Achilles Tendinitis in a 62 Year Old Competitive Sprinter!

by Gary

I'm a 62 year old master's sprinter, I've been plagued with achilles tendonitis (on and off) for a while now, it is only in my left tendon, one small hot spot, I believe there is a bump there.


I've tried almost everything you mentioned, ultrasound, PT, etc, the ONLY thing that seems to help is ICE.

After a pain-free Fall and Winter, the problem started again, I believe I was overstretching, ie; stair stretches, standing on a rocker arm device, now I only do wall push ups, and have stayed on the grass for 98% of my workouts.

The problem is, my season starts in 3 weeks and I've yet to put the spikes on, should I now religiously start your ice therapy treatment as many times per day as I can?

Am I reading correctly that with ice dipping, it's done every two hours for ONLY 10-15 seconds at a time? Also, what about a SMALL, 1/8 " heel lift, have you had any success with that? Thank you for a GREAT article and hope to hear from you.

Gary



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Joshua Answers:

Hi Gary. Let's get you into competition shape.

So let's see...in no particular order....


1. If you can only find one small hot spot, that's good news. A bump makes sense.


2. Ultrasound, PT, etc, isn't bad, it just doesn't seem to be the RIGHT tool for the specific job.

Ice, however, is your best friend.


3. RE: a heel lift for Achilles Tendonitis. I'm not a fan in theory or in real practice.

Theoretically a heel lift is going to tilt you forward some, which can be problematic for shin splints. Also, heel lifts aren't a 'fix', and I prefer to put effort into a fix instead of something that doesn't reverse the problem and just slows the progressive pattern of something like Achilles Tendonitis.

In real practice, your calves and Achilles tendon are already too chronically contracted and too short, with too much constant tension on the tendon and hot spot.

A heel lift may 'help' by shortening the structure and taking the tension off the lesion site, but you can see how that just helps make the entire structure even shorter.

And the body will adjust to that by basically shrink wrapping down to the new shortness, which will become the new normal, which will then result in MORE tension on the spot of tendonitis when you aren't wearing the heel lift, and then even when you are.

You -could- wear one ONLY when you train, and ONLY for a week or so while you Ice like crazy, to eliminate a small amount of tension and negative communication to the nervous system.

Not worth it in my mind, but it won't hurt to experiment with it.


4. YES, now is a great time
to throw yourself at Ice Dipping and Ice Massage. Religiously and Fanatically.

If you hit it like your life depends on it, it is well within the realm of possibility that you can help your body heal the problem within the next couple of weeks. Or at the very least get out of pain or very close too it, such that you can still train and compete and continue to ice to help your body heal.

Due to various factors, it can take a good long while to 'heal' Achilles Tendonitis. But the pain is almost solely due to the Inflammation Process and Pain Enhancing Chemical, and you can get that out fast. Which will then help the healing process immensely.


5. Over a 2 hour period, Ice Dip a minimum of 10x, for 10-15 seconds each. Ice cold, and immersed as high as possible. Ice Massage as directed. Again, the more the merrier.

But not too much:)


6. With light, gentle streching, add in Stretching By Hand. This is self massage, but not just squeezing and rubbing. Push and pull into the tissue of the calf muscles such that your are stretching the tissue manually in a variety of directions.


7. Also, my across the board suggestion to you is to:

A. If you're not already, start a good high level of Omega-3 fatty acids/fish oil. These are anti-inflammatory, and vital on so many other levels.


B. Lay out in the sun regularly and/or take a good loading dose of Vit D3. See the Vit D pages at www.easy-immune-health.com.


C. Increase your protein intake. Protein is the building block required to heal the wear and tear damage of Tendonosis and Tendonitis of the Achilles Tendon. I'm confident in predicting that you don't eat enough protein.



Also, I have a couple questions:

1. How bad does that little hot spot hurt and/or limit you?

2. When did it first show up? Years ago? Decades ago?


Ask whatever questions that come up. I'm happy to help.


