close.

The culprit is the muscles and connective tissue of your lower leg, and then probably hamstrings and such.

If they're not functioning properly because they're neurologically too short and unable to do their job, then it totally makes sense that you're getting rip and tear injuries.

The force of movement has to go -somewhere-. And if the muscles aren't absorbing force, something is going to break somewhere, sooner or later.

How old are you?

Say more about how this started and how it progressed.
Jan 22, 2011
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starstarstarstarstar 		Reply -- Achilles Tendon injury and now Dr. says tendon is too short
by: El

I was born with genetically short tendons, and I had them surgically lengthened when I was 5 so I was able to put my heels flat on the ground.

Although lengthened, the tendons were still very tight and I would experience terrible pain up my shins, and in my tendons and calves.

I am now 15, and my tendons are once again short as I have been growing over the past year. It has resulted in many tears of the shin and calf muscles, and is know causing problems with my knees and hamstrings. The pain I had when I was younger is now permanent.

I do special stretches everyday, and when they are really bad I go to the physio to get them massaged, but the pain does not leave.

I don't know what to do next - they are just so painful! I can't sleep properly, and when I try to do sport I get bad shin splints. Half the time I know walk on my toes again without even meaning too.

I went back to the surgeon late last year, and he didn't want to operate because he didn't want to weaken the tendon any further.

I don't know what to do next, but I just have to do something to help them!

My family is considering getting braces fitted to my feet/ankles which would help me walk flat footed and to stretch my tendons, but we don't know whether this would help or not.


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Joshua Comments:

Hi El.

The problem is no longer the tendon.

The problem is that the entire structure of your lower leg is TOO SHORT and TOO TIGHT and OVERWORKED.

In short, you need daily massage, and lots of it, on your lower legs. Magnesium and Vitamin D and such wouldn't hurt anything.

You can do it all yourself, but you need to work at it until you get results.
Feb 08, 2011
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starstarstarstarstar 		April - ankle sprains/achilles too tight/weakened calf
by: april

I sprained my ankle exactly a year ago. I did PT with different therapies a couple months and when that didn't work..ignored the pain. After months of other injuries caused by overcompensation while running and playing sports I went to ortho in july then was sent to podiatrist and now today a foot surgeon.

I have heard 3 completely different things and went thru completely different methods I do not know what to do. I hurt on both sides under and behind ankle bone more literally.

All Mri said back in Sept was a couple torn ligaments in an area that doesn't hurt now. Any ideas?


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Joshua Comments

Hi April.

1. What were you doing that caused the original sprain?

2. One a scale of 1-10, how bad is it when at rest, when walking, when running?

3. Constant pain, or come and go pain?

4. When you say other injuries, what specifically does that mean?
Feb 27, 2011
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starstarstarstarstar 		Long Term Ruptured Achilles Tendon, Carolyn
by: Carolyn

I tore my Achilles about 20 yrs ago when I was 17 jumping off a diving board I still remember hearing the pop... Back then I thought it was a very bad sprain & didn't see a Dr till 7 mos.

Later Dr said I had too much scar tissue & there's nothing that can be done. I have been living this way ever since its horrible!! One leg skinnier them the other, can't tipy toe, limping etc... It sucks.


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Joshua Comments:

Hi Carolyn.

Yes, that doesn't sound great.

Too much scar tissue and nothing can be done? Wha? That doesn't inspire me with confidence.

If your Achilles is totally or mostly torn, it's not life threatening but certainly debilitating.

1. How motivated are you to get this fixed?
2. Is the tendon totally or partially severed?
Feb 27, 2011
Rating
starstarstarstarstar 		April - ankle sprains/achilles too tight/weakened calf
by: Anonymous

1. I initially sprained my ankle playing softball...just rolled it in a hole and it actually wasn't that bad of a sprain

2. At rest my ankle is fine maybe slightly swollen..walking I say a 4 for uncomfort fast walking it turning while walking creates a momentary 7 or so...shooting pain in spots, run at first burning and award then numbs...I can't stand right tip toes at all and it has an 8 or 9 burn on back of ankle when I try...

3. Walking is a constant uncomfort but usually the worst Sharp shooting pain comes more when I move certain way such as toes pointed down or manually push up my heel

4. Other injuries were my left hip got really painful almost not walking from overuse..back of my right knee got painful and now the left side of the bottom of my left foot is painful and gets worse when I exercised...now I was told to stop working out.


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Joshua Comments:

That makes sense.

