Achilles Tendinitis with painful scar tissue - 9 months now

by Janice

I was training for my first 5K last July (at the age of 49). Everything was going great but I think I started pushing myself too hard and didn't stretch well enough.

To make a long story short, I started having pain in my left heel area and then the knot developed. Had terrible stiffness and pain upon rising in the morning, when sitting for too long, and when over doing it during the day (I stopped running immediately when I realized something was wrong).

In October, my family doctor ordered an MRI and PT. No major tear was noted. Physical therapy did nothing to improve my situation. Finally in January, I went to an orthopedist. He was horrible. Put me in an Aircast which did help as long as I was wearing it but after several months there was no real improvement.

Went back and he wanted me to try a very expensive boot, the blood injections, and more PT. I said no more. Now, I feel like it has worsened, back to wearing the Aircast to work (teacher, on my feet all day). The knot never goes away.

Have had Active Release Treatment for knots in calves. All evidence points to major scar tissue problems. I have an appointment with a podiatrist tomorrow. We will see what he says.

I am at the point that I feel I cannot take any more of this day in day out pain. I want it fixed but I have read so many horror stories. So, we will see. I am just scared!


Joshua Answers:

Hi Janice.

Yes, I understand 'I want it fixed'. Unfortunately, surgery is often the holy grail of fixing. Sounds good in theory...

Important questions:

1. Why is there a knot?

2. Why won't the knot go away on it's own over time?

3. Why won't it go away after manual therapy?

Until one knows (or at least theorizes about) the cause, treatment isn't going to work. Let me say that another way. Every problem has a solution. The solution to some other problem isn't
going to solve -your- problem.

Tendonitis is a very predictable mechanism. Everybody and everybody's different body parts and situation and scenario or different, of course, but all the same factors apply.

See: What Is Tendonitis

Rest, as I'm sure you noticed, doesn't help. For good reason.

Achilles Tendonitis has it's own specific set of behaviors. Stand, walk, run, jump, wiggle your toes, etc, it's all about the lower leg (and everything else, of course).

When things go awry, it's a downward spiral that left to it's own devices, generally doesn't just get better.

It's all about the Pain Causing Dynamic.

There's a few reasons why that knot won't let go:

* Nutritional Insufficiency/Deficiency

* Nervous system won't let it relax

* A variety of triggers (including too tight muscle, too tight connective tissue) keeping the tightness turned on

* Some muscle(s) not doing their job so the knotty area thinks that it has to take up the slack

'Stretching and Strengthening' only helps if it's something that stretching and strengthening can help.

For you right now, stretching tells the brain it's being attacked so the brain tightens things up.

The good news is, just because it's hurt (a lot) for 9 months doesn't -necessarily- mean that there's an injury.

See: There Are Two Types Of Tendonitis

My 4th question to you is:

4. Why do you think it's a scar tissue problem?

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.

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

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Comments for Achilles Tendinitis with painful scar tissue - 9 months now

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May 18, 2012
Achilles Tendinitis pain won't go away
by: Janice

Thanks for your response. I hope I can respond to all of your questions as I cannot see your questions as I am typing this.

The reason I thought it was scar tissue is because that was what my original orthopaedist said. Thankfully, I have changed doctors and I am seeing a rather conservative podiatrist. He's an older guy, very physically active but takes plenty of time to talk, ask questions, check things out,,,he's done things that my first doctor never did. So first visit, he tells me to wear my Aircast for 2 weeks, do 10 10 sec stretches x 4 daily, ice it, and prescribed an anti-inflammatory. Went back after 2 weeks with no improvement and seems surprised that there is no tear noticed in my MRI...anyway, he gave me two steroid injections and told me to wear my cast all the time, no stretches, but still do ice and take anti-inflammatory. I am one week in and it's doing okay. Normally fine during the day when I am wearing the cast but I am a teacher so I am on my feet all day :-(.

So, I am resting it a lot when I get home. The only exercise I do is biking, which doesn't seem to bother it at all. He did say he didn't think it was scar tissue, just mostly inflammation. I go back in 2 weeks to see if the injection and cast with no stretches helps. I will be out of school in 4 weeks, so I am hoping that being off of my feet (floating in the pool :-) for a few weeks will make a difference. We will see.

Still frustrated and cannot understand why nothing seems to be working. I imagine my age does not help a I have always been pretty active.

Again, Thanks for your response! Janice


Joshua Comments:

Hi Janice.

I imagine that nothing's working because nothing you're doing is targeting the actual cause of the problem.

Anit-inflammatories and corticosteroid shots etc are fine to get you though the day, but they don't -help- the dynamic.

Ask you podiatrist what exactly is causing the pain and inflammation.

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