----------------------
Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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May 04, 2009
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PART 2 -- Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

1. How bad does that little hot spot hurt and/or limit you?

2. When did it first show up? Years ago? Decades ago?


Thanks Joshua for the great tips, you're probably correct about the protein intake, not enough. To answer your questions:

1. If I warm-up properly I can get through the workout although lately I've been doing more quality than quantity, the problem starts AFTER the workout, upon sitting in my car to drive home, when I get out it's sore and I'm limping. After ice therapy it calms down, the next day is usually an easy day, no soreness.

2. It began a decade ago, goes away, comes back.

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Joshua Answers:

A decade ago, yep. Tendonitis is a progressive dynamic. You can start to get a sense of how it has slowly been developing over time, your body has been fighting it off and trying to compensate, and now it's getting to the point of being overwhelmed.

What you describe makes sense. You are working out, the tissue is mobile and getting lots of circulation.

Then you sit down, and basically things get 'cold'. You stiffen up for a variety of reasons, and specifically to this conversation, you sit down and your nervous system starts to notice wear and tear and other factors and says "Hey, we're injured!"

So it kicks in more and more of the Inflammation Process, which traps fluid in the area and releases chemicals which enhance your sensitivity to pain. Which makes things tighten up even more.

Protein. Self massage/stretching. Make sure you're well warmed up before exercising, and Ice like a bandit afterwards, and for the next 7 days, actually.

Keep me updated. Ask questions.



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





May 07, 2009
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Part 3 -- Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

Joshua, thank you for your comments, wrote back yesterday but don't know if you received it.

I have been doing the ice therapy religiously, yesterday went to the track, 1st time in 2.5 weeks, warmed up well, put spikes on, ran 4x100m @ 400 pace, ended up limping after the 3rd one, stopped workout, went home and iced, iced, iced, today, iced, feels better, BIT sore but better.

Season starts in 2 weeks, should I stop training for 3 weeks, and build -up again or try and compete, on grass it's not so bad but when I get on the track area hurts, what do you suggest?


Hate to curtail season but I don't want this thing to rupture, looking forward to your reply.

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Joshua Answers:

Hey Gary.

That's good you're icing and pushing it a little bit.

If you don't see what you sent yesterday on this page, I didn't get it.

Here's a couple of concepts you want to follow.

1. Prevent your body from feeling the sensation of pain there in the Achilles tendon. Two sprints is good, that third on....not so good because the body ups it's defensive mechinism.

2. RELAX all the structure. Tight calves and Soleus muscle keep extra tension on the lesion on the tendon.

If I were you, this is what I would do.

1. Write off the first 2 weeks of the season.

2. Depending on how fast you heal, don't sprint for the next 1-2 weeks while you do the next several numbered variables.

Long walks with long stride. Gentle easy stretching. Bike (stationary), swim, other cardio that is not achilles intesive. Stay in shape in other ways that won't put strain on the Achilles.

3. Lots of gentle, easy stretching of the calves/soleus muscles.

4. LOTS of icing and ice massage.

More and more, start digging that ice cube into the hot spot on the tendon. Grind into it, force old stuff and new circulation in.

I don't usually say this, but alternate with heat. Tendonosis and Tendinitis of the Achilles tendon is heavily effected by lack of blood flow. You want to create as much circulation to that spot as possible, as well as keep is squishy with massage with the ice cube.

5. Massage your calves and soleus. Essentially, you are going to stretch all the tissue in the area in new and different directions with your hands and elbows.




Ultimately, Achilles Tendonitis can be blamed on two things.

Too much tightness, and not enough circulation.

If you want to heal, correct those two factors.

If you want to heal quickly, correct those two factors a lot.


Also, up your protein intake and good fats A LOT for the next few weeks, and the season in general.

And keep up the icing. You don't really have a better option than investing a week or two into doing WAY MORE ICING THAN YOU WANT TO DO.