Torn ligaments and injury in the right ankle, scar tissue forms and stops the nervous system from being able to communicate through that barrier. Thus muscles aren't firing correctly so they can't do work/absorb force.

Since you can't properly absorb force, all that load transfers elsewhere, to places not designed to take it. Thus the knee, hip, and other foot pain. All from compensation pattern.

This also explains why you feel pain in area other than the torn ligaments.

1. Are the ligaments partly or completely torn?
2. Where are the torn ligaments?
3. You mentioned hearing three other things. Meaning what?
Feb 28, 2011
Rating
starstarstarstarstar 		3 other things - April
by: Anonymous

1. Ortho Doc said in Sept Its not Achilles tendons its ankle...did Mri said no using ankle for a while let's brace it...lace up during day hours...after 3 months he sent me to.

2. Podiatrist the end of Nov. says we need to rest it so ligaments and the tendons can heal..had me wear a trilok brace religiously during all day hours and Jan tried flector patch which made me very sick..then said let's rest ankle more...by Feb pains worsened so he sent me to surgeon.

3. Foot surgeon says not ankle its Achilles tendon rubbing ur boot forming an irritated notch (no I don't feel one) that's causing pain and ligaments won't ever repair without surgery so we need to build ur calf muscle with calf raises and start walking and jogging to ur tolerance while stretching and use moleskin in heel of boots (i am military)

4. My pcms at air force hospital reviewed case and said don't run yet...like walking w brace they gave me 3rd one.. and do pt again...same things I did in July

Mri from Sept summary says...chronic complete tear of atl and cl. Type 1 and 2 tears of peroneous longs tendon w thick and thinning

The inner ankle pain has developed after the Mri I believe from the


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Joshua Comments:

Well, yeah, that's a tough one. There's actual damage, and likely that's resulting from muscles not doing their job correctly so the weak points rip/tear.

Time isn't going to recover it. Boots might be rubbing on the achilles at the heel but that would hurt RIGHT there. I did that last summer. Ouch.

1. Ice dip like crazy for 7 days.
2. Then get a frozen water bottle and (gently at first) plow the lower leg. If it hurts, if it's tight, go after it until it softens up. That's the next 7 days.

Walking on it should be fine, pay attention and tell everything to fire correctly as you walk. No limp, no compensation. Start paying attention to how everything feels in there, what it's doing as you move etc.

Ask questions along the way.
May 09, 2014
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starstarstarstarstar 		Scholarship softball player, achilles tendon surgery never again!
by: Kerri

I started having heel pain when I was 19. I was an avid softball player all through high school and took a scholarship to play in college. The pain got to the point I could barely walk.

So I went to the doctor and he put my in an boot for 3 weeks to rest it. Went back with no relief. Had an MRI done and it showed small tears (6-7) of them on my right Achilles. The doctor gave me a cortisone injection in my heel, and I wish I had never agreed to it.

That was so much more painful the the pain I had to begin with. Went back in a month and was still in pain.Surgery was said to be my only option at that point. So it was scheduled for 2 weeks after that appointment. Day of surgery was not bad at all. Very relaxed, the doctor came in and marked my heel, and we were set. I had a nerve block placed in my right leg, which was supposed to numb it for 24 hours or so.

Surgery was said to have gone well. Went home that day with a cast on, and on crutches. All was good till the next morning, at that point there was not enough pain killers in the world to help with the pain. I continued to follow doctors orders and basically lived on the couch for 8 days.

Then I went back to the doctor, had the cast and stitches removed. I was then placed in a boot, on crutches, no weight bearing for 4 weeks. No physical therapy was mentioned, or performed. It was a slow recovery. Made numerous trips to the doctor office with the hopes of good news, but nothing changed... except my heel, and not for the better.

I developed a large knot on the back of my heel. Presented it to the doctor. MRI was done and he said it looked ok. I still dealt with pain every day, walked with a limp, or with my heel not touching the ground. Could not wear closed shoes, like tennis shoes or anything.

My surgery was June 9, 2010. To this day, I walk with a limp, can not wear closed shoes for much of a time span. I still have the large knot on my heel. At times it feels as if my heel is on fire, and my 2 out side toes will go numb.

The doctor insist it will just take time to heal..... so how much time are we talking? Because I am still young and have lots to see and do!


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Joshua Comments:

Hmmm, doctors...

So two years later after surgery the doctor is still saying it just needs time to heal?

That means it's time to find another doctor. OR better yet, learn to reverse all the factors that led to your heel pain and 'need' for surgery.

