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.

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.





Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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

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Sep 07, 2009
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
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
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
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
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
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
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
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
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
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
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
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
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.




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