Keep all the soreness out with the icing and you will heal faster.

Key to staying pain free: Keep all the soreness out with icing.

Let me know if I missed anything you sent, keep me updated, ask questions.

Joshua



May 07, 2009
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PART 4 - Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

Joshua, thank you so much.

Everything you listed made sense, will back off sprints for 2 weeks, should not lose too much conditioning, will keep you posted, you're the best. :)

May 08, 2009
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PART 5 - Achilles Strengthening! - Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

Joshua, what is your feelings toward Eccentric Strengthening, something I've read about on the internet for the Achilles?

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Joshua Answers:

I'm a fan of anything that helps.

I admit, I don't put a lot of attention on strengthening exercises inside of an Achilles Tendonitis context. (Or any other tendonitis context, actually.)

The calves and Soleus are already -STRONG-. If you're a sprinter/runner, they are already way strong.

Strength, in my experience, isn't the issue.

One issue is that people don't eat enough protein and good fats to support strong tendons.

Another is that because the lower leg muscles are super strong and used so much, they get tight. Too tight. And stay tight.

This is problematic for the Achilles Tendon because it keeps too much tension on the tendon, and it essentially lessens circulation into the tendon.

I will say this for Eccentric Strengthening and the Heel Drop exercise.

Eccentric lengthening of the structure is -great- for lengthening a muscle and helps reset how tight the nervous system holds the muscle.

Personally, I would focus on the lengthening and the drop, not so much the contraction at the top.

Research may or may not show Eccentric Strengthing to be good for Achilles Tendonitis, I just don't know.

And, if it is effective, it makes sense, as A. Eccentric lengthening helps relax too tight muscle, and B. Movement is Life. Movement creates circulation, circulation brings blood to the tendon, the tendon REALLY NEEDS CIRCULATION to stay healthy.

I like questions. Keep asking. :)

Joshua

May 10, 2009
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Supplements question -- Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

Joshua, started doing the drop, just 2 sets of 10 right now, no weight, achilles is better, not limping anyway, did a nice 20 minute power walk yesterday and of course ice and some heat.

Are you an advocate of any type of supplements for inflammation; ie, Bromase and Super Cissus RX? Have you heard of them, will wait for your comments.

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Joshua Answers:

Bromelain gets a thumbs up. Make sure you take it on an empty stomach, otherwise the enzyme will digest your food as opposed to eat up scar tissue in your body.

I don't know the science on how that works, but that's what they tell me.

SuperCissus I haven't heard of, but there are lots of products out there.

I'm a big fan of natural anti-inflammatory options. Turmeric, for example is a highly regarded natural anti-inflammatory.

Pretty soon here I'm going to put some suggestions for natural options on my site.

And they're a good idea anyway, as systemic inflammation is part of the aging process, and the less of that our body has to deal with, the happier we will be in the short and the long run.

Natural options for injuries like Achilles Tendonitis are a good option because there are really no side effects, certainly no dangerous ones (when used appropriately).

Glucosamine and chondroitin sulfate are good ideas too. Different research says different things about them, so do your due diligence.

Make sure you are doing a lot of ice massage, and the self-massage stretching.

Wouldn't hurt to take notes on what you actually do each day. I'll ask for specifics later so we can compare actions to results.

Joshua

May 18, 2009
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PART 7 - Achilles Still In Pain - Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: Gary

Hi Joshua.

I need your help and fast, I have been doing everything you suggested for my Achilles, however, today I went to the track ( 1st time on track in 2.5 wks.) been on grass, warmed up really well, it was a nice warm day, put spikes on, ran 4x 100m @ my 400m pace with a 5 minute interval between runs, the achilles hurt like a toothache, especially after the 3rd and 4th rep.

I ended the workout.

Right now I'm icing, I gave it the pinch test, no pain, but I'm limping, with 2 weeks to go until my 1st race, I'm perplexed.

I have a couple of choices, see what you think.