You're young and motivated, get to work!


Also, see related: Contemplating Surgery For Plantar Fasciitis And Other Foot Issues
Sep 22, 2016
Rating
starstarstarstarstar 		scar area
by: Garett

I ruptured my achilles 5 years ago, had surgery all went well.

Last week my knee swelled up and was very stiff, I do not remember what I did I could have jumped out a truck at work who knows.

The knee problem lasted about 4 days. The swelling has gone down and movement is back to normal.

The probably now is that where the scar is from my surgery is red, painful, and very tight. Could this be from limping around from the knee pain for 4 day?

I have not had a problem in 5 years with this area, I don't exercise like I should but I play a lot of golf and my job is pretty labor intensive.

Thanks for any advice.


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Joshua Comments:

Hi Garett.

In short, while you have recovered from the surgery to the extent that you have, all the factors that caused the achilles rupture are still in place, and still slowly getting worse over time.

1. Too tight muscle doesn't absorb force like it's supposed to. That's why you had an achilles rupture.

It's safe to say that now that force is (also) transferring up to your knee. So you jumped out of a truck (for instance) and your knee took force it wasn't supposed to.

And they're causing pull on the surgery scar (and presumably on the tendon reattachment as well).

2. Surgery can repair a rupture, but entirely ignores the causes of the rupture.

3. You recovered and feel better for a while, but the causative factors are still in play.

4. Now you're feeling (literally) the predictable, progressive effects of those factors.


Read this thread and the links/pages in it, etc.

And in short, I suggest that you get to work reversing the factors that are (still) causing problems with my Reversing Achilles Tendonitis program.
Apr 16, 2017
Rating
starstarstarstar 		Torn Achilles 3 years ago, getting worse
by: Margaret

3 years ago I had Achilles tear and a hill that look like a slide not round. I've been babying it for three years. Now my Achilles is giving out. It's like when your knee gives out.

Now I would like for you this plain to me what's happening there and do I need to go back to my doctor. Do you think I'm going to have to have surgery. Thank you.


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Joshua Comments:

Hi Margaret.

REad this thread, and follow the links in this thread (read those pages too).

That explains what's going on.

If you had an achilles tear, and it wasn't surgically repaired, then chances of it healing and getting better, as opposed to 'healing' and getting worse, are pretty tiny.

As far as whether you need surgery, I'd need a lot more details. How big was the tear? What self care did you do, if any? Etc.
May 17, 2017
Rating
starstarstarstarstar 		Hip pain after Achilles injury
by: Anonymous

Two years ago I tore my right Achilles' tendon playing soccer. I am finally back playing however by the end of games, my right hip is so sore I can hardly walk. The Achilles still burns a little when playing, but is minor compared to the hip pain.

I've been told hip pain can be common after an Achilles injury. Is this true? If so, how do I fix it?

Please help


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Joshua Comments:

Is true.

The achilles tore because the function of the lower leg muscles was poor (too tight, basically, so can't absorb force like it's supposed to...that force has to go somewhere....achilles tears.).

Post reattachment surgery, the muscles etc are still too tight. You run/play soccer, and long story short, the lower leg isn't working right and other body parts have to compensate as best they can.

Work on your lower leg structures...soleus and calves specifically are TOO TIGHT and thus not working properly/can't work properly.
Aug 30, 2017
Rating
starstarstarstarstar 		tendon too short after achilles rupture and operation
by: Oli

My Achilles tendon is too short after Achilles rupture and operation to join. The operation was two years ago. I try stretching several times every day, but the tendon is still shorter.


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Joshua Comments:

Hi Oli.

I'd imagine that the tendon itself is shorter (if, say, half an inch or more of it was removed during surgery).

But the thing to focus on is the muscles and connective tissue of the lower leg that is attached to the tendon.

That all stretches/is stretchable, and can be made more relaxed. But tendon is like a cable..you're not going to be stretching it/lengthening it.

Point being, don't focus on the tendon, it's not really the problem at this point.
Nov 26, 2017
Rating
starstarstarstarstar 		Dumbsht
by: Anonymous

Your smoking crack....ive been to numerous experts in 30 years....i have to stretch every morning dumb shit.....


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Joshua Comments:

You've been to experts for 30 years, they've told you to stretch for 30 years, and 30 years of stretching hasn't fixed the problem?


INTERESTING! You should definitely keep doing that thing that hasn't worked for 30 years. That's smart medicine right there!

Also, learn to spell and punctuate if you're going to call other people dumb.

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