1. Lay off hard training for a week.
2. Go to meet, warm up good, see what happens.
3. Bite the bullet, take 3-4 weeks active rest and begin again EASY, this choice will end season.

What do you suggest?


I have the Bromase in hand, am dubious to take it although you gave a thumbs up, went to pharmacist today and she said it is up to me but she is dubious about efficacy.

I've been icing and some moist heat and gentle stretching, can run fast but NOT up on toes, am dubious about putting spikes on right now, could not run a full 400 w/o pain, can run a possible 800 flat-footed, am training on grass, can get through w/o major pain, know my speed limits, what about this Bromase, any side affects?

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Joshua Answers:

Hey Gary.

That's great you're pushing your limits. That is not a bad thing.

Here's a concept to bring with you into your training and upkeep:

Just because there is pain doesn't necessarily mean that you have to stop.

Please don't take this out of context. Specifically for you Gary and where your Achilles Tendon is at, there is a healing/activity balance to find.

If you are doing all the right things to heal, you can push your body and your 'injury'. It's just a matter of push it the right amount such that you are pushing the limits but not causing more damage than you can quickly recover from.

So if you can train and keep the pain in a good area without making it progress, that is good.

If you trained like you say you have been doing, and the pain isn't getting worse, that's not a horrible place to be.

And of course the more you Ice and Ice Massage, the better. Ice keeps the Inflammation pain out.

It's unlikely that you are injuring yourself significantly as you train now. But you want to keep in mind that you are managing 3 things.

1. The inflammation pain. (The immediate problem)
2. Actual damage.
3. The rate of healing and what helps healing.



(Continued in PART 8)


May 18, 2009
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PART 8 - Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: The Tendonitis Expert

(Continued from PART 7)


Plus, ya know, you're 62. Fact is, we do break down a little bit. Sure you have Okinawan guys living and active til age 99, but they're not running sprints.

The fact is, you can get to and stay at pain free levels of competition. It just takes more work the older you get.

And depending on how much you enjoy sprinting, you will want to push yourself and your body more or less.

I love Brazillian Jiujitsu. I have trained through bruises, crushed ribs for 3 months, horrible meniscus pain in one knee, neck pain and f&*$ed up thumb joints injury.

Yes it hurts, but there's a thrill to it for me. Plus it's a great learning for the profession I'm in....

If you shift your thinking that you're not just in the sport of sprinting, but you are also in the sport of pushing your machine to it's limits on injury/healing levels too, that might make a difference.

You're 62 now. It's not just about running anymore. It's about keeping your body alive, functioning at as high a level as possible, and staying pain free through it all. (Well, really, it's getting pain and then finding out how to get and stay pain free.)

Problem is, the Achilles Tendon is one of the most necessary parts of sprinting. Hard to compensate around that one.

So. You certainly can take 4 weeks off and dedicate it to healing. No shame there.

Or you can push yourself. Pushing the icing. Push the eating protein and cleaning up your diet and adding in lots of Omega 3 fats and coconut oil. Push the massage, massage stretching, light and frequent stretching (and Ice Massage deeply).

Push yourself paying attention to and learning about the pain.

Every athlete has to discover their limits, and the science of keeping themselves fit.

You have wisdom. This injury is a learning lesson. You can make the best choice about whether to push it. I can't make that choice for you, but I am here to support you in doing what you want to do.

If you want to push yourself through the season and then take time and heal fully, I can help you do that.

If you want to back off and invest in repairing your structure fully now, I can help you do that.

Let me know what path feels right.



On Bromase: Bromalain is a natural enzyme derived from Pineapple. There is no downside that I know of. Do take it on an empty stomach or the enzyme digests food instead of scar tissue type tissue.

Effectiveness? It's hard to tell, is different for everyone. Enzymes are used widely in Europe. I have tried the product Wobenzyme before, and found it to be noticeably effective.

(But it was expensive to me and you have to take a lot of pills throughou the day, wasn't worth it to me to continue.)


So this last round was pretty conceptual. Let me know what I said means to you. I really want you to get the dynamic around injury, pain, perceived pain, and rate of damage but just touched on it here.




Jun 01, 2009
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Update!
by: gary

Hi Joshua, thought I'd give you an update on my situation, it does not seem any worse.

I have decided to train on my own for another 5 weeks and take 4 weeks active rest.

I have been on the track 3x since we last corresponded, I still cannot or am reluctant to get up on the balls of my feet, but can run hard for a couple of reps.

When I finish the tendon is sore, like a toothache, however, when I apply the ice it calms it right down, when I sit around and get up it is a bit sore, then I apply more ice and it's fine.

How does this sound to you, nothing serious?

Jun 04, 2009
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You're doing great Gary!
by: The Tendonitis Expert

Hey Gary. Thanks for the update.

It sounds like you're on track (pun intended).

I think you mean that you're going to train for 5 weeks, then take 4 off.

It's all about finding the best strategy, for sure.

It sounds like you are pushing yourself, training, icing afterwards, and managing the pain.

That's pretty good. Finding the limits and behavior of the Achilles Tendonitis is an important step.

Once you get a feel for what you can do and what it takes to manage the pain, then you can start to play with the edges.

For instance, if you push more, can you ice more and get the same result?

So that's a good sign you can train, and ice it and get the pain out. A very good sign.

Now let's help the tendon heal.

A. Ice as often as you are willing too.

B. Start eating Essential Bone Broth

C. Light stretching, often throughout the day. Constant repetition is the key, as opposed to one sit down stretching session.

Healing Achilles Tendonitis, and yours because you are on the 'more experienced' end of the age range, is all about nutrition and circulation.

You need the right nutrition in, and circulation to the tendon to get it the nutrients so it can repair itself.

Circulation, circulation, circulation.

I'm writing a page right now about magnesium and tendonitis, I'll update this conversation when I finish it. I definitely suggest calcium and magnesium supplementation too.


Joshua

Jun 05, 2009
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Another option for treatment
by: Bart - Sports Injury Info

Great advice here Gary - I agree with much of what Joshua has recommended. I would also recommend looking at moving up the chain of the lower extremity and examining the function of your hips and core.

Everything in the body is interconnected - from the fascia that "shrink wraps" all of the muscles together, to the interactions between all of the muscles and bones, and all the way up to the nervous system and the various levels of control that they exert in order to provide the function we use everyday.

I have found in my practice that tightness in the hips and lumbar spine can contribute significantly to Achilles tendon pain.

The mechanics suggest that if your hips and spine are not moving enough, then the body has to compensate in order to find that needed motion somewhere else. Sometimes that compensation comes at the knee (which will often result in patellar tendonitis) or at the ankle in Achilles tendonitis.

The treatments you have focused on so far have dealt very much with the structure of the Achilles, and the inflammatory process that is occurring there. But something had to have caused that problem, the overload to cause the inflammation and irritation.

I am sure you go through some type of stretching before/after your workouts - you may find some benefit in adding in a few more hip/low back stretches to try to improve your mobility in those areas. Won't hurt anything, may help a lot.

The body is an amazing machine, and it amazes me everyday how everything is so connected. You can find some additional stretches at www.sports-injury-info.com/hip-stretches.html and at www.sports-injury-info.com/piriformis-stretches.html

Cheers,

Bart Anderson, MS, ATc


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Joshua Comments:

Thanks Bart.

Hey Gary, I highly recommend checking out Bart's website and content on hip stretches and such.

I've recently started to team up with Bart. I'm at expert at getting rid of the specific pain and damage from the Tendonitis dynamic, and in my words, Bart is an expert at the bigger picture of muscle balance and alignment and the role it plays in injury.

I haven't read anything of his so far that I disagree with. And his site has a lot of content/education that mine doesn't. And because of the different directions of our specialty and focus, likely never will.

Check his work out. Whether you start getting out of pain with my focus or his, if you want to continue to be an athlete operating at the level you want to be, realistically you need to deal with both.

Joshua

Jun 15, 2009
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Competition, finally!
by: gary

Hi Joshua, fyi, am competing tomorrow night.

The Achilles is better, not 100% but better, will let you know how I do, told my friends, keep the ice near by, :)

The correspondence between us has really helped.

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Joshua Comments:

Great.

You've done a great job of keeping at it.

Ultimately, you can expect getting close to or full recovery -IF- you keep at it.

Most people give up or stop too soon.

Bone broth, Ice Massage, appropriate stretching.

Over time, you can keep your body going down a path of Achilles Tendonitis healing and recovery, even if you are training and competing.

The more you train/compete, the more ice massage, self massage, and stretching you need to do to compensate/aid your body to do more positive things than negative things.

Go get em!

Keep me updated!

Joshua

Jul 09, 2009
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Active Rest!
by: Gary

Joshua, did you receive my last comment?

I did enter and compete in 1 meet, however, the Achilles is not 100%, better but not where I can run at my best, so I am going to take a 4 week active rest; power walking, stationary bik, upper body, flexibility.

What should I do or contimue to do for therapy to insure that this will not return? Thanks! Gary

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Joshua Comments:

Hi Gary. Sorry, I did receive it, and I've been scurrying about getting ready for a massage gig I'm leaving right now(!) for for a F-Sun at the 2009 Crossfit Games.

I'll give you a full response Monday, or sooner if there's internet out in the middle of nowhere where we're going to be.

The short 2 minutes response is:
Active Rest is GREAT! And in my opinion, your focus on the Achilles Tendonitis spot should be to get as much new blood to it as you can as often as you can, and as much waste product and old fluid out and away as often as you can.

This is icing, heat, massage.

You have the tools for that.

I am curious exactly how you're doing. Talk with you on Monday (possibly sooner).

Gotta finish packing. Out the door in 20.

Jul 23, 2009
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Active Rest Over!
by: Gary

Joshua, I have nearly completed my 4 week active rest from fast running, in fact I have not run at all, today I gave my achilles the ultimate pinch test, I pinch my entire achilles so hard my fingers were turning blue, no pain at all,

HOWEVER, it still does not feel right when I get up high on the balls of the feet and try and push off.

When can I start my Fall training and do you think it has healed and what can I do to ascertain that it not not return? Thank you!

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Joshua Answers:

Argggh. Totally didn't get back to you on monday.

My excuse is that I was totally tired after 30 hours of massage in 3 days.

But really, I just forgot. Sorry.

In the future, feel free to bug me often. The persistent bird gets the worm, as they say.

So...

Awesome with the pinch test. That's a great sign.

Now, essentially, you get back into running slowly and patiently.

And not matter how much you push it or not, for the first few weeks, ice massage afterwards religiously and zealously (fanatically?)

Let's say that you've 'healed'. Awesome. And let's also take the case that there is still -some- degree of tendinosis (degradation of the tendon due to lack of blood supply).

Meaning, if you stopped your self care and started trainign/running/competing again, it's predictable that the whole mechanism would still start up again.

Really, let's take the case that IT WILL TRY TO DO THE SAME PROCESS AGAIN, tightness, irritation, pain, tightness, etc.

Your job is to A. Keep all inflammation out and B. Push as much new blood to the area as possible.

You are now in the context of 'the art of tendonitis prevention'. Now you have to pay attention, feel it out, play with your edges, pay attention, self care self care self care as necessary and then some.

YOu know how it doesn't feel 'right' when you are up on your toes? There's a lot of possible explanations, and here is were it gets kind of esoteric and iffy. Lots of things one -could- say about that.

I'm going with 'keep doing the icing and nutritional self care you're doing, and see if you can massage and massage stretch wherever it doesn't feel right.'

It is likely that you can get to a point of training as much as you want with a minimum amount of self care.

Are you done with self care forever? No.

Can you get really efficient to counter the effects of training on your Achilles Tendon with very little time and effort? Yes.

Basically it's this equation: You have gotten benefit. You will continue to get benefit if you keep at it. And when you train, you must counter any negative effects with the self care, as much as it takes.

Go ahead and start training now.

I'm a big fan of easing into it (your nervous system, that is still monitoring the Achilles Tendonitis area/system and that is still worried about it, DOES NOT LIKE SURPRISES).

Does that answer your question(s)?

Joshua

Aug 02, 2009
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PART 15 - Achilles Tendonitis Bump!
by: Gary

Hi Joshua, my 4 week active rest is over and stated my program yesterday, did 15 minute jog and some 70% 100m strides, went very well, iced and self massaged the achilles after the w/o.

Question for you is this; is there any way to get rid of or reduce the bump on the left hand side of my Achilles?

I assume this is the troubled spot, my guess is, that it may be scar tissue and I read where scraping has little benefit, thoughts and comments? Gary

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Joshua Comments:

Hey Gary.

That's great to hear. I'm proud of you for all the work you've been diligently doing on yourself.

Most people don't.

So...

Assuming that that bump is the spot where there was scar tissue build up, possible scar tissue regrowth if there was/is Tendonosis, then than is indeed the spot (and a couple inches on either side of it) to focus your work.

Your job is to keep it soft, mobile, getting circulation (old off/out, new on/in), and then after workouts to keep inflammation out and circulation to it again.

The softer and more mobile it is, the healthier it is. The 'healthier' the scar tissue is, the less likely it is to get any tiny rip and tear damage from training/running/etc.

I wouldn't worry about reducing or getting rid of it. I'm not sure it's really possible without surgery. And the bump itself isn't necessarily a problem if the bump consists of healthy, mobile fibers.

Keep the fibers soft and mobile, instead of dry and crunchy, and they're -almost- as good as undamaged fibers.

On the topic of Tendinosis, it sounds like you're tissue is healthy now, if not 1000% back to normal (You don't get back to pre-injury structural strength, but you're getting very close to it).

If you want to keep competing, I would do some amount of regular icing/massage, if only to keep circulation coming to the tendon to keep any future Achilles Tendinosis from developing.

Preventing Achilles Tendonosis is the best way of never having to worry about it. The way to do that is to do self-care LONG before you have pain.

Now, you'll have to do some upkeep, both to continue the healing of the tendon, and to keep it in optimal health.

Good, bad, I don't know, but in the interests of staying active and out of pain....I believe you'll agree that it's worth it.


Joshua

Nov 16, 2010
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PART 16 - Achilles Tendinitis in a 62 Year Old Competitive Sprinter!
by: The Tendonitis Expert

Update Conversation On This Thread found here:
Achilles Tendonitis Gone, now knee pain after 8 track meets in 8 weeks.

Nov 21, 2017
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Significant pain in hotspot after ice dipping and massage
by: Mueng

Hey Joshua,

I have had Achilles tendonitis for almost nine months now, and I have tried different things such as heel drops, rolling out, and stretching, but I have gotten no luck.

I bought your ebook on reversing Achilles tendonitis a couple of days ago and started the ice dipping and massaging phase. But my hotspot seems to get super irritated even after I am done with the ice dipping and massaging. Is that normal? Will it continue to hurt when I do the ice dipping and massaging until the issue is fixed?


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Joshua Comments:

Hi Mueng.

We've been talking by email. I'll drop this in as a quick answer to your question here:

Yes it's common/normal.

You're getting in there and literally stirring the pot. An increase in tenderness/soreness is common, especially if you're really getting in there. As your tissue gets more healthy/more 'in shape', you'll get less soreness resulting and be able to go deeper with less soreness or tenderness